Understanding and Coding MDS 3.0 Item A2105: "Discharge Status"

Understanding and Coding MDS 3.0 Item A2105: "Discharge Status"

Introduction

Purpose:

MDS 3.0 Item A2105, "Discharge Status," is an important part of the discharge process in long-term care facilities. It records the resident’s status or destination at the time of discharge, providing crucial information for understanding the resident’s post-discharge needs and for ensuring continuity of care. Accurate coding of this item is essential for regulatory compliance and for supporting effective care transitions.

What is MDS Item A2105?

Explanation:

MDS Item A2105 captures the status or destination of a resident upon discharge from a long-term care facility. This item documents where the resident is going or their condition upon leaving the facility, such as being discharged to home, another healthcare facility, or in the event of the resident’s death. Properly recording the discharge status is crucial for planning follow-up care, coordinating with other healthcare providers, and ensuring that the resident’s care continues seamlessly.

The discharge status options typically include:

1. Community (Code 01): The resident is discharged to their own home or another private residence.
2. Another nursing home or swing bed (Code 02): The resident is transferred to another nursing facility or a swing bed within another facility.
3. Acute hospital (Code 03): The resident is discharged to an acute care hospital.
4. Psychiatric hospital (Code 04): The resident is transferred to a psychiatric hospital.
5. Inpatient rehabilitation facility (IRF) (Code 05): The resident is discharged to an IRF.
6. Assisted living facility (Code 06): The resident is discharged to an assisted living facility.
7. Hospice (Code 07): The resident is discharged to a hospice care setting.
8. Long-term care hospital (LTCH) (Code 08): The resident is discharged to an LTCH.
9. Deceased (Code 09): The resident has passed away while in the care of the facility.
10. Other (Code 10): The resident is discharged to another location not specified above.

Guidelines for Coding A2105

Coding Instructions:

1. Identify the Discharge Status:

   • Determine the correct status or destination of the resident at the time of discharge. This should be based on the resident’s actual situation at the time they leave the facility.

2. Response Coding:

   • Code 01 for Community.
   • Code 02 for Another nursing home or swing bed.
   • Code 03 for Acute hospital.
   • Code 04 for Psychiatric hospital.
   • Code 05 for Inpatient rehabilitation facility (IRF).
   • Code 06 for Assisted living facility.
   • Code 07 for Hospice.
   • Code 08 for Long-term care hospital (LTCH).
   • Code 09 for Deceased.
   • Code 10 for Other.

3. Documentation:

   • Ensure that the discharge status is clearly documented in the resident’s medical record, with supporting details that confirm the discharge destination or condition. This documentation is essential for care continuity and regulatory compliance.

Example Scenario:

Ms. Anderson was discharged from the long-term care facility to return to her home, where she will continue to receive home health services. For MDS Item A2105, this would be coded as 01 (Community).

Best Practices for Accurate Coding

Documentation:

• Maintain thorough documentation of the resident’s discharge status, including any communication with the resident’s family or the receiving facility. This documentation helps ensure a smooth transition and supports follow-up care.

Communication:

• Ensure effective communication between the care team, the resident or their family, and the receiving facility (if applicable) to confirm the discharge status. Clear communication helps prevent misunderstandings and ensures the resident’s needs are met post-discharge.

Training:

• Train staff on the importance of accurately recording the discharge status, emphasizing how it impacts care transitions, follow-up care, and regulatory reporting. Regular training helps keep staff informed of any changes in discharge coding practices.

Conclusion

Summary:

Accurately coding MDS Item A2105 is crucial for documenting the discharge status of a resident, ensuring that their care needs are met during and after the transition from the facility. Proper documentation and communication are key to supporting effective care transitions and ensuring regulatory compliance.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference

This information is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page 2-13.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item A2105: "Discharge Status" was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.