P0200. Alarms

Step-by-Step Coding Guide for P0200. Alarms

1. Review of Medical Records

• Begin by carefully reviewing the resident's medical records, including care plans, nursing notes, and incident reports, to identify any use of alarms as a safety measure.
• Focus on gathering data during the 7-day look-back period to ensure all instances of alarm use are captured.

2. Understanding Definitions

• Alarms: Devices that monitor resident movement and alert staff through audible or inaudible means when a resident attempts to move unsafely. This includes bed, chair, door, and motion sensor alarms.

3. Coding Instructions

• P0200: Indicate the use of any alarms for the resident within the 7-day look-back period.
  • Code 0: Not used.
  • Code 1: Used less than daily.
  • Code 2: Used daily.

4. Coding Tips

• Clarify the purpose of each alarm to distinguish between safety measures and those that might restrict a resident's freedom of movement, potentially classifying them as restraints.
• Review interdisciplinary team notes for mentions of alarm adjustments or removals, ensuring accurate coding.

5. Documentation

• Document the specific types of alarms used, their purposes, and any resident-specific settings (e.g., volume or sensitivity adjustments).
• Record any discussions with residents or families about alarm use, including their preferences and consent.
• Include evaluations of alarm efficacy and any modifications to alarm use in the resident's care plan.

6. Common Errors to Avoid

• Failing to differentiate between the use of alarms as a safety measure and their potential to act as restraints.
• Overlooking temporary uses of alarms (e.g., during acute illness).
• Not updating the MDS with changes in alarm use within the look-back period.

7. Practical Application

• Example 1: A resident has a bed alarm activated nightly due to a high risk of falls. Coding: P0200 = 2 (used daily).
• Example 2: A chair alarm is used occasionally when the resident is seated in the common area. Coding: P0200 = 1 (used less than daily).
• Example 3: Motion sensors are installed in the resident's room but do not restrict movement; rather, they alert staff when the resident attempts to leave the bed at night. Coding: P0200 = 2 (used daily), ensuring it is not coded as a restraint.

The Step-by-Step Coding Guide for item P0200 in MDS 3.0 Section P is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Healthcare guidelines, policies, and regulations can undergo frequent updates. Therefore, healthcare professionals must ensure they are referencing the most current version of the MDS 3.0 manual. This guide aims to assist with understanding and applying the coding procedures as outlined in the referenced manual version. However, in cases where there are updates or changes to the manual after the mentioned date, users should refer to the latest version of the manual for the most accurate and up-to-date information. The guide should not substitute for professional judgment and the consultation of the latest regulatory guidelines in the healthcare field.