Understanding and Coding MDS Item A1250B: Transportation -from NACHC: Yes, Kept from Non-Medical Appointments

Understanding and Coding MDS Item A1250B: Transportation (from NACHC©): Yes, Kept from Non-Medical Appointments

Introduction

Purpose:
MDS Item A1250B, "Transportation (from NACHC©): Yes, Kept from Non-Medical Appointments," is part of the Social Determinants of Health (SDOH) section in the MDS 3.0 assessment. This item identifies residents who are unable to attend non-medical appointments due to transportation limitations. Accurate coding of this item allows facilities to identify potential barriers impacting a resident’s social engagement and quality of life, as consistent access to non-medical appointments (such as social events, religious gatherings, or personal errands) is important for overall well-being and social health.

What is MDS Item A1250B?

Explanation:
MDS Item A1250B is included in Section A of the MDS 3.0, which gathers information on demographics and social determinants of health. This item focuses specifically on whether transportation barriers have kept the resident from attending non-medical appointments within the past month.

Non-medical appointments may include social, religious, or community activities, as well as personal errands. Barriers to accessing these appointments can negatively impact the resident’s mental health and social support, making it essential to document this information accurately.

• Relevance: Regular participation in non-medical activities supports a resident’s sense of independence, engagement, and emotional well-being.
• Importance: Coding A1250B correctly enables facilities to address transportation barriers and promote greater access to social and personal activities, thereby enhancing the resident’s quality of life.

Guidelines for Coding MDS Item A1250B

Coding Instructions:

1. Identify Transportation Barriers to Non-Medical Appointments:
   Staff should determine if the resident has been unable to attend non-medical appointments over the past month specifically due to transportation limitations. Non-medical appointments may include religious services, community events, or other personal activities.

2. Scoring the Presence of Transportation Barriers:

   • Code 0 (No) if the resident has not been kept from attending non-medical appointments due to transportation issues in the past month.
   • Code 1 (Yes) if the resident has been kept from attending non-medical appointments due to transportation issues in the past month.

3. Documentation Requirements:
   If coding “Yes,” document any known transportation barriers that kept the resident from attending non-medical appointments. Describing specific transportation issues (e.g., lack of transportation services, unreliable transit options) helps the care team address these obstacles.

4. Discuss with the Resident or Family:
   When possible, speak with the resident or their family to understand if they have been limited in their access to transportation for non-medical activities. This helps provide accurate information and ensures resident needs are documented.

Example Scenario:
Mr. Jones has missed his weekly religious service and monthly social club meeting because transportation is not available from his assisted living facility. Based on this information, code 1 (Yes) for A1250B, indicating that transportation barriers have kept him from non-medical appointments.

Best Practices for Accurate Coding

Engage in Resident Conversations:
Discuss the resident’s recent experiences with transportation to understand any limitations they may be facing. Including the resident’s perspective offers valuable context and ensures accurate coding.

Gather Information from Family Members:
Involve family members or caregivers who may arrange transportation for the resident. Understanding the resident’s transportation options can reveal challenges in accessing non-medical appointments.

Collaborate with the Care Team to Address Barriers:
If transportation barriers are identified, work with the care team to explore available transportation services or community resources that may improve the resident’s access to activities outside the facility.

Conclusion

MDS Item A1250B is essential for identifying transportation barriers to non-medical appointments for residents who may be isolated from community and social engagements. By accurately documenting these barriers, care teams can take steps to address transportation issues, fostering a more inclusive and engaging environment for residents. Ensuring access to non-medical appointments supports residents’ mental and social well-being and contributes to an improved quality of life.

Click here for a detailed step-by-step link for this item set

Reference

For more detailed guidelines on coding MDS Item A1250B, 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 A1250B: "Transportation (from NACHC©): Yes, Kept from Non-Medical Appointments" 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.