Understanding and Coding MDS Item A1250Y: Transportation (from NACHC): Resident Declines to Respond

Understanding and Coding MDS Item A1250Y: Transportation (from NACHC©): Resident Declines to Respond

Introduction

Purpose:
MDS Item A1250Y, "Transportation (from NACHC©): Resident Declines to Respond," is used to document situations where a resident chooses not to answer the question related to their transportation access. This item is part of the MDS assessment, which collects information on various social determinants of health, including transportation. By acknowledging when a resident declines to respond, care teams can accurately reflect the resident’s preferences while still respecting their privacy.

What is MDS Item A1250Y?

Explanation:
MDS Item A1250Y is part of Section A, which gathers demographic and social information about the resident. This particular item focuses on transportation access as a social determinant of health, specifically noting if a resident chooses not to provide an answer regarding their transportation situation. Access to reliable transportation can significantly impact a resident’s ability to attend medical appointments, receive care, and engage in social activities.

However, a resident may choose to decline answering this question for various reasons, such as personal privacy concerns or discomfort discussing transportation challenges. Item A1250Y ensures that this decision is respected and accurately documented.

• Relevance: Reliable transportation is a critical factor for accessing healthcare services and maintaining independence. Capturing when a resident declines to respond helps maintain the integrity of the assessment without forcing residents to disclose information they may not wish to share.
• Importance: Proper coding of A1250Y ensures that the MDS assessment reflects the resident’s choice not to answer, allowing the care team to respect the resident’s autonomy while still completing the assessment.

Guidelines for Coding MDS Item A1250Y

Coding Instructions:

1. Ask the Resident About Their Transportation Access:
   During the assessment, the resident (or their representative) is asked about their access to transportation. If the resident chooses not to answer this question, it must be documented using A1250Y.

2. Answering A1250Y:

   • Code 1 (Yes) if the resident declines to respond to the transportation-related question.
   • Code 0 (No) if the resident provides an answer to the transportation question or if the question was not asked.

3. Documentation Requirements:
   Ensure that the resident’s decision to decline responding to the transportation question is noted in the assessment. This item should be used specifically when the resident has made it clear they do not wish to answer.

4. Verification:
   No additional verification is required. It is sufficient to document the resident’s choice to decline answering the transportation question.

Example Scenario:
During the assessment, Mrs. Lee is asked about her transportation access. She declines to provide any information on this topic, citing privacy concerns. In this case, code 1 (Yes) for A1250Y to indicate that the resident declined to respond to the transportation question.

Best Practices for Accurate Coding

Respecting Resident Preferences:
Always respect the resident’s right to decline responding to questions during the MDS assessment. If they choose not to disclose information about transportation, their decision should be recorded without pressure or assumption.

Communication:
Ensure that staff members conducting the assessment are trained to ask questions respectfully and explain the purpose behind gathering information on transportation. Clear communication can help residents understand why the information is being collected while respecting their autonomy to decline answering.

Training:
Provide training to staff on how to document resident choices accurately, especially when a resident declines to respond. Staff should be familiar with how to use the appropriate codes to reflect these situations while maintaining a respectful and non-intrusive approach.

Conclusion

MDS Item A1250Y is essential for documenting when a resident declines to respond to questions regarding their transportation access. Proper coding of this item ensures that the resident’s choice is respected and accurately reflected in the MDS assessment, contributing to a more personalized and resident-centered care plan. By documenting the resident’s autonomy, healthcare providers can maintain the integrity of the assessment process.

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

Reference

For more detailed guidelines on coding MDS Item A1250Y, 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 A1250Y: "Transportation (from NACHC©): Resident Declines to Respond" 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.