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ADL CAA

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I have a resident who is totally dependent on staff for the majority of her ADLs. During her BIMS she scored a 3 because she gave sensical answers but they were incorrect. My software is not triggering ADLs because of the BIMS score. Has anyone else run into this problem? We will still address her ADLs in her care plan but I'm trying to figure out why the BIMs score makes a difference in the trigger. Thanks

mdecastronp

Specializes in LTC, Magt, family practice, legal nsg.

Your BIMS score was lower than 5 to trigger ADLs. Although you may need to care plan the ADL need, it does not trigger on the new MDS 3.0 unless your BIMS is at least 5. I quoted below Chap. 4 from RAI. Hope that helps. Goodluck!

The new CAT logic does not trigger ADLs if the following were not met:

1. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for bed mobility was needed as indicated by:

(G0110A1 >= 1 AND G0110A1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

2. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for transfer between surfaces (excluding to/from bath/toilets) was needed as indicated by:

(G0110B1 >= 1 AND G0110B1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

3.Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for walking in his/her room was needed as indicated by:

(G0110C1 >= 1 AND G0110C1

( (C1000 >= 0 AND C1000

C0500 >= 5 AND C0500

4. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for walking in corridor was needed as indicated by:

(G0110D1 >= 1 AND G0110D1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

5. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for locomotion on unit (including with wheel chair, if applicable) was needed as indicated by:

(G0110E1 >= 1 AND G0110E1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

6. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for locomotion off unit (including with wheel chair, if applicable) was needed as indicated by:

(G0110F1 >= 1 AND G0110F1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

7. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for dressing was needed as indicated by:

(G0110G1 >= 1 AND G0110G1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

8. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for eating was needed as indicated by:

(G0110H1 >= 1 AND G0110H1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

9. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for toilet use was needed as indicated by:

(G0110I1 >= 1 AND G0110I1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

10. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary

as indicated by:

(G0110J1 >= 1 AND G0110J1

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

11. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for self-performance bathing (excluding washing of back and hair) has a value of 1 through 4 as indicated by:

(G0120A>= 1 AND G0120A

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

12. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while balance during transition has a value of 1 or 2 for any item as indicated by:

( (G0300A = 1 OR G0300A = 2) OR

(G0300B = 1 OR G0300B = 2) OR

(G0300C = 1 OR G0300C = 2) OR

(G0300D = 1 OR G0300D = 2) OR

(G0300E = 1 OR G0300E = 2) ) AND

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

13. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while resident believes he/she is capable of increased independence as indicated by:

G0900A = 1 AND

( (C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

14. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while direct care staff believe resident is capable of increased independence as indicated by:

G0900B = 1 AND

((C1000 >= 0 AND C1000

(C0500 >= 5 AND C0500

golflinda2214

Specializes in gerontology. Has 40 years experience.

It doesn't trigger because with a BIMS so low, they assume she is not rehab/restorative potential.