Q0550: Resident’s Preference to Avoid Being Asked Question Q0500B

Item Rationale

Some individuals, such as those with cognitive impairments, mental illness, or end-stage conditions, may be upset by asking them if they want to return to the community. CMS pilot tested Q0500 language and determined that respondents would be less likely to be upset by being asked if they want to talk to someone about returning to the community if they were given the opportunity to opt-out of being asked the question every quarter. The intent of the item is to achieve a better balance between giving residents a voice and a choice about the services they receive, while being sensitive to those individuals who may be unable to voice their preferences or be upset by being asked question Q0500B in the assessment process.

Coding Instructions for Q0550A, Does the resident (or family or significant other or guardian or legally authorized representative only if resident is unable to understand or respond) want to be asked about returning to the community on all assessments? (Rather than on comprehensive assessments alone)

• Code 0, No: if the resident (or family or significant other, or guardian or legally authorized representative) states that they do not want to be asked again on Quarterly assessments about returning to the community. In this case, document in resident’s clinical record and ask question Q0500B again only on the next comprehensive assessment.

• Code 1, Yes: if the resident (or family or significant other, or guardian or legally authorized representative) states that they do want to be asked the return to community question, Q0500B, on all assessments.

• Code 8, Information not available: if the resident cannot respond and the family or significant other is not available to respond on the resident’s behalf and a guardian or legally authorized representative is not available or has not been appointed by the court.

Coding Instructions for Q0550C, Indicate information source for Q0550A

• Code 1, Resident: if resident responded to Q0550A.

• Code 2, Family.

• Code 3, Significant other.

• Code 4, Legal guardian.

• Code 5, Other legally authorized representative.

• Code 9, None of the above.

Example

1. Resident W is an 81-year-old individual who was admitted after a fall that broke their hip, wrist and collar bone. Their recovery is slow and their family visits regularly. Their apartment is awaiting them and they hope within the next 4–6 months to be discharged home. When asked, resident W stated that they would like to be asked about discharging to the community on all assessments.

Coding: Q0550A would be coded 1, Yes. Q0550C would be coded 1, Resident.

Rationale: Resident W responded yes to item Q0550A, indicating they want to be asked about returning to the community on all assessments.