MDS 3.0 Item E0600C: Behavioral Symptoms That Disrupt Care or the Living Environment

Introduction

Purpose: In long-term care settings, certain behavioral symptoms can disrupt the care provided to the resident and affect the overall living environment. MDS Item E0600C assesses whether a resident’s behavioral symptoms, such as aggression, shouting, or throwing objects, have disrupted care routines or created disturbances in the living environment over the past seven days. Accurate coding of this item is important for ensuring that disruptive behaviors are identified early, allowing for appropriate interventions to maintain a peaceful and safe atmosphere for both residents and staff.

What is MDS Item E0600C?

Explanation: MDS Item E0600C is part of Section E: Behavioral Symptoms. This item evaluates whether a resident’s behavioral symptoms have disrupted the care provided to them or caused disturbances in the living environment. These behaviors may interfere with other residents' peace, make it difficult for staff to deliver care, or create a chaotic environment. Addressing such behaviors is essential for maintaining a calm, safe, and functional care setting.

Guidelines for Coding MDS Item E0600C

Coding Instructions: To code MDS Item E0600C, staff must assess whether the resident’s behavioral symptoms over the past seven days have disrupted care or the living environment. Disruptive behaviors may include:

• Yelling or shouting during care routines
• Throwing objects or physical aggression
• Making loud noises or banging on objects
• Causing disturbances that affect other residents or staff

The coding options are:

• 0 - No: The resident’s behavioral symptoms have not disrupted care or the living environment.
• 1 - Yes: The resident’s behavioral symptoms have disrupted care or the living environment.

Example Scenario: If a resident regularly yells during care routines, preventing staff from completing care tasks or causing distress to other residents, you would code E0600C as 1 - Yes. If the resident has not exhibited any behaviors that disrupt care or the environment, code 0 - No.

Best Practices for Accurate Coding

Observation: Staff should monitor the resident’s behavior during care routines and interactions with others in the living environment. Note any behaviors that disrupt the care process or negatively affect the atmosphere in shared spaces, such as dining areas or activity rooms.

Documentation: Record specific examples of disruptive behaviors, including their frequency, duration, and the impact they have on care delivery or the environment. This documentation supports the coding decision and helps guide the development of care plans to address disruptive behavior.

Communication: Share observations with the interdisciplinary care team to ensure that strategies are in place to manage disruptive behaviors. This might involve adjusting the resident’s care plan, using de-escalation techniques, or involving mental health professionals to address underlying causes.

Training: Provide regular training for staff on managing disruptive behaviors, including de-escalation strategies, non-pharmacological interventions, and methods to maintain a calm environment while delivering care.

Conclusion

Summary: MDS Item E0600C is crucial for identifying behavioral symptoms that disrupt care or the living environment in long-term care settings. Accurate coding of this item ensures that these behaviors are addressed early, allowing for the development of interventions that promote a safe and calm care environment for all residents and staff.

Click here to see a detailed Step-by-Step of 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 E-9.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item E0600C: "Behavioral Symptoms That Disrupt Care or the Living Environment" 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. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.