Understanding and Coding MDS 3.0 Item D0150A1: PHQ Response - Little Interest or Pleasure in Doing Things

Understanding and Coding MDS 3.0 Item D0150A1: PHQ Response - Little Interest or Pleasure in Doing Things

Introduction

Purpose: Assessing mood is a vital part of resident care in long-term care facilities, as mood disorders like depression significantly affect the quality of life. MDS Item D0150A1, which asks whether the resident has shown "little interest or pleasure in doing things," is crucial for identifying signs of depression. Accurate coding of this item helps in creating effective care plans and improving resident outcomes.

What is MDS Item D0150A1?

Explanation: MDS Item D0150A1 is part of the Patient Health Questionnaire (PHQ-9) interview under Section D: Mood. This item specifically assesses whether the resident has experienced little interest or pleasure in doing things over the last two weeks. It is a key indicator of anhedonia, a core symptom of depression. The response options help determine the frequency of this symptom, aiding in the overall assessment of the resident’s mood.

Guidelines for Coding MDS Item D0150A1

Coding Instructions: To code MDS Item D0150A1, the interviewer asks the resident directly about their interest or pleasure in activities over the past two weeks. The coding is based on the resident's response and is recorded as follows:

• 0 - No: The resident has not experienced little interest or pleasure in doing things.
• 1 - Yes: The resident has experienced little interest or pleasure in doing things on several days.
• 2 - Yes: The resident has experienced little interest or pleasure in doing things on more than half of the days.
• 3 - Yes: The resident has experienced little interest or pleasure in doing things nearly every day.

Example Scenario: Consider a resident who reports feeling disinterested in their usual activities, like attending social events or engaging in hobbies, and states that this has occurred almost every day over the last two weeks. In this case, you would code D0150A1 as 3 - Yes, nearly every day. If the resident only felt this way occasionally, you might code 1 - Yes, several days.

Best Practices for Accurate Coding

Documentation: It’s important to document the resident's statements and any observable behavior that supports their response to the interview question. Accurate documentation helps in validating the coding choice and informs future care decisions.

Communication: Ensure that interdisciplinary team members, particularly those involved in mental health care, are aware of the resident's responses to the PHQ-9 interview. This promotes a holistic approach to addressing the resident's mood and overall well-being.

Training: Provide regular training sessions for staff on conducting PHQ-9 interviews. This training should emphasize sensitivity and accuracy when discussing mood-related topics with residents.

Conclusion

Summary: Accurate coding of MDS Item D0150A1 is essential in identifying residents who may be experiencing symptoms of depression, such as anhedonia. By following the coding guidelines and best practices, healthcare providers can ensure that they accurately assess and address the mental health needs of their residents.

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-4.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150A1: "PHQ Response - Little Interest or Pleasure in Doing Things" 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.