Long-Term Care Survey Alert

Question: I have several residents who have dementia and are not consistent with their responses to the interviews. I was told that if I don’t think a resident can respond to the interview questions I can complete the staff assessment instead. I’m not sure I agree with this direction.

Answer: The only time that his staff assessment can be completed without first attempting to do the interview is when the resident’s MDS indicates the resident is rarely or never understood. If section B0700 “makes self understood” is coded anything but a three, all interviews must be started. If the interview cannot be completed, which is defined in each interview section, a staff assessment is completed.

·         For the BIMS^©: The resident’s inability to respond or the giving of nonsensical responses would result in a summary score of 99, indicating the interview was not completed and a staff assessment must be conducted.

·         For the PHQ-09^©: If the resident is unable to complete this interview as indicated by the frequency of identified symptoms not being coded for three or more items, a staff assessment must be completed.

The assessment for daily and activity preferences can be conducted with family members or significant others. The only time a staff assessment would be needed is when neither the resident nor family/significant other was available to answer the questions in the interview. The guidance directing a staff assessment is that three or more of the items in the interview for daily and activity preferences were not completed.

·         For the pain assessment: A staff interview is required when J0400, pain frequency is coded 9, unable to answer.