Understanding and Coding MDS Item A1805: Entered From

Title: Understanding and Coding MDS Item A1805: Entered From

Introduction

Purpose:
MDS Item A1805, "Entered From," records the location from which a resident entered the facility before the start of their current stay. This item captures important background information about the resident’s prior location, which may impact their care needs, assessment, and planning. Accurate documentation of this item provides context for the resident’s recent healthcare journey and any relevant medical or social factors associated with their previous setting.

What is MDS Item A1805?

Explanation:
MDS Item A1805 is part of Section A, which includes Identification and Demographic Information about the resident. This item specifically captures the type of setting from which the resident entered the nursing facility, such as a hospital, another nursing facility, or their private home. This information helps healthcare providers understand the resident's recent care environment, any continuity of care considerations, and factors that might affect their immediate and long-term care needs.

• Relevance: The location from which a resident entered the facility can provide insight into their current health status and recent medical history. For example, residents entering from a hospital setting may require specific post-acute care, whereas those coming from home may need a different type of assessment and support.
• Importance: Proper coding of A1805 ensures that the facility captures relevant information about the resident’s recent care setting, supporting effective assessment, care planning, and continuity of care.

Guidelines for Coding MDS Item A1805

Coding Instructions:

1. Identify the Resident’s Last Location:
   Determine where the resident was immediately before entering the current facility. This may include settings such as a hospital, a private home, or another nursing facility.

2. Answering A1805:

   • Code 01 if the resident entered from an acute care hospital.
   • Code 02 if the resident entered from a psychiatric hospital.
   • Code 03 if the resident entered from another nursing facility.
   • Code 04 if the resident entered from a home or community setting.
   • Code 05 if the resident entered from another location not listed above.

3. Documentation Requirements:
   Clearly document the resident’s previous location in the medical record and ensure that it matches the code selected for A1805. This helps maintain an accurate and compliant resident record.

4. Verification:
   Verify the resident’s previous location with transfer documents, discharge summaries, or admission records to ensure accurate coding. Confirming this information with family members or legal representatives can also provide additional clarity if necessary.

Example Scenario:
Mr. Thompson was admitted to the nursing facility after a hospital stay for surgery. In this case, code 01 for A1805 to indicate that the resident entered from an acute care hospital.

Best Practices for Accurate Coding

Verification and Consistency:
Ensure that transfer documents are reviewed thoroughly to verify the previous location. Consistent documentation helps avoid errors in resident records and promotes continuity of care.

Collaboration with Transfer Facilities:
When possible, collaborate with hospitals or other transfer facilities to ensure smooth transitions and accurate information transfer. This can help the facility identify any specific post-acute care needs based on the resident’s previous setting.

Training Staff on Coding Protocols:
Ensure that admissions and nursing staff are trained on accurately identifying and coding the previous location of residents. Proper training helps improve coding accuracy and enhances care planning.

Conclusion

MDS Item A1805 is critical for documenting the last location a resident was in before entering the current facility. Proper coding of this item ensures that the facility has context about the resident’s recent healthcare experiences, which is essential for creating effective care plans and ensuring continuity of care. Accurate documentation, staff training, and effective communication with transfer facilities are key components in managing this item successfully.

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Reference

For more detailed guidelines on coding MDS Item A1805, 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 3-7.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item A1805: "Entered From" 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.