Understanding and Coding MDS 3.0 Item K0520C1: Nutritional Approaches – Mechanically Altered Diet at Admission

Introduction

Purpose:
MDS Item K0520C1, Nutritional Approaches – Mechanically Altered Diet at Admission, documents whether a resident was placed on a mechanically altered diet at the time of admission to the facility. A mechanically altered diet involves modifying the texture of food to ensure safety for residents who have difficulty chewing or swallowing. Proper coding of this item helps in tracking the resident’s dietary needs from the beginning of their stay and ensures that the facility can plan appropriate care. This article explains how to code MDS Item K0520C1 according to MDS 3.0 guidelines.

What is MDS Item K0520C1?

Explanation:
MDS Item K0520C1 refers to residents who were placed on a mechanically altered diet at the time of admission. A mechanically altered diet includes foods that are:

• Pureed,
• Chopped,
• Mashed, or
• Ground to make them easier to swallow or chew.

This diet is typically prescribed for residents with dysphagia, poor dental health, or other conditions that impair their ability to eat regular-textured food. Coding this item ensures the resident’s nutritional needs related to texture-modified diets are managed upon entry into the facility.

Guidelines for Coding K0520C1

Coding Instructions:
To accurately code Item K0520C1, follow these steps:

1. Review the Resident’s Admission Records:

   • Check the resident’s admission records and dietary plan to confirm whether they were placed on a mechanically altered diet at the time of admission.
   • Verify that the diet was recommended to address conditions such as difficulty chewing or swallowing.

2. Confirm That a Mechanically Altered Diet Was Used at Admission:

   • If the resident was on a mechanically altered diet prescribed at admission, proceed to code this item.

3. Code Based on the Resident’s Nutritional Status at Admission:

   • Code “1” for Mechanically Altered Diet at Admission if the resident was placed on this diet upon entering the facility.
   • If the resident was not on a mechanically altered diet at admission, leave this item unmarked and code the appropriate nutritional approach.

4. Enter the Response in Item K0520C1:

   • If the resident received a mechanically altered diet at admission, enter “1” in K0520C1.

Example Scenario 1:
A resident with dysphagia was placed on a pureed diet upon admission to prevent choking. In this case, “1” would be entered in Item K0520C1 to document that the resident was on a mechanically altered diet at admission.

Example Scenario 2:
A resident with dental issues was admitted on a mashed diet to accommodate their difficulty in chewing solid foods. In this case, “1” would be entered in Item K0520C1 to indicate the use of a mechanically altered diet at the time of admission.

Best Practices for Accurate Coding

Documentation:

• Ensure that the care plan and admission records clearly document the use of a mechanically altered diet, including the reason for the diet and any texture modifications needed.
• Keep records of any recommendations from healthcare providers, such as a speech-language pathologist or dietitian, regarding the resident’s dietary needs at admission.

Communication:

• Share the resident’s dietary requirements with the interdisciplinary care team, including nurses, dietitians, and food service staff, to ensure the mechanically altered diet is implemented properly.
• Communicate with the resident and their family about the diet plan and its importance to ensure compliance and understanding.

Monitoring and Follow-Up:

• Regularly assess the resident’s progress on the mechanically altered diet and adjust the care plan if needed. This is especially important if the resident’s condition improves or worsens during their stay.
• Arrange follow-ups with healthcare professionals, such as a dietitian or speech therapist, to ensure the diet continues to meet the resident’s needs.

Conclusion

Summary:
MDS Item K0520C1 is used to track whether a resident was placed on a mechanically altered diet at the time of admission. Proper coding of this item ensures that the resident’s dietary needs are identified and managed from the start of their stay. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure that residents requiring mechanically altered diets receive appropriate care.

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

Reference

CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Refer to [Chapter 3, Page 3-184] for detailed guidelines on coding mechanically altered diets at admission.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520C1: Nutritional Approaches – Mechanically Altered Diet at Admission 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.