Understanding and Coding MDS Item D0500B1: PHQ Staff Assessment - Feeling Down, Depressed (Presence)

MDS 3.0 Item D0500B1: PHQ Staff Assessment - Presence of Feeling Down or Depressed

Introduction

Purpose: Identifying signs of depression, such as feeling down or depressed, is vital for ensuring the mental health and well-being of long-term care residents, particularly when they are unable or unwilling to self-report. MDS Item D0500B1 focuses on whether staff have observed that the resident has been feeling down, depressed, or hopeless over the past two weeks. Accurate coding of this item allows for early detection of mood disorders, enabling timely interventions that can improve the resident's quality of life.

What is MDS Item D0500B1?

Explanation: MDS Item D0500B1 is part of the staff assessment for mood under Section D: Mood. This item asks staff whether they have observed that the resident has been feeling down, depressed, or hopeless during the past two weeks. It is used when the resident cannot or does not complete the mood interview (PHQ-9), and staff observations are recorded instead. Identifying the presence of these feelings is crucial for understanding the resident’s mental state and for guiding appropriate interventions.

Guidelines for Coding MDS Item D0500B1

Coding Instructions: To code MDS Item D0500B1, the staff member assesses whether they have observed that the resident has been feeling down, depressed, or hopeless over the past two weeks. The coding is binary, based on the staff's observations:

• 0 - No: The resident has not shown signs of feeling down, depressed, or hopeless.
• 1 - Yes: The resident has shown signs of feeling down, depressed, or hopeless.

Example Scenario: If a staff member notices that a resident has become withdrawn, appears sad, or frequently expresses feelings of hopelessness during the past two weeks, you would code D0500B1 as 1 - Yes. If there have been no observable signs of these feelings, you would code 0 - No.

Best Practices for Accurate Coding

Observation: Staff should carefully observe the resident’s behavior and emotional expressions over the two-week period. Consistent monitoring is essential to capture accurate data regarding the resident's mood.

Documentation: Thorough documentation of the resident's behavior is essential. Staff should record specific examples of interactions or behaviors that indicate the resident is feeling down or depressed. This supports the coding decision and informs the care plan.

Communication: Share observations regarding the resident’s mood with the interdisciplinary team to ensure that any signs of depression are addressed comprehensively. This may include discussing potential interventions such as counseling or medication adjustments.

Training: Provide regular training for staff on recognizing signs of depression, particularly feelings of being down or hopeless, and on how to document and code these observations accurately. Training should emphasize the importance of observing subtle changes in a resident’s behavior that may indicate a decline in mood.

Conclusion

Summary: MDS Item D0500B1 is essential for identifying residents who may be experiencing feelings of being down, depressed, or hopeless, which are significant indicators of depression. Accurate coding of this item based on staff observations ensures that mood disorders are detected and addressed promptly, leading to better mental health outcomes for residents.

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

Reference

This guide is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page D-17.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0500B1: "PHQ Staff Assessment - Presence of Feeling Down or Depressed" 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.