Understanding and coding MDS 3.0 Item E0600A: Behavioral Symptoms That Put Others at Risk for Injury

MDS 3.0 Item E0600A: Behavioral Symptoms That Put Others at Risk for Injury

Introduction

Purpose: Behavioral symptoms in long-term care residents, such as physical aggression or verbal threats, can pose a significant risk to the safety of others, including staff and other residents. MDS Item E0600A focuses on assessing whether a resident’s behavioral symptoms have put others at risk of injury over the past seven days. Identifying these behaviors is crucial for implementing safety measures and protecting the well-being of everyone in the care facility.

What is MDS Item E0600A?

Explanation: MDS Item E0600A is part of Section E: Behavioral Symptoms. It evaluates whether the resident has exhibited any behaviors over the past seven days that put others at risk of injury. These behaviors include physical aggression (e.g., hitting, kicking, pushing) or actions that could cause harm to staff, other residents, or visitors. Recognizing such behaviors is essential for developing safety protocols, modifying care approaches, and ensuring a safe environment for all.

Guidelines for Coding MDS Item E0600A

Coding Instructions: To code MDS Item E0600A, staff must assess whether the resident’s behavioral symptoms over the past seven days have put others at risk for injury. These symptoms might include:

• Hitting or striking staff or other residents
• Pushing or shoving
• Throwing objects
• Threatening others with physical harm
• Exhibiting aggressive outbursts

The coding options are:

• 0 - No: The resident’s behavioral symptoms have not put others at risk for injury.
• 1 - Yes: The resident’s behavioral symptoms have put others at risk for injury.

Example Scenario: If a resident has physically attacked staff members or other residents, such as hitting or shoving, you would code E0600A as 1 - Yes. If the resident has not exhibited any behaviors that put others at risk for injury, the appropriate code would be 0 - No.

Best Practices for Accurate Coding

Observation: Staff should carefully observe the resident’s interactions with others over the seven-day period. Pay attention to any physically aggressive behaviors or verbal threats that could potentially lead to harm. Staff should also note the triggers and context of these behaviors.

Documentation: Record specific examples of behaviors that put others at risk for injury, including the frequency and circumstances in which they occurred. Thorough documentation is important for developing effective interventions and ensuring accurate coding.

Communication: Share observations with the interdisciplinary care team to ensure that strategies are in place to address aggressive behaviors. This may include behavioral interventions, adjustments to the care environment, increased supervision, or referrals to mental health professionals.

Training: Provide ongoing training for staff on how to manage aggressive behaviors in residents. Training should cover de-escalation techniques, safe handling of aggressive residents, and methods for preventing harm to others.

Conclusion

Summary: MDS Item E0600A is crucial for assessing behavioral symptoms that put others at risk for injury in long-term care settings. Accurate coding based on staff observations ensures that these behaviors are identified and addressed early, allowing for the development of safety protocols and interventions that protect both the resident and those around them.

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 E-9.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item E0600A: "Behavioral Symptoms That Put Others at Risk for Injury" 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. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.