Understanding and Coding MDS Item D0150G1: PHQ Resident Interview - Trouble Concentrating (Presence)

MDS 3.0 Item D0150G1: PHQ Response - Presence of Trouble Concentrating

Introduction

Purpose: Concentration issues can be a significant symptom of depression and other cognitive conditions in long-term care residents. MDS Item D0150G1 addresses whether the resident has experienced trouble concentrating on tasks such as reading the newspaper or watching television over the past two weeks. Accurate coding of this item is essential for identifying cognitive and emotional difficulties that may impact the resident’s daily functioning and overall well-being.

What is MDS Item D0150G1?

Explanation: MDS Item D0150G1 is part of the Patient Health Questionnaire (PHQ-9) interview under Section D: Mood. This item specifically assesses whether the resident has had trouble concentrating on things, such as reading or watching TV, during the past two weeks. Identifying the presence of concentration difficulties is important for understanding the resident’s cognitive and emotional state and for developing appropriate interventions to support their mental health.

Guidelines for Coding MDS Item D0150G1

Coding Instructions: To code MDS Item D0150G1, the interviewer asks the resident if they have had trouble concentrating over the past two weeks. The coding is binary, based on the resident's response:

• 0 - No: The resident has not experienced trouble concentrating.
• 1 - Yes: The resident has experienced trouble concentrating.

Example Scenario: If a resident reports that they have been unable to focus on reading a book or watching their favorite television show due to difficulty concentrating, you would code D0150G1 as 1 - Yes. If the resident indicates that they have not had any concentration issues, you would code 0 - No.

Best Practices for Accurate Coding

Documentation: Document the resident's statements and any observed difficulties with concentration. This documentation should include specific examples provided by the resident, helping to justify the coding decision and informing the care plan.

Communication: Ensure that the information about the resident's concentration issues is shared with the interdisciplinary team. Addressing these issues often requires a coordinated approach, including input from nursing, psychology, and other relevant professionals.

Training: Provide regular training for staff on conducting the PHQ-9 interview and discussing sensitive cognitive issues like trouble concentrating with residents. This training should emphasize the importance of empathy, accurate documentation, and appropriate coding.

Conclusion

Summary: MDS Item D0150G1 is crucial for identifying residents who may be experiencing trouble concentrating, which can be a symptom of depression or other cognitive issues. By accurately coding this item, healthcare providers can ensure that these cognitive difficulties are recognized and addressed, contributing to the resident’s overall mental and emotional well-being.

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-10.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150G1: "PHQ Response - Presence of Trouble Concentrating" 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, this guide will not be changed.

This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, understand and apply 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.