Understanding and Coding MDS 3.0 Item B0700: Makes Self Understood

Understanding and Coding MDS 3.0 Item B0700: Makes Self Understood

Introduction

Purpose:
Assessing a resident's ability to express themselves clearly is vital in ensuring effective communication within a long-term care facility. MDS 3.0 Item B0700 evaluates how well a resident can communicate their needs, thoughts, and feelings to others, which is essential for their overall well-being and care planning. Accurate coding of this item helps to identify residents who may require additional support or alternative communication methods.

What is MDS Item B0700?

Explanation:
MDS Item B0700, "Makes Self Understood," assesses the resident's ability to convey their needs, desires, and opinions through any form of communication, including verbal, nonverbal, or via assistive devices. This item is part of Section B, which focuses on hearing, speech, and vision. The resident's ability to make themselves understood is crucial in ensuring that they receive appropriate care and that their preferences are honored.

The item captures the usual performance of the resident, not just their best or worst instances, providing a comprehensive view of their communication abilities.

Guidelines for Coding B0700

Coding Instructions:
When coding Item B0700, the assessment should be based on observations and interactions with the resident over time, ensuring that the code reflects their usual ability to make themselves understood.

1. Code 0 - Understood: The resident can express themselves without difficulty, consistently making themselves understood.
2. Code 1 - Usually understood: The resident is generally understood but may occasionally need repetition or clarification, especially in complex conversations.
3. Code 2 - Sometimes understood: The resident frequently has difficulty making themselves understood, requiring repetition, rephrasing, or additional effort from others to interpret their meaning.
4. Code 3 - Rarely/Never understood: The resident has severe difficulty communicating, and their attempts are rarely or never understood by others.

Example Scenario:
Consider Mr. Thompson, a resident who can usually express basic needs like requesting food or assistance but struggles with more complex or abstract conversations. He often needs to repeat himself or use gestures to aid understanding. In this case, Mr. Thompson should be coded as "1 - Usually understood" because he can generally communicate effectively, though with some limitations.

Best Practices for Accurate Coding

Documentation:
Ensure that all observations about the resident’s ability to communicate are thoroughly documented. This should include both successful and unsuccessful communication attempts to provide a complete picture of the resident's abilities.

Communication:
Encourage interdisciplinary communication among staff to gather consistent information about the resident’s communication skills. This ensures that all staff members have a shared understanding of the resident’s abilities and can code Item B0700 accurately.

Training:
Provide ongoing training for staff on effective communication strategies with residents who have impaired speech or other communication difficulties. This training should include techniques for interpreting nonverbal cues and using assistive communication devices.

Conclusion

Summary:
Accurately coding MDS Item B0700 is essential for assessing a resident's ability to make themselves understood. This information is critical in developing individualized care plans that cater to the resident's communication needs. By following the coding guidelines and best practices, healthcare professionals can ensure that the resident’s communication abilities are correctly evaluated and supported.

Reference

Please refer to CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, specifically Chapter 3, Page B-3, for detailed instructions on coding Item B0700.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item set B0700: Makes Self Understood 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.