Understanding and Coding MDS 3.0 Item K0520Z2: Nutritional Approaches – None of the Above, Not a Resident

Introduction

Purpose:
MDS Item K0520Z2, Nutritional Approaches – None of the Above, Not a Resident, is used to document that a person who is not a current resident of the facility did not receive any specialized nutritional interventions, such as parenteral nutrition, tube feeding, or mechanically altered diets, during the applicable period. This item is essential for accurate documentation when assessing non-residents or individuals who do not fall under the facility's standard residency care. Correct coding of this item ensures clarity in care and nutritional documentation. This article provides a detailed explanation of how to code MDS Item K0520Z2 based on the MDS 3.0 guidelines.

What is MDS Item K0520Z2?

Explanation:
MDS Item K0520Z2, Nutritional Approaches – None of the Above, Not a Resident, applies to individuals who are not residents and who have not received any specialized nutritional approaches, such as:

• Parenteral nutrition
• Tube feeding
• Mechanically altered diets
• Any other specialized nutritional interventions

This item indicates that the person was not a resident of the facility during the time of assessment and did not require nutritional interventions under the facility's care plan.

Guidelines for Coding K0520Z2

Coding Instructions:
To correctly code Item K0520Z2, follow these steps:

1. Confirm the Individual’s Residency Status:

   • Ensure that the individual being assessed is not a current resident of the facility. This might apply to individuals seen for short-term evaluations or those receiving outside services but not admitted as residents.

2. Verify that No Specialized Nutritional Approaches Were Used:

   • Check records or care plans to ensure that the individual did not require any specialized nutritional approaches, such as parenteral nutrition or tube feeding, during the assessment period.

3. Code Based on Nutritional Approaches:

   • Code “1” if the individual was not a resident and did not require any specialized nutritional interventions during the assessment period.
   • If the individual received specialized nutritional support, another appropriate code should be used.

4. Enter the Response in Item K0520Z2:

   • If the individual did not receive any specialized nutritional approaches and was not a resident, enter “1” in K0520Z2.

Example Scenario 1:
An individual received a health assessment at the facility but was not admitted as a resident. They did not require any parenteral nutrition or tube feeding during their assessment. In this case, “1” would be entered in Item K0520Z2, indicating that no nutritional interventions were used and the individual was not a resident.

Example Scenario 2:
A patient received care at the facility’s outpatient unit but was not admitted as a resident. Since the patient did not receive any specialized nutritional support, “1” would be entered in Item K0520Z2 to document that the patient was not a resident and no nutritional approaches were applied.

Best Practices for Accurate Coding

Documentation:

• Ensure that the individual’s residency status is clearly documented in the medical records, including details of any evaluations or assessments that took place while the individual was not a resident.
• Document any relevant nutritional assessments and clarify that no specialized nutritional approaches were used during the assessment period.

Communication:

• Share the individual’s nutritional status and residency information with the care team to ensure that the individual’s assessment is documented correctly and that no specialized nutritional interventions are applied.
• Ensure that administrative and clinical teams are aware of the distinction between residents and non-residents to avoid confusion in documentation.

Nutritional Monitoring:

• Even though no specialized nutritional approaches may be required, individuals undergoing health assessments should still have their nutritional status reviewed regularly to detect any potential issues that may require future interventions.

Conclusion

Summary:
MDS Item K0520Z2 is used to document that no specialized nutritional approaches were applied to an individual who is not a resident of the facility. Accurate coding of this item ensures that the person’s nutritional status and residency are properly recorded, supporting transparency in care assessments. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure accurate documentation for individuals who receive care but are not residents in long-term care settings.

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 nutritional approaches for non-residents.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520Z2: Nutritional Approaches – None of the Above, Not a Resident 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.