Understanding and Coding MDS 3.0 Item K0520C3: Nutritional Approaches - Mechanically Altered Diet While a Resident

Understanding and Coding MDS 3.0 Item K0520C3: Nutritional Approaches – Mechanically Altered Diet While a Resident

Introduction

Purpose:
MDS Item K0520C3, Nutritional Approaches – Mechanically Altered Diet While a Resident, tracks whether a resident was on a mechanically altered diet during their stay in the facility. A mechanically altered diet is used to ensure safe eating for residents who have difficulty chewing or swallowing. Proper coding of this item helps ensure that the resident’s nutritional needs are met through texture-modified foods, contributing to better overall health outcomes. This article explains how to code MDS Item K0520C3 based on MDS 3.0 guidelines.

What is MDS Item K0520C3?

Explanation:
MDS Item K0520C3 refers to residents who were prescribed a mechanically altered diet during their stay in the facility. This diet involves modifying the texture of food to make it easier to chew and swallow, and includes options such as:

• Pureed food,
• Mashed food,
• Chopped or minced food,
• Ground food.

This type of diet is typically recommended for residents with conditions like dysphagia or other issues that impact their ability to safely consume regular food textures.

Guidelines for Coding K0520C3

Coding Instructions:
To correctly code Item K0520C3, follow these steps:

1. Review the Resident’s Care Plan:

   • Examine the resident’s care plan and dietary records to confirm whether they were placed on a mechanically altered diet during their stay.

2. Confirm That a Mechanically Altered Diet Was Used:

   • If the resident was prescribed a mechanically altered diet due to chewing or swallowing difficulties, you should proceed to code this item.

3. Code Based on the Resident’s Nutritional Needs During Their Stay:

   • Code “1” for Mechanically Altered Diet While a Resident if the resident was on a mechanically altered diet during any part of their stay in the facility.
   • If the resident was not on a mechanically altered diet, leave this item unmarked, and code the appropriate nutritional approach instead.

4. Enter the Response in Item K0520C3:

   • If the resident received a mechanically altered diet during their stay, enter “1” in K0520C3.

Example Scenario 1:
A resident with dysphagia was placed on a pureed diet to prevent choking while in the facility. In this case, “1” would be entered in Item K0520C3 to document that the resident was on a mechanically altered diet.

Example Scenario 2:
A resident recovering from a stroke had difficulty chewing and was prescribed a minced diet to facilitate safer eating. In this case, “1” would be entered in Item K0520C3 to reflect the use of a mechanically altered diet.

Best Practices for Accurate Coding

Documentation:

• Ensure that the care plan documents the resident’s need for a mechanically altered diet, including the type of texture modification used (e.g., pureed, chopped, or ground food).
• Record any changes to the resident’s diet and document the reason for those changes, such as improvements in chewing ability or the need for further dietary adjustments.

Communication:

• Inform all members of the care team about the resident’s dietary needs, including nursing staff, dietitians, and speech-language pathologists. This ensures that the diet is followed correctly during the resident’s stay.
• Share information about the resident’s diet with family members or caregivers, particularly if the resident transitions to home care.

Monitoring and Follow-Up:

• Regularly monitor the resident’s response to the mechanically altered diet, ensuring that it meets their nutritional needs and prevents potential complications like choking or malnutrition.
• Adjust the resident’s care plan as needed based on ongoing assessments by the interdisciplinary care team.

Conclusion

Summary:
MDS Item K0520C3 is used to track whether a resident was on a mechanically altered diet during their stay in the facility. Accurate coding of this item ensures that the resident’s nutritional needs, particularly those related to chewing and swallowing difficulties, are managed effectively. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure that residents on mechanically altered diets receive appropriate care throughout their stay.

Click here to see a detailed step-by-step on how to complete this item set 

Reference

CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Refer to [Chapter 3, Page 3-184] for detailed guidelines on coding mechanically altered diets during residency.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520C3: Nutritional Approaches – Mechanically Altered Diet While a Resident 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.