P0200E. Wander/ elopement alarm

Step-by-Step Coding Guide for P0200E: Wander/Elopement Alarm

1. Review of Medical Records

• Objective: Examine the resident's medical records meticulously for any mention of wander/elopement alarm use. Key documents include physician orders, nursing notes, and documentation by nursing assistants, focusing on the 7-day look-back period.
• Key Documents: Look for specific mentions of alarms used to monitor the resident's movements, especially if they are at risk of wandering or elopement.

2. Understanding Definitions

• Wander/Elopement Alarm: Devices such as bracelets, pins/buttons worn on the resident’s clothing, sensors in shoes, or building/unit exit sensors worn by/attached to the resident that activate an alarm and/or alert the staff when the resident nears or exits a specified area or the building.

3. Coding Instructions

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

4. Coding Tips

• Review care plans and discuss with the care team to ensure that the use of wander/elopement alarms matches documented strategies for managing wandering or elopement risks.
• Verify that the device used fits the definition of a wander/elopement alarm specifically designed for monitoring and preventing wandering or elopement.

5. Documentation

• Document the type of wander/elopement alarm used, including where it is worn or placed, and the rationale for its use, focusing on the resident's specific wandering or elopement risks.
• Record any incidents where the alarm was activated, detailing how staff responded and any adjustments made to care plans or interventions as a result.

6. Common Errors to Avoid

• Failing to Distinguish Between Types of Alarms: Ensure the alarm specifically addresses wandering or elopement, not just general movement.
• Inadequate Documentation: Lack of detailed documentation about why the wander/elopement alarm is necessary and how it's integrated into the resident's care plan.
• Incorrect Coding of Usage Frequency: Misreporting how frequently the alarm was actually used versus being equipped as a precaution.

7. Practical Application

• Example Scenario: A resident diagnosed with Alzheimer's disease is known to attempt unsupervised exits. A wrist-worn wander/elopement alarm is used to alert staff if the resident approaches exit doors. The alarm is part of the resident's daily wear.
  • Documentation Needed: Note the implementation of the wrist-worn alarm, specific days it was activated, staff interventions following activations, and any discussions with family about its use.
  • Coding: For continuous daily use, code P0200E as "2 (Used Daily)."

The Step-by-Step Coding Guide for item P0200E 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.