Understanding and Coding MDS Item D0150H1: PHQ Resident Interview - Slow, Fidgety, Restless (Presence)

MDS 3.0 Item D0150H1: PHQ Response - Presence of Being Slow, Fidgety, or Restless

Introduction

Purpose: Assessing motor activity changes, such as feeling slowed down or being fidgety and restless, is critical in evaluating the mental and physical health of long-term care residents. MDS Item D0150H1 focuses on whether the resident has been noticeably moving more slowly, feeling fidgety, or being unusually restless over the past two weeks. Accurate coding of this item helps identify potential symptoms of depression or anxiety, which can significantly impact a resident’s quality of life and daily functioning.

What is MDS Item D0150H1?

Explanation: MDS Item D0150H1 is part of the Patient Health Questionnaire (PHQ-9) interview under Section D: Mood. This item specifically asks whether the resident has been moving or speaking so slowly that others could have noticed, or the opposite—being so fidgety or restless that they have been moving around a lot more than usual. Identifying the presence of these motor activity changes is important for understanding the resident’s emotional state and for developing appropriate interventions.

Guidelines for Coding MDS Item D0150H1

Coding Instructions: To code MDS Item D0150H1, the interviewer asks the resident or observes whether they have experienced any noticeable changes in their motor activity, such as moving or speaking more slowly than usual, or being unusually fidgety or restless, over the past two weeks. The coding is binary, based on the resident’s response or observed behavior:

• 0 - No: The resident has not experienced noticeable changes in motor activity, such as slowness, fidgetiness, or restlessness.
• 1 - Yes: The resident has experienced noticeable changes in motor activity, such as slowness, fidgetiness, or restlessness.

Example Scenario: If a resident reports that they have been feeling unusually restless or if staff observe that the resident has been moving much more slowly than normal during the past two weeks, you would code D0150H1 as 1 - Yes. If there have been no noticeable changes in the resident’s motor activity, you would code 0 - No.

Best Practices for Accurate Coding

Documentation: Document the resident's responses and any observed changes in their motor activity, including specific examples that support the coding decision. This documentation is crucial for ensuring accuracy and for informing the care plan.

Communication: Share observations of the resident’s motor activity with the interdisciplinary team to ensure that any underlying issues, such as depression or anxiety, are addressed holistically in their care plan.

Training: Provide regular training for staff on how to observe and document changes in residents’ motor activity accurately, as well as how to discuss these observations sensitively with residents during the PHQ-9 interview.

Conclusion

Summary: MDS Item D0150H1 is essential for identifying residents who may be experiencing significant changes in motor activity, such as moving more slowly or being unusually restless, which can be symptoms of depression or anxiety. By accurately coding this item, healthcare providers can ensure that these symptoms are recognized and addressed, contributing to the resident’s overall mental and physical 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-11.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150H1: "PHQ Response - Presence of Being Slow, Fidgety, or Restless" 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.