understanding and coding MDS Item H0400, Bowel Continence

MDS Item H0400 – Bowel Continence

Introduction

Bowel continence is a significant factor in maintaining dignity and comfort for residents in long-term care facilities. MDS Item H0400 evaluates a resident’s bowel continence over a seven-day observation period, ensuring that care teams can monitor and address any related issues.

What is MDS Item H0400?

MDS Item H0400 tracks bowel continence levels. Incontinence can affect a resident’s physical health, leading to skin breakdown, increased infection risk, and social embarrassment, making accurate documentation essential for personalized care.

Guidelines for Coding H0400

• Code 0: Always continent, if the resident had no bowel incontinence episodes during the seven-day observation period.
• Code 1: Occasionally incontinent, if the resident had one episode of bowel incontinence during the observation period.
• Code 2: Frequently incontinent, if the resident was incontinent more than once but had at least one continent bowel movement.
• Code 3: Always incontinent, if the resident had no continent bowel movements.
• Code 9: Not rated, if the resident had an ostomy or no bowel movements during the observation period.

Example Scenario:

Resident B had one episode of bowel incontinence but was otherwise continent. Code 1 for occasionally incontinent.

Best Practices for Accurate Coding

• Documentation: Record bowel movements and incontinence episodes consistently across all shifts.
• Communication: Ensure staff coordinate to document incontinence events, especially during changes in resident status.
• Training: Provide regular training to staff on the importance of bowel continence monitoring and coding accuracy.

Conclusion

MDS Item H0400 helps care teams assess bowel continence accurately, ensuring that residents receive appropriate interventions and maintaining their dignity and comfort.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference:

CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Chapter 3, Page H-12 .

Disclaimer:

Please note that the information provided in this guide for MDS 3.0 Item H0400 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.