Understanding and Coding MDS Item GG0170E5: Chair/Bed-to-Chair Transfer (OBRA/Interim Performance)

Understanding and Coding MDS Item GG0170E5: Chair/Bed-to-Chair Transfer (OBRA/Interim Performance)

Introduction

Purpose:
MDS Item GG0170E5, "Chair/Bed-to-Chair Transfer (OBRA/Interim Performance)," is part of the Functional Abilities and Goals section within Section GG of the MDS 3.0 assessment. This item documents the resident’s performance in transferring from a bed or a chair to another chair, such as a wheelchair, specifically as observed in the OBRA (Omnibus Budget Reconciliation Act) or Interim Performance Assessment. Accurate coding of this item is crucial for assessing the resident’s functional mobility, identifying the level of assistance required, and supporting individualized care planning aimed at enhancing or maintaining independence in daily activities.

What is MDS Item GG0170E5?

Explanation:
MDS Item GG0170E5 is included in Section GG (Functional Abilities and Goals) of the MDS 3.0, which captures information on the resident’s functional status and goals. This item focuses on the resident’s ability to transfer between a bed and a chair or between two chairs, specifically as assessed during OBRA-required or interim assessments.

• Definition: This item documents the resident’s level of independence or need for assistance during the chair/bed-to-chair transfer, capturing an important aspect of functional mobility.
• Importance: Documenting this transfer ability provides insight into the resident’s functional status, identifying the level of physical assistance or supervision required. This information supports safe mobility, helps prevent falls, and promotes the resident’s independence as much as possible.

Guidelines for Coding MDS Item GG0170E5

Coding Instructions:

1. Observe the Resident’s Ability to Transfer Independently or with Assistance:
   Observe the resident’s performance while transferring between a bed and a chair or between two chairs. Assess the level of assistance required from caregivers, if any, and determine how consistently the resident can perform this task under usual conditions.

2. Scoring GG0170E5: Code GG0170E5 based on the level of assistance the resident requires for a safe and complete transfer:

   • 06 - Independent: The resident completes the transfer safely without any assistance, setup, or supervision.
   • 05 - Setup or Clean-up Assistance: The resident completes the transfer independently but requires assistance with setup (e.g., positioning the wheelchair or walker) or clean-up.
   • 04 - Supervision or Touching Assistance: The resident completes the transfer but requires supervision or light touch support for safety.
   • 03 - Partial/Moderate Assistance: The resident performs more than half of the effort, but a helper provides less than half.
   • 02 - Substantial/Maximal Assistance: The resident performs less than half of the effort, and the helper provides more than half.
   • 01 - Dependent: The resident requires full assistance from one or more helpers to complete the transfer.
   • 07 - Resident Refused: The resident refuses to complete the transfer during the observation period.
   • 09 - Not Applicable: The transfer does not occur (e.g., the resident is bedbound).
   • 10 - Not Attempted Due to Environmental Limitation: The transfer was not attempted due to environmental limitations.
   • 88 - Not Attempted Due to Medical Condition or Safety Concerns: The transfer was not attempted due to medical conditions or safety concerns.

3. Documentation Requirements:
   Document any notable factors that affect the resident’s ability to perform the transfer, such as environmental setup, safety considerations, or physical limitations. This ensures an accurate representation of the resident’s current functional status and care needs.

4. Consult with the Care Team:
   Engage multiple caregivers to confirm the resident’s level of independence in transferring between a bed and a chair or between two chairs. Consistent feedback across shifts and settings helps ensure accurate coding.

Example Scenario:
Mrs. Thompson can transfer from her bed to a wheelchair but requires minimal physical assistance to stabilize herself during the transition. Based on these observations, code 03 - Partial/Moderate Assistance for GG0170E5 to reflect that Mrs. Thompson can complete over half of the transfer effort but requires some physical help from a caregiver.

Best Practices for Accurate Coding

Observe Consistent Transfer Patterns:
Observe the resident’s transfer performance consistently to determine their regular level of independence or assistance. Daily patterns provide a reliable understanding of their functional ability and inform accurate coding.

Engage the Full Care Team in Observations:
Coordinate with all staff members who assist the resident with transfers to ensure an accurate and comprehensive assessment. Collective input supports consistency in documenting the resident’s abilities and needs.

Provide Training on Assessing Functional Mobility:
Educate staff members on how to assess and document transfer abilities accurately, including recognizing when supervision or physical assistance is needed. Proper training helps enhance safety and supports accurate MDS documentation.

Conclusion

MDS Item GG0170E5 is essential for documenting the resident’s ability to complete a chair/bed-to-chair transfer during the OBRA or interim assessment. Accurate coding of this item helps the care team understand the level of physical assistance the resident needs, plan mobility interventions, and work toward goals that promote independence and safety. Observing and coding this transfer accurately is vital for person-centered care in long-term care settings.

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

Reference

For more detailed guidelines on coding MDS Item GG0170E5, 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 GG, Page 3-47.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item GG0170E5: "Chair/Bed-to-Chair Transfer (OBRA/Interim Performance)" 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