Understanding and Coding MDS Item D0150G2: PHQ Resident Interview - Trouble Concentrating (Frequency)

MDS 3.0 Item D0150G2: PHQ Response - Frequency of Trouble Concentrating

Introduction

Purpose: Assessing how frequently a resident experiences trouble concentrating is essential for understanding the severity of cognitive or emotional difficulties they may be facing. MDS Item D0150G2 focuses on the frequency with which the resident has had trouble concentrating on tasks such as reading or watching television over the past two weeks. Accurate coding of this item helps identify the extent of cognitive challenges and informs the development of appropriate care plans.

What is MDS Item D0150G2?

Explanation: MDS Item D0150G2 is part of the Patient Health Questionnaire (PHQ-9) interview in Section D: Mood. This item assesses the frequency with which a resident has experienced trouble concentrating in the last two weeks. Understanding how often these concentration difficulties occur is crucial for evaluating their impact on the resident’s cognitive functioning and mental health, and for guiding interventions to address these challenges.

Guidelines for Coding MDS Item D0150G2

Coding Instructions: To code MDS Item D0150G2, the interviewer asks the resident how often they have had trouble concentrating on things, such as reading or watching television, over the past two weeks. The coding is based on the resident’s response and is categorized as follows:

• 0 - Not at all: The resident has not experienced trouble concentrating.
• 1 - Several days: The resident has experienced trouble concentrating on several days.
• 2 - More than half the days: The resident has experienced trouble concentrating on more than half of the days.
• 3 - Nearly every day: The resident has experienced trouble concentrating nearly every day.

Example Scenario: If a resident reports that they have struggled to concentrate on reading or watching TV on four out of the last fourteen days, you would code D0150G2 as 1 - Several days. If the resident indicates that these concentration issues have occurred almost every day, the appropriate code would be 3 - Nearly every day.

Best Practices for Accurate Coding

Documentation: Accurately document the resident's statements regarding their concentration levels and the frequency of any difficulties. Detailed documentation helps ensure that the coding accurately reflects the resident’s experiences and supports the development of an appropriate care plan.

Communication: Share the findings related to concentration difficulties with the interdisciplinary team, as addressing these issues may require input from multiple healthcare providers, including mental health professionals.

Training: Regular training for staff on conducting the PHQ-9 interview and documenting and coding responses accurately is important. Training should focus on discussing cognitive challenges with residents sensitively and ensuring that their responses are fully understood and correctly recorded.

Conclusion

Summary: MDS Item D0150G2 is crucial for assessing the frequency of trouble concentrating in long-term care residents. By accurately coding this item, healthcare providers can better understand the severity of cognitive difficulties and implement appropriate interventions to support the resident’s cognitive 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 D0150G2: "PHQ Response - Frequency 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, 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.