MDS 3.0 Item D0150D1: PHQ Response - Presence of Feeling Tired or Having Little Energy

MDS 3.0 Item D0150D1: PHQ Response - Presence of Feeling Tired or Having Little Energy

Introduction

Purpose: Assessing the presence of fatigue or low energy in long-term care residents is crucial for identifying potential health issues, including depression. MDS Item D0150D1, which focuses on whether the resident has been feeling tired or having little energy, is a key component of the Patient Health Questionnaire (PHQ-9). Accurate coding of this item is essential for recognizing symptoms that may impact a resident's quality of life and for developing appropriate care plans.

What is MDS Item D0150D1?

Explanation: MDS Item D0150D1 is part of the PHQ-9 interview in Section D: Mood. This item assesses whether the resident has felt tired or had little energy over the past two weeks. Fatigue and low energy are common symptoms of depression and can also indicate other underlying health issues. Identifying the presence of these symptoms helps healthcare providers address the resident's physical and mental well-being.

Guidelines for Coding MDS Item D0150D1

Coding Instructions: To code MDS Item D0150D1, the interviewer asks the resident if they have felt tired or had little energy over the past two weeks. The coding is binary, based on the resident's response:

• 0 - No: The resident has not experienced feelings of tiredness or low energy.
• 1 - Yes: The resident has experienced feelings of tiredness or low energy.

Example Scenario: If a resident reports that they have been feeling unusually tired or have had little energy on most days in the last two weeks, you would code D0150D1 as 1 - Yes. If the resident indicates that they have not felt this way, you would code 0 - No.

Best Practices for Accurate Coding

Documentation: Document the resident's statements regarding their energy levels, including any relevant observations that support the coding decision. This documentation should be detailed enough to justify the coding and to inform the care plan.

Communication: Share the results of the PHQ-9 interview, particularly regarding energy levels, with the interdisciplinary team. This information is vital for addressing potential underlying issues such as depression, anemia, or other health conditions that may cause fatigue.

Training: Regular training for staff on conducting the PHQ-9 interview is important to ensure that they can accurately capture and document residents' responses. Training should emphasize sensitivity when discussing symptoms like fatigue, which can significantly affect the resident's quality of life.

Conclusion

Summary: MDS Item D0150D1 is essential for identifying residents who may be experiencing fatigue or low energy, which are common symptoms of depression and other health issues. By accurately coding this item, healthcare providers can better understand the resident's condition and implement appropriate interventions to improve their health 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-7.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150D1: "PHQ Response - Presence of Feeling Tired or Having Little Energy" 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.