P0200B. Chair alarm

Step-by-Step Coding Guide for P0200B: Chair Alarm

1. Review of Medical Records

• Objective: Begin with a comprehensive review of the resident’s medical records for mentions of chair alarm use. Focus on physician orders, nursing notes, and documentation from nursing assistants.
• Key Documents: Look for evidence of chair alarm use within the 7-day look-back period, noting reasons for its use and any incidents related to attempts to stand or leave the chair unassisted.

2. Understanding Definitions

• Chair Alarm: A device, such as a sensor pad placed on a chair or a clip attached to clothing, designed to alert staff audibly or silently when a resident attempts to stand or leave the chair, indicating potential fall risk or unassisted mobility attempt.

3. Coding Instructions

• Code 0 (Not Used): If the chair alarm was not used at any time (day or night) during the 7-day look-back period.
• Code 1 (Used Less Than Daily): If the chair alarm was used less than daily during the look-back period.
• Code 2 (Used Daily): If the chair alarm was used on a daily basis during the look-back period.

4. Coding Tips

• Ensure the use of the chair alarm corresponds to documented care plans and is not simply present for precautionary reasons without actual usage.
• Verify usage frequency through discussions with care staff and review of shift reports.

5. Documentation

• Clearly document the rationale for using the chair alarm, including any specific incidents that prompted its use.
• Include details of the chair alarm type, how the resident responds to its activation, and any modifications to care plans resulting from its use.
• Record efforts to minimize reliance on the chair alarm through alternative interventions or environmental modifications.

6. Common Errors to Avoid

• Overlooking Documentation: Missing documentation of the chair alarm's usage, especially if it was used sporadically.
• Misinterpreting Usage: Coding the chair alarm as used daily when it was actually used less frequently or vice versa.
• Incomplete Rationale: Failing to document the specific reasons and circumstances that justify the chair alarm's use.

7. Practical Application

Example Scenario: A resident with a recent history of falls has a chair alarm placed on their wheelchair, activated during high-traffic times in the common areas to prevent unsupervised attempts to stand. The alarm was used selectively, based on the resident's location and activity level.

• Coding: If the chair alarm was employed during specific times but not consistently every day, it would be coded as 1 (Used Less Than Daily).
• Documentation: Note the selective use of the chair alarm, the rationale behind its application, and any feedback or outcomes observed, including resident and family discussions about its use.

The Step-by-Step Coding Guide for item P0200B 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.