Understanding and Coding MDS Item A1010B: Race - Black or African American

Introduction

Purpose:
MDS Item A1010B, "Race - Black or African American," is used to document a resident’s self-identified race as part of the MDS 3.0 assessment. Collecting racial demographic data helps long-term care facilities ensure culturally sensitive care and address the unique healthcare needs of residents. Accurate documentation supports inclusivity and informs care plans that reflect the resident’s background.

What is MDS Item A1010B?

Explanation:
MDS Item A1010B is part of Section A, which captures identification information about the resident. This specific item focuses on whether the resident identifies as Black or African American. Race is self-reported by the resident or their representative and may influence the resident’s healthcare needs and experiences.

The term Black or African American includes individuals with origins in any of the Black racial groups of Africa, including people who identify as African American, Afro-Caribbean, or other Black identities.

• Relevance: Racial identity can impact health outcomes, communication styles, and cultural practices in healthcare settings. Capturing this information allows for personalized care that respects the resident’s cultural background and addresses specific health risks more prevalent in the Black or African American community, such as higher rates of hypertension and diabetes.
• Importance: Proper coding of A1010B ensures that the resident’s race is accurately reflected in the MDS assessment, contributing to a comprehensive understanding of their health needs and fostering culturally competent care.

Guidelines for Coding MDS Item A1010B

Coding Instructions:

1. Ask the Resident About Their Race:
   The resident (or their representative) should be asked to self-identify their race. Specifically, ask if they identify as Black or African American.

2. Answering A1010B:

   • Code 1 (Yes) if the resident self-reports their race as Black or African American.
   • Code 0 (No) if the resident does not identify as Black or African American.

3. Documentation Requirements:
   Ensure that the resident’s race is recorded as self-reported. Avoid making assumptions based on external factors such as appearance or surname. This information must come directly from the resident or their representative.

4. Verification:
   No additional verification is required beyond asking the resident or their representative directly. Race is self-reported, and it is important to respect the resident’s personal identification.

Example Scenario:
Mr. Harris, a 68-year-old resident, identifies as African American. When asked about his race during the MDS assessment, he states that he identifies as Black or African American. In this case, code 1 (Yes) for A1010B.

Best Practices for Accurate Coding

Respecting Resident Preferences:
Always allow the resident or their representative to self-identify their race. Do not assume a resident’s race based on appearance, name, or other factors. Respect the resident’s choice in how they identify themselves.

Communication:
Ensure that staff members conducting assessments are trained to ask demographic questions respectfully. It is important to explain to residents why this information is being collected and how it contributes to improving care.

Training:
Provide training on the importance of collecting accurate demographic data. Understanding the significance of race in healthcare helps staff provide culturally competent care, recognize health disparities, and address health risks that may disproportionately affect certain racial groups, such as high blood pressure or diabetes in the Black community.

Conclusion

MDS Item A1010B is essential for documenting whether a resident identifies as Black or African American. Accurate coding of this item ensures that the resident’s race is properly recorded in the MDS assessment, leading to more personalized and culturally sensitive care. By allowing residents to self-identify their race, healthcare providers can better meet the diverse needs of long-term care residents.

Reference

For more detailed guidelines on coding MDS Item A1010B, refer to the CMS’s Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Chapter 3, Section A, Page 3-5.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item A1010B: "Race - Black or African American" 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.