Understanding and Coding MDS Item D0150I1: PHQ Resident Interview - Thoughts of Being Better Off Dead (Presence)

MDS 3.0 Item D0150I1: PHQ Response - Presence of Thoughts of Being Better Off Dead

Introduction

Purpose: Identifying and addressing suicidal thoughts or thoughts of self-harm in long-term care residents is crucial for ensuring their safety and mental health. MDS Item D0150I1 focuses on whether the resident has had thoughts that they would be better off dead or of hurting themselves in some way over the past two weeks. Accurate coding of this item is critical for recognizing residents at risk of self-harm and ensuring that they receive immediate and appropriate care and support.

What is MDS Item D0150I1?

Explanation: MDS Item D0150I1 is a component of the Patient Health Questionnaire (PHQ-9) under Section D: Mood. This item specifically asks whether the resident has had thoughts of being better off dead or thoughts of hurting themselves over the past two weeks. Identifying the presence of these thoughts is vital for assessing the resident's mental health and for taking necessary steps to ensure their safety and well-being.

Guidelines for Coding MDS Item D0150I1

Coding Instructions: To code MDS Item D0150I1, the interviewer asks the resident if they have had thoughts that they would be better off dead or of hurting themselves in some way over the past two weeks. The coding is binary, based on the resident’s response:

• 0 - No: The resident has not had these thoughts.
• 1 - Yes: The resident has had these thoughts.

Example Scenario: If a resident reports having had thoughts that they would be better off dead or that they have considered harming themselves, you would code D0150I1 as 1 - Yes. If the resident denies having these thoughts, you would code 0 - No.

Best Practices for Accurate Coding

Documentation: Document the resident’s response carefully and accurately. This documentation is crucial, especially if the resident indicates that they have had these thoughts, as it ensures that the appropriate follow-up actions and interventions are taken to protect the resident’s safety.

Communication: Immediately communicate any positive response to this item to the interdisciplinary team, including mental health professionals, to ensure that the resident receives the necessary support and that a safety plan is put in place.

Training: Regular training for staff on how to conduct the PHQ-9 interview is essential, particularly for discussing sensitive topics like suicidal thoughts. Staff should be trained to respond appropriately and ensure that residents feel supported and understood during these discussions.

Conclusion

Summary: MDS Item D0150I1 is critical for identifying residents who may be experiencing suicidal thoughts or thoughts of self-harm. By accurately coding this item, healthcare providers can ensure that these residents receive immediate and appropriate care, helping to protect their safety and 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-12.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150I1: "PHQ Response - Presence of Thoughts of Being Better Off Dead" 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.