Understanding and coding MDS 3.0 Item E1100: Change in Behavior or Other Symptoms

MDS 3.0 Item E1100: Change in Behavior or Other Symptoms

Introduction

Purpose: In long-term care, it is critical to monitor changes in a resident’s behavior or other symptoms as these can indicate worsening health conditions, emotional distress, or cognitive decline. MDS Item E1100 assesses whether there has been a noticeable change in the resident's behavior or symptoms over the past seven days. Identifying these changes early allows for timely interventions that can improve the resident's quality of life and prevent further complications.

What is MDS Item E1100?

Explanation: MDS Item E1100 is part of Section E: Behavioral Symptoms. It evaluates whether the resident has experienced any notable changes in behavior or other symptoms, such as increased agitation, mood swings, or a decline in physical abilities, during the past seven days. These changes may be due to various factors, including medical conditions, medication side effects, or environmental stressors. Monitoring and addressing these changes ensures that the care team can adapt the resident’s care plan accordingly.

Guidelines for Coding MDS Item E1100

Coding Instructions: To code MDS Item E1100, staff must assess whether there has been any change in the resident's behavior or symptoms over the past seven days. Changes to monitor may include:

• Increased aggression, anxiety, or depression
• Sudden changes in mood or emotional state
• New or worsening physical symptoms, such as pain or discomfort
• Increased confusion or disorientation
• Changes in social engagement or isolation

The coding options are:

• 0 - No: There has been no significant change in the resident’s behavior or symptoms over the past seven days.
• 1 - Yes: There has been a significant change in the resident’s behavior or symptoms over the past seven days.

Example Scenario: If a resident who was previously calm has suddenly become aggressive or withdrawn, or if they have shown signs of increased confusion, you would code E1100 as 1 - Yes. If there have been no notable changes in behavior or symptoms, code 0 - No.

Best Practices for Accurate Coding

Observation: Staff should closely monitor the resident’s behavior, mood, and physical symptoms throughout the week. Any noticeable deviations from the resident’s typical behavior or emotional state should be documented, especially if they occur suddenly or persist for several days.

Documentation: Record specific examples of changes in behavior or symptoms, noting when the change occurred, how long it lasted, and the possible causes. Accurate documentation ensures that changes are clearly communicated to the care team and helps guide appropriate interventions.

Communication: Share observations of behavioral or symptom changes with the interdisciplinary care team. This may involve adjusting the resident’s care plan, exploring medical causes for the changes, or providing emotional support or counseling.

Training: Provide staff with ongoing training on recognizing and documenting behavioral changes, including how to respond to increased aggression, anxiety, or emotional distress. Understanding the factors that can contribute to changes in behavior, such as medication adjustments or environmental stressors, is important for accurate coding and timely intervention.

Conclusion

Summary: MDS Item E1100 is crucial for identifying any changes in a resident’s behavior or symptoms. Accurate coding of this item helps ensure that changes are recognized and addressed early, allowing the care team to provide timely interventions that can improve the resident’s overall well-being and prevent further complications.

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-12.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item E1100: "Change in Behavior or Other Symptoms" 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 item within MDS 3.0. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.