Q0500B. Do you want to talk about returning to community, Step-by-Step

Step-by-Step Coding Guide for Item Set Q0500B: Do You Want to Talk About Returning to Community

This guide is designed to assist with accurately coding a resident's interest in discussing their potential return to the community, as outlined in Q0500B of the MDS 3.0.

1. Review of Medical Records

• Objective: To determine the resident's expressed interest or lack thereof in discussing returning to the community.
• Key Points:
  • Examine the resident's medical and care planning records for any notes indicating their desire to discuss or not discuss returning to the community.
  • Look for documentation of discussions between the resident and care team members, social workers, or family about post-discharge plans or preferences.

2. Understanding Definitions

• Objective: Clarify what is meant by "Want to Talk About Returning to Community."
• Key Points:
  • This item captures the resident's interest in engaging in conversations about the possibility and logistics of returning to live in the community, outside of the care facility.

3. Coding Instructions

• Objective: Provide guidance on accurately reflecting the resident's preference.
• Key Points:
  • Code 0: If the resident has not expressed an interest in discussing returning to the community or has explicitly stated they do not want to discuss it.
  • Code 1: If the resident has expressed an interest in discussing returning to the community.
  • Code 9: If the resident is unable to communicate their preference due to cognitive impairment or other reasons.

4. Coding Tips

• Engage in a direct conversation with the resident about their interests and preferences regarding returning to the community to ensure accurate coding.
• Consider the resident's cognitive ability and emotional state when evaluating their expressed preferences.

5. Documentation

• Clearly document in the resident's medical record any expression of interest or disinterest in discussing returning to the community, including the context and date of such expressions.
• Note conversations with or observations by the care team that inform the coding of this item.

6. Common Errors to Avoid

• Misinterpreting the resident's general conversations about the community as an expressed interest in discussing discharge plans.
• Overlooking or not documenting the resident's stated preferences regarding discussions about returning to the community.

7. Practical Application

• Scenario: A resident mentions to a social worker that they are interested in exploring options for returning home after rehabilitation. The social worker documents this conversation, including the resident's specific interests and concerns, and the care team initiates a discussion about what supports and services might be needed for successful community reintegration.

The Step-by-Step Coding Guide for item Q0500B in MDS 3.0 Section Q 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.