Understanding and Coding MDS 3.0 Item O0500H: "Eating and/or Swallowing Training: Number of Days"

Introduction

Purpose:
Eating and swallowing difficulties are common challenges among residents in long-term care facilities, particularly those with neurological conditions, strokes, or other health issues that affect these functions. MDS Item O0500H, "Eating and/or Swallowing Training: Number of Days," is used to document the number of days that eating or swallowing training was provided to the resident during the assessment period. Accurate documentation is essential to ensure that residents receive the necessary support to maintain adequate nutrition and reduce the risk of complications like aspiration. This article provides detailed guidance on how to correctly code this item based on the latest MDS guidelines.

What is MDS Item O0500H?

Explanation:
MDS Item O0500H, "Eating and/or Swallowing Training: Number of Days," is part of Section O, which focuses on special treatments, procedures, and programs provided to the resident. This item specifically captures the number of days the resident received training to improve or maintain their ability to eat and swallow safely during the assessment period. Eating and swallowing training can involve speech therapy, occupational therapy, or specialized exercises designed to strengthen the muscles involved in these functions. This training is crucial for residents who have difficulty chewing, swallowing, or managing food and liquids, as it helps prevent malnutrition, choking, and aspiration pneumonia.

Documenting the number of days eating or swallowing training was provided is essential for tracking the resident’s progress and ensuring that appropriate interventions are in place.

Guidelines for Coding O0500H

Coding Instructions:
To correctly code Item O0500H, follow these steps:

1. Identify Eating and/or Swallowing Training: Determine if the resident received any form of eating or swallowing training during the assessment period. This includes sessions with speech or occupational therapists, exercises to improve swallowing function, and training on safe eating techniques.
2. Count the Number of Days: Record the total number of days that eating and/or swallowing training was provided to the resident during the 7-day look-back period. Each day a session is provided counts as one day, regardless of the duration of the session.
3. Select the Appropriate Response:
   • Enter the number of days (0 to 7) that eating and/or swallowing training was provided during the assessment period.
   • If no training was provided, enter 0.
4. Enter the Response in Item O0500H: Record the calculated number of days in Item O0500H. Ensure that the resident’s care plan includes details of the training provided and how it supports the resident’s nutritional and safety needs.

Example Scenario:
A resident with Parkinson’s disease has difficulty swallowing, increasing their risk of choking. During the 7-day look-back period, the resident participated in swallowing training with a speech therapist on three separate days. The training involved exercises to strengthen the swallowing muscles and instruction on safe swallowing techniques. The MDS Coordinator documents this by entering 3 in Item O0500H. This ensures that the resident’s care plan reflects the frequency of the training and allows for ongoing assessment of its effectiveness.

Best Practices for Accurate Coding

Documentation:
Maintain accurate records of all eating and swallowing training sessions, including the dates, type of training provided, and the resident’s response. This documentation should support the coding of Item O0500H and provide a clear record for tracking the resident’s progress and adjusting care plans as needed.

Interdisciplinary Communication:
Ensure effective communication among the care team regarding the resident’s eating and swallowing abilities and the interventions provided. Regular updates should be shared during team meetings to ensure consistency in the resident’s care and to identify any necessary adjustments to the training plan.

Ongoing Assessment:
Regularly assess the resident’s eating and swallowing abilities to determine the effectiveness of the training and make necessary adjustments to the care plan. Document any changes in the resident’s condition that may impact their ability to eat or swallow safely.

Conclusion

Summary:
MDS Item O0500H is essential for documenting the number of days eating and/or swallowing training was provided to residents in long-term care settings. By accurately coding this item and ensuring clear documentation, healthcare professionals can monitor the effectiveness of interventions and ensure that residents receive the support they need to maintain or improve their ability to eat and swallow safely. Following the guidelines and best practices outlined in this article will help ensure that eating and swallowing training is properly managed and documented.

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 3-151] for detailed guidelines on documenting eating and/or swallowing training and other special treatments.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item O0500H: "Eating and/or Swallowing Training: Number of Days" 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.

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