MDS 3.0 Item D0150D2: PHQ Response - Frequency of Feeling Tired or Having Little Energy

MDS 3.0 Item D0150D2: PHQ Response - Frequency of Feeling Tired or Having Little Energy

Introduction

Purpose: Monitoring the frequency of fatigue or low energy in long-term care residents is crucial for identifying the severity of potential health issues, including depression. MDS Item D0150D2 focuses on how often the resident has felt tired or experienced little energy over the past two weeks. Accurate coding of this item is essential for understanding the impact of these symptoms on the resident’s daily life and for developing appropriate care plans.

What is MDS Item D0150D2?

Explanation: MDS Item D0150D2 is part of the Patient Health Questionnaire (PHQ-9) interview in Section D: Mood. This item assesses the frequency with which a resident has felt tired or had little energy in the last two weeks. Identifying how often these symptoms occur is crucial for determining their impact on the resident’s overall health and well-being, and for guiding interventions to improve their quality of life.

Guidelines for Coding MDS Item D0150D2

Coding Instructions: To code MDS Item D0150D2, the interviewer asks the resident how often they have felt tired or had little energy over the past two weeks. The coding is based on the resident’s response and is categorized as follows:

• 0 - Not at all: The resident has not experienced feelings of tiredness or low energy.
• 1 - Several days: The resident has experienced feelings of tiredness or low energy on several days.
• 2 - More than half the days: The resident has felt tired or had little energy on more than half of the days.
• 3 - Nearly every day: The resident has felt tired or had little energy nearly every day.

Example Scenario: If a resident reports that they have felt tired or had little energy on four out of the last fourteen days, you would code D0150D2 as 1 - Several days. If the resident indicates that they have felt this way almost every day, you would code 3 - Nearly every day.

Best Practices for Accurate Coding

Documentation: Document the resident’s statements about the frequency of their symptoms, including any details that support the chosen code. This documentation is important for ensuring the accuracy of the assessment and for developing an appropriate care plan.

Communication: Ensure that all relevant members of the interdisciplinary team are informed about the resident’s energy levels and the frequency of their symptoms. Effective communication is key to addressing the resident’s needs comprehensively.

Training: Provide ongoing training for staff on how to conduct the PHQ-9 interview accurately and sensitively. This training should focus on how to discuss energy levels and fatigue with residents, ensuring that their responses are correctly documented and coded.

Conclusion

Summary: MDS Item D0150D2 is vital for assessing the frequency of fatigue or low energy in long-term care residents. Accurate coding of this item helps healthcare providers understand the severity of these symptoms and implement appropriate interventions to improve the resident’s 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 D0150D2: "PHQ Response - Frequency 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.