MDS 3.0 Section F

MDS 3.0 Section F - Preferences for Customary Routine and Activities: This section combines the previous sections of the MDS 2.0 Customary Routines (Section AC) and (Section N) Activity Pursuit Patterns. The intent is to gain information regarding the patient's preferences for their daily routine and activities. To best accomplish that goal the section is comprised of two interviews. These interviews will provide the facility with patient specific information that will allow an individualized plan for daily care and activity involvement.

Though the patient resides in a nursing home they continue to have the right to a distinct lifestyle and personal preferences. Maintaining the patient's lifestyle in the nursing home setting can enhance dignity, assist in the prevention of depression and assist in the prevention of behavioral symptoms.

The first step for the facility assessor is to determine whether the resident is understood at least sometimes. This is indicated on the MDS 3.0 in Section B, item B0700 = 0,1,2. Next the clinician determines if the resident needs or wants an interpreter.

The first interview is the Interview for Daily Preferences. There are eight questions that pertain to the patient's preferences for clothing, bathing, care of their personal items, snacks, bedtime, and privacy.

The second interview is the Interview for Activity Preferences. There are eight items in this interview that question the importance of things such as reading, music, animals, social interaction, and religious services.

Both interviews are coded on the following scale:

1. Very important.

2. Somewhat important.
3. Not very important.
4. Not important at all.
5. Important, but can't do or no choice.
6. No response or non-responsive.

The interview is conducted by the facility

professional using the suggested language listed in Chapter 3 of MDS 3.0 RAI manual. These responses can be provided verbally or written. It may be beneficial to utilize a cue card with the above scale printed on it so that the patient can point to the most appropriate choice during the interview.

If the patient is not able to complete the interview it is appropriate to interview the patient's family or significant other. The look back for the staff assessment is 7 days. Item F0600 allows for coding of whom provided the answers to the interview. If three or more items were not completed by the resident or family/significant other then the Staff Assessment of Daily and Activity Preferences can be conducted. There are 26 items that can be checked off which apply to the staff's observations across all shifts of the patient's preferences. These range from choosing clothes, receiving a tub bath or shower, use of phone in private, listening to music or participation in religious activities or practices.

April 22, 2010: CMS posted an ADL Decision Flowchart to assist with the completion of the ADL assessment with MDS 3.0. The file is called MDS 3.0 ADL Flowchart April 22, 2010.

Link to CMS page, RAI Manual for MDS 3.0: http://www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp

MDS 3.0 3-Day Intensive Training Course

MAY 11-13
JUNE 22-24
JULY 13-15
AUGUST 23-25
at Harmony University

Includes a Copy of the MDS 3.0 RAI Manual

Call Sue Pellegrini at Ext. 21 for more information or to register.