Understanding and Coding MDS 3.0 Item D0160: PHQ Response - Total Mood Severity Score

Understanding and Coding MDS 3.0 Item D0160: PHQ Response - Total Mood Severity Score

Introduction

Purpose: The total mood severity score, calculated from the Patient Health Questionnaire (PHQ-9), is a critical measure in assessing the overall mood of residents in long-term care settings. MDS Item D0160 provides a quantifiable score that reflects the severity of a resident's depressive symptoms based on their responses to the PHQ-9. Accurate calculation and interpretation of this score are essential for identifying residents at risk of depression and for guiding appropriate interventions and care planning.

What is MDS Item D0160?

Explanation: MDS Item D0160 represents the total mood severity score derived from the PHQ-9, a widely used tool for screening and assessing the severity of depression. This score is calculated by summing the points assigned to each response on the nine items of the PHQ-9, which range from 0 (not at all) to 3 (nearly every day). The total score can range from 0 to 27, with higher scores indicating more severe depressive symptoms. Understanding and accurately calculating this score is crucial for determining the resident’s level of depression and the need for further evaluation or treatment.

Guidelines for Calculating and Coding MDS Item D0160

Calculation Instructions: The total mood severity score is calculated by summing the individual scores from the PHQ-9 items (D0150A1 through D0150I2). Each item is scored based on the frequency of the symptom reported by the resident:

• 0 - Not at all
• 1 - Several days
• 2 - More than half the days
• 3 - Nearly every day

After scoring each item, add the scores together to obtain the total mood severity score (D0160).

Scoring Interpretation:

• 0-4: Minimal or no depression
• 5-9: Mild depression
• 10-14: Moderate depression
• 15-19: Moderately severe depression
• 20-27: Severe depression

Example Scenario: If a resident's responses to the PHQ-9 items result in the following scores: 1, 2, 1, 0, 2, 2, 1, 1, and 0, their total mood severity score would be 10. This score indicates moderate depression, and appropriate follow-up actions, such as a referral to a mental health professional, may be necessary.

Best Practices for Accurate Calculation and Documentation

Documentation: Ensure that each PHQ-9 item is accurately scored based on the resident's responses. The total score should be documented clearly in the resident's assessment record, along with any relevant observations or notes that may affect interpretation.

Communication: Share the total mood severity score with the interdisciplinary team to ensure that any necessary interventions are implemented in a timely manner. This score is an important indicator of the resident’s mental health and should be considered in the overall care plan.

Training: Regular training on administering the PHQ-9 and calculating the total mood severity score is essential for staff involved in MDS assessments. Training should cover how to accurately interpret the scores and how to communicate the results to the care team.

Conclusion

Summary: MDS Item D0160 is a vital component of the PHQ-9, providing a total mood severity score that helps quantify the level of depressive symptoms in long-term care residents. Accurate calculation and interpretation of this score are crucial for identifying residents who may require further evaluation or treatment for depression, ensuring that they receive the appropriate care to improve their mental health and overall well-being.

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

Reference

This guide 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 D-13.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0160: "PHQ Response - Total Mood Severity Score" 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 procedures for calculating and interpreting 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.