Understanding and Coding MDS Item D0150F2: PHQ Resident Interview - Feeling Bad About Self (Frequency)

Understanding and Coding MDS Item D0150F2: PHQ Resident Interview - Feeling Bad About Self (Frequency)

Introduction

Purpose:
MDS Item D0150F2, "PHQ Resident Interview: Feeling Bad About Self - Frequency," is part of the Patient Health Questionnaire (PHQ-9), used in the MDS 3.0 assessment to evaluate symptoms of depression and other mood disorders in residents. This item assesses how often the resident feels bad about themselves or feels like a failure. Such self-critical thoughts are common indicators of depression, and documenting their frequency enables care providers to understand the resident's emotional state and develop appropriate interventions. Accurate coding of this item is essential to support residents’ mental well-being and ensure they receive timely psychological support.

What is MDS Item D0150F2?

Explanation:
MDS Item D0150F2 is part of Section D (Mood) in the MDS 3.0, specifically the PHQ-9 Resident Mood Interview. The PHQ-9 is a standardized tool for assessing depressive symptoms, including feelings of low self-worth or failure, which can impact a resident’s mental and physical health.

For this item, the resident is asked about the frequency of feeling bad about themselves or feeling like a failure over the past two weeks. Their answer provides insights into the depth and frequency of depressive symptoms and guides the care team in developing a mental health care plan.

• Relevance: Feelings of worthlessness or failure are key indicators of depressive symptoms, which can significantly impact a resident's quality of life. Monitoring these symptoms enables healthcare providers to recognize and address mental health concerns.
• Importance: Properly coding D0150F2 allows for an accurate assessment of the resident’s depressive symptoms, ensuring the resident receives appropriate care and mental health support based on their needs.

Guidelines for Coding MDS Item D0150F2

Coding Instructions:

1. Ask the Resident About Their Feelings:
   During the PHQ-9 interview, ask the resident the following question:
   “Over the last two weeks, how often have you felt bad about yourself or that you are a failure or have let yourself or your family down?”

2. Scoring the Response:

   • Code 0 (Never) if the resident reports they have never felt bad about themselves or like a failure during the past two weeks.
   • Code 1 (1–2 days) if the resident reports feeling this way on several days over the past two weeks.
   • Code 2 (3–4 days) if the resident reports feeling this way more than half of the days over the past two weeks.
   • Code 3 (5–7 days) if the resident reports feeling this way nearly every day over the past two weeks.

3. Documentation Requirements:
   Record the resident’s response accurately in the MDS under Item D0150F2. Ensure that the response reflects the resident's report of the frequency of these feelings without any prompting.

4. Verification:
   Ensure the resident’s response is coded correctly by cross-checking with interview notes. If there are any inconsistencies or uncertainties, ask clarifying questions to confirm the resident’s answer.

Example Scenario:
Ms. Thompson reports that she has felt bad about herself nearly every day over the past two weeks. In this case, code 3 (5–7 days) for D0150F2, as the resident reports experiencing these feelings almost daily.

Best Practices for Accurate Coding

Create a Supportive Environment:
Conduct the interview in a private, comfortable setting where the resident feels safe to share their emotions. This encourages open communication and helps the resident feel understood.

Use Consistent Interview Techniques:
Ask the question clearly and neutrally, allowing the resident to respond without any influence. Avoid leading questions or suggestions to ensure the resident’s answer is accurate and authentic.

Staff Training:
Train staff to administer the PHQ-9 interview with empathy and attentiveness. Understanding the importance of nonjudgmental listening and clear communication helps staff obtain accurate responses.

Conclusion

MDS Item D0150F2 is essential for identifying and understanding how often a resident feels bad about themselves or like a failure, an indicator of potential depressive symptoms. Proper coding of this item allows healthcare providers to assess the resident’s mental health accurately and ensure they receive appropriate support and intervention. By recognizing and addressing depressive symptoms, caregivers can help improve the resident’s quality of life and emotional well-being.

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Reference

For more detailed guidelines on coding MDS Item D0150F2, refer to the CMS’s Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Chapter 3, Section D, Page 3-16.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150F2: "PHQ Resident Interview - Feeling Bad About Self (Frequency)" 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.