MDS section G

[MDSinNE]

Can someone clarify how you code section G personal hygiene on the MDS? If a resident is independent in all aspects of the personal hygiene but requires full staff assistance to do pericare each shift each day, how is that coded? Thanks!

[jkaee]

When I was an RNAC I always coded the patient based on the most care that he/she needed during any given "activity". I think I would code this as min assist of one, since the resident can do the majority of the acitvity of personal hygiene but needs assist with her peri area. You must have the documentation to support this, though. The staff can't write in the NN that she's independent with hygiene or needs set up help only, but then reports that they wash her peri area. The documentation needs to reflect exactly what she does independently and what she needs assist with.

I would not code it as dependent on staff because she can do a lot for herself, but just needs assist with hard to reach areas. Your MDS guidebook may give examples on how to code certain situations.

[MDSinNE]

Thanks so much for the info!

When I was an RNAC I always coded the patient based on the most care that he/she needed during any given "activity". I think I would code this as min assist of one, since the resident can do the majority of the acitvity of personal hygiene but needs assist with her peri area. You must have the documentation to support this, though. The staff can't write in the NN that she's independent with hygiene or needs set up help only, but then reports that they wash her peri area. The documentation needs to reflect exactly what she does independently and what she needs assist with.

I would not code it as dependent on staff because she can do a lot for herself, but just needs assist with hard to reach areas. Your MDS guidebook may give examples on how to code certain situations.

[Talino]

Extensive Assistance.

A combination of activities complete Personal Hygiene. So even though the Full staff performance was only provided in one area of these activities, and Independent on the rest, you will still need to code this as Extensive Assistance.

You can also refer to examples on the RAI Manual, p. 3-100.

[FrazzledRN]

I also would code that as extensive assist due to staff performance is required to complete the activity on a daily basis. :)

[jkaee]

I stand corrected.....it's been many years since my RNAC days!! :)

But....if the resident can do SOME of the washing of the peri area herself, but just needs staff assist for getting it completely clean and dried, would that still be considered extensive assist or min assist? Just for my own future reference......

[Talino]

Hi jkaee... don't feel bad. Even CMS themselves can't get everything methodic, another MDS updates are coming out on Thurs., April 22nd.

But....if the resident can do SOME of the washing of the peri area herself, but just needs staff assist for getting it completely clean and dried, would that still be considered extensive assist or min assist?

For MDS coding purposes, the objective is to identify the resident's ability to complete a task (including subtasks). Since perineal care cannot be completed w/o staff intervention, it can either be considered Limited or Extensive depending on the "frequency" the staff provided physical assist to complete the task.

You are right in documenting where and what type of help is required.

[ADON132]

I Would Code It As Extensive Assist Because The Resident Requires Assist At Least 3 Times During Last 7 Days.hope This Helps.

[CapeCodMermaid, RN]

Hmmmm...don't y'all include pericare under BATHING? We consider personal hygiene teeth brushing and hair combing. Hope I haven't been doing it wrong all these years.

But, given the number of days she needs help, and if the staff performed ALL the activity 3 or more days a week, I would code it a max assist.

[snikodym]

You code to the highest assistance required and if this resident requires one person assist to do the pericare then you code a 2 under the ADL support provided and under the self-performance it would depend if the resident did any of the actual procedure themselves or if the staff person did it all.

Can someone clarify how you code section G personal hygiene on the MDS? If a resident is independent in all aspects of the personal hygiene but requires full staff assistance to do pericare each shift each day, how is that coded? Thanks!

[CapeCodMermaid, RN]

OOOPS....just looked at the small print on the MDS and the peri-area isn't included in a bath...don't you think that's odd?