K0310: Weight Gain

K0310: Weight Gain

Item Rationale

Health-related Quality of Life

Weight gain can result in debility and adversely affect health, safety, and quality of life.

Planning for Care

Weight gain may be an important indicator of a change in the resident’s health status or environment.

If significant weight gain is noted, the interdisciplinary team should review for possible causes of changed intake, changed caloric need, change in medication (e.g., steroidals), or changed fluid volume status.

Weight should be monitored on a continuing basis; weight gain should be assessed and care planned at the time of detection and not delayed until the next MDS assessment.

Steps for Assessment

At a point closest to 30-days preceding the current weight.

At a point closest to 180-days preceding the current weight.

For a New Admission

Ask the resident, family, or significant other about weight gain over the past 30 and 180 days.

Consult the resident’s physician, review transfer documentation, and compare with admission weight.

If the admission weight is more than the previous weight, calculate the percentage of weight gain.

Complete the same process to determine and calculate weight gain comparing the admission weight to the weight 30 and 180 days ago.

For Subsequent Assessments

From the medical record, compare the resident’s weight in the current observation period to

their weight in the observation period 30 days ago.

If the current weight is more than the weight in the observation period 30 days ago, calculate the percentage of weight gain.

From the medical record, compare the resident’s weight in the current observation period to

their weight in the observation period 180 days ago.

If the current weight is more than the weight in the observation period 180 days ago, calculate the percentage of weight gain.

Coding Instructions

Code 0, no or unknown: if the resident has not experienced weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days or if information about prior weight is not available.

Code 1, yes on physician-prescribed weight-gain regimen: if the resident has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain was planned and pursuant to a physician’s order. In cases where a resident has a weight gain of 5% or more in 30 days or 10% or more in 180 days as a result of any physician ordered diet plan, K0310 can be coded as 1.

Code 2, yes, not on physician-prescribed weight-gain regimen: if the resident has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain was not planned and prescribed by a physician.

Coding Tips

A resident may experience weight variances in between the snapshot time periods. Although these require follow up at the time, they are not captured on the MDS.

If the resident is gaining a significant amount of weight, the facility should not wait for the 30- or 180-day timeframe to address the problem. Weight changes of 5% in 1 month, 7.5% in 3 months, or 10% in 6 months should prompt a thorough assessment of the resident’s nutritional status.

To code K0310 as 1, yes, the expressed goal of the weight gain diet must be documented.