QM 11 ADL Decline

Specialties MDS

Published

We are having an issue that I'm sure one of you can set us straight on. Our ADL Decline is through the roof. But we've found out why. We have 2 facliities, one will code let's say 8 of 52 residents for a 10-15% adl decline which is the norm. The other will code as 10 of 10 or 8 of 8. for 100% ADL decline which kills us on the 5 star/qm's.

So, my question is.. Very specifically what causes a person to be in the denominator group for ADL Decline? We have 60-65 long term residents and there seems to be something very simple that we're not coding on the MDS's because 40-50 of these residents aren't being included in the sample group. Any help would be very much appreciated.

andy3k

124 Posts

According to the MDS 3.0 QM Manual, below is the information about the nominator for "MDS 3.0 Measure (#0688): Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay)".

Numerator

Long-stay residents with selected target and prior assessment assessments that indicate the need for help with late-loss Activities of Daily Living (ADLs) has increased when the selected assessments are compared. The four late-loss ADL items are self-performance bed mobility (G0110A1), self-performance transfer (G0110B1), self-performance eating (G0110H1), and self-performance toileting (G0110I1).

An increase is defined as an increase in two or more coding points in one late-loss ADL item or one point increase in coding points in two or more late-loss ADL items. Note that for each of these four ADL items, if the value is equal to [7, 8] on either the target or prior assessment, then recode the item to equal [4] to allow appropriate comparison.

Residents meet the definition of increased need of help with late-loss ADLs if either of the following are true

1. At least two of the following are true (note that in the notation below, [t] refers to the target assessment, and [t-1] refers to the prior assessment):

1. Bed mobility: [Level at target assessment (G0110A1[t]] - [Level at prior assessment (G0110A1[t-1])] > [0], or

2. Transfer: [Level at target assessment (G0110B1[t]] - [Level at prior assessment (G0110B1[t-1])] > [0], or

3. Eating: [Level at target assessment (G0110H1[t]] - [Level at prior assessment (G0110H1[t-1])] > [0], or

4. Toileting: [Level at target assessment (G0110I1[t]] - [Level at prior assessment (G0110I1[t-1])] > [0],

2. At least one of the following is true:

1. Bed mobility: [Level at target assessment (G0110A1[t]] - [Level at prior assessment (G0110A1[t-1])] > [1], or

2. Transfer: [Level at target assessment (G0110B1[t]] - [Level at prior assessment (G0110B1[t-1])] > [1], or

3. Eating: [Level at target assessment (G0110H1[t]] - [Level at prior assessment (G0110H1[t-1])] > [1], or

4. Toileting: [Level at target assessment (G0110I1[t]] - [Level at prior assessment (G0110I1[t-1])] > [1].

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