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

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

Introduction

Purpose:
MDS Item D0150G1, "PHQ Resident Interview: Trouble Concentrating - Presence," is part of the Patient Health Questionnaire (PHQ-9) used in the MDS 3.0 assessment to evaluate depressive symptoms in residents. This item specifically addresses whether the resident has experienced trouble concentrating in the last two weeks, a common symptom of depression that can impact cognitive function and daily activities. Properly coding this item helps ensure that residents experiencing difficulties with concentration receive appropriate mental health support.

What is MDS Item D0150G1?

Explanation:
MDS Item D0150G1 is part of Section D (Mood) in the MDS 3.0, specifically under the PHQ-9 Resident Mood Interview. The PHQ-9 is a widely used screening tool for depression, with items targeting specific symptoms such as low mood, concentration issues, and self-worth.

For Item D0150G1, the resident is asked whether they have experienced trouble concentrating on things, such as reading the newspaper or watching television, during the past two weeks. This item measures the presence of concentration issues, which can affect daily functioning and overall quality of life. Recognizing this symptom helps identify residents at risk for or currently experiencing depression, allowing for targeted mental health interventions.

• Relevance: Trouble concentrating is a significant symptom of depression, often affecting a resident’s ability to engage in activities and make decisions. Identifying its presence supports mental health treatment planning.
• Importance: Accurately coding D0150G1 provides insight into the resident’s mental state, allowing for individualized care planning to support residents struggling with depressive symptoms and cognitive challenges.

Guidelines for Coding MDS Item D0150G1

Coding Instructions:

1. Ask the Resident About Concentration Issues:
   During the PHQ-9 interview, ask the resident the following question:
   “Over the last two weeks, how often have you had trouble concentrating on things, like reading the newspaper or watching television?”

2. Scoring the Presence of Trouble Concentrating:

   • Code 0 (No) if the resident reports they have not experienced any trouble concentrating in the past two weeks.
   • Code 1 (Yes) if the resident confirms they have experienced trouble concentrating during the past two weeks.

3. Documentation Requirements:
   Record the resident’s response accurately in the MDS under Item D0150G1. If the resident has experienced concentration issues, ensure that this is documented as part of the assessment to support further evaluation or care interventions.

4. Verification:
   If there is any uncertainty about the resident’s response, ask clarifying questions to ensure the coding is accurate. Also, confirm the accuracy of coding with notes from the interview or input from caregivers, especially if the resident has cognitive impairments that affect self-reporting.

Example Scenario:
Mr. Lee reports that he has had trouble concentrating on reading and watching TV on several days during the past two weeks. In this case, code 1 (Yes) for D0150G1 to reflect the presence of trouble concentrating.

Best Practices for Accurate Coding

Maintain a Supportive Environment:
Conduct the PHQ-9 interview in a quiet, private space where the resident feels comfortable discussing personal experiences. Reducing distractions can also help improve the accuracy of the resident’s response.

Consistent Interview Techniques:
Ask the question in a straightforward, non-judgmental manner. Allow the resident to respond freely, as a supportive interview approach can encourage accurate self-reporting of mood symptoms.

Staff Training:
Train staff to conduct the PHQ-9 interview with empathy, attentiveness, and understanding of depression’s impact on concentration. Effective training helps interviewers capture accurate responses and recognize potential depressive symptoms.

Conclusion

MDS Item D0150G1 is essential for identifying the presence of trouble concentrating as part of the PHQ-9 mood assessment. This symptom is a key indicator of potential depression and other mood-related challenges that can affect a resident’s daily functioning and quality of life. By accurately coding this item, healthcare providers can ensure residents receive the necessary mental health support to improve their well-being and cognitive function.

click here for a detailed step-by-step link for this item set

Reference

For more detailed guidelines on coding MDS Item D0150G1, 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 D0150G1: "PHQ Resident Interview - Trouble Concentrating (Presence)" 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.