Understanding and Coding MDS Item D0100: PHQ - Should Resident Mood Interview Be Conducted

Understanding and Coding MDS Item D0100: PHQ - Should Resident Mood Interview Be Conducted

Introduction

Purpose:
MDS Item D0100, "PHQ: Should Resident Mood Interview Be Conducted," is used to determine if the Patient Health Questionnaire (PHQ-9) resident mood interview should be administered. The PHQ-9 interview assesses the resident’s mood and potential symptoms of depression, providing insight into mental health needs and guiding personalized care. Coding this item accurately is essential to ensure that residents are screened for mood symptoms, supporting timely intervention for those at risk of depression or other mood disorders.

What is MDS Item D0100?

Explanation:
MDS Item D0100 is part of Section D (Mood) in the MDS 3.0 assessment. This item asks whether the resident should participate in the PHQ-9 Resident Mood Interview. The decision to conduct this interview depends on the resident’s ability to participate and provide accurate responses. If the resident cannot participate, staff may complete an alternative PHQ-9 Staff Assessment of Resident Mood based on observed behaviors and staff interactions with the resident.

• Relevance: Conducting the mood interview ensures that the resident’s emotional well-being is assessed, allowing the care team to detect potential symptoms of depression and other mood-related concerns.
• Importance: Properly coding D0100 determines whether the resident will be evaluated directly through the PHQ-9 interview, leading to accurate assessment and intervention based on the resident’s self-reported mood symptoms.

Guidelines for Coding MDS Item D0100

Coding Instructions:

1. Assess the Resident’s Ability to Participate in the PHQ-9 Interview:
   Determine if the resident can understand and respond to the questions in the PHQ-9 interview. This assessment is based on cognitive status, communication ability, and willingness to participate.

2. Answering D0100:

   • Code 0 (No) if the resident should not be interviewed, typically due to cognitive limitations, inability to communicate, or a condition that prevents accurate self-reporting of mood.
   • Code 1 (Yes) if the resident should be interviewed, meaning they are able and willing to participate in the PHQ-9 mood interview.

3. Documentation Requirements:
   Document the decision to conduct or not conduct the PHQ-9 interview clearly in the resident’s medical record. If the resident is unable to participate, record the reasons for selecting Code 0 and prepare for the alternative PHQ-9 Staff Assessment if appropriate.

4. Verification:
   Verify the coding decision with interdisciplinary team members familiar with the resident’s cognitive and communicative abilities. This helps ensure that the decision to conduct or not conduct the interview aligns with the resident’s current status.

Example Scenario:
Ms. Lewis, a resident with mild cognitive impairment, understands the questions posed in the PHQ-9 interview and is willing to participate. In this case, code 1 (Yes) for D0100, as the resident is able to complete the mood interview directly.

Best Practices for Accurate Coding

Conduct a Preliminary Assessment of the Resident’s Cognition and Communication:
Ensure that the resident’s cognitive status is evaluated before deciding to conduct the PHQ-9 interview. Use observation and input from caregivers to determine if the resident can provide accurate self-reports.

Involve the Care Team in Decision-Making:
Work with the interdisciplinary care team to assess the resident’s ability to participate in the PHQ-9 interview. Input from nursing staff, social workers, and therapists can provide a comprehensive view of the resident’s cognitive and communicative abilities.

Train Staff on PHQ-9 Interviewing Procedures:
Provide training on administering the PHQ-9 interview and recognizing when a resident cannot complete it due to cognitive or communicative limitations. Proper training helps ensure the resident’s ability is accurately assessed and that alternative assessments are used when necessary.

Conclusion

MDS Item D0100 is essential for determining whether a resident’s mood should be assessed directly through the PHQ-9 Resident Mood Interview. Accurate coding of this item ensures that residents who can self-report their mood receive the interview, while those unable to participate are evaluated through alternative methods. Proper assessment of the resident’s capability and documentation supports effective mental health care and timely intervention.

step-by-step links for this article

Reference

For more detailed guidelines on coding MDS Item D0100, 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 D, Page 3-14.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0100: "PHQ - Should Resident Mood Interview Be Conducted" 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.