MDS Alert

Answer 1: c) 5 days. The look-back period for items J0300 through J0600 is five days, and you should conduct the pain assessment interview close to the end of the five-day look-back period. Preferably, you should conduct the assessment on the day before or the day of the Assessment Reference Date (ARD) to more accurately capture pain episodes that occurred during the five-day look-back period.

Answer 2: d) All of the above. You should directly ask the resident each item in J0300 through J0600 in the order provided in the MDS. But you should initiate a follow-up discussion with the resident if he seems unsure, because some residents may avoid using the word “pain” and may instead use words like “hurt,” “aching,” or “burning.”

Answer 3: a) 9. If the resident refuses to or cannot answer one of the items, you should code the item as 9 — Unable to answer. For J0600A — Numeric Rating Scale (00-10), you would code 99 if unable to answer.

Answer 4: a) True. Rates of self-reported pain are higher than observed rates, despite some observers’ concerns that residents may not complain and may deny pain. “The regular and objective use of self-report pain scales enhances residents’ willingness to report,” the RAI Manual states.

Answer 5: b) The more frequent of the two. First, help the resident clarify his response by echoing (repeating) his own comment and providing the response options again. If the resident still has difficulty choosing between two of the responses, select the more frequent of the two.

Answer 6: c) Leave it blank. Regardless of whether you use the Numeric Rating Scale (J0600A) or the Verbal Descriptor Scale (J0600B), you should leave the unused scale blank. Also, try to use the same scale for a resident’s successive assessments.

Answer 7: a) 0 — No. Even if the reason a resident says he experienced no pain is that he received pain management interventions that were effective, you should still code item J0300 as 0 — No. Then, skip to item J1100 — Shortness of Breath.