MDS Alert

The RAI User's Manual provides these coding examples.

Look for decline in two or more of the following areas,which could signify a significant change:

o Resident's decision-making changes from 0 or 1 to 2 or 3 for Item B4;

o Emergence of sad or anxious mood pattern as a problem that is not easily altered (Item E2);

o Increase in the number of areas where behavioral symptoms are coded as "not easily altered" (i.e., an increase in the number of code "1"s for Item E4B);

o Any decline in an ADL physical functioning area where a resident is newly coded as 3, 4, or 8 (Extensive assistance, Total dependency, Activity did not occur) for Item G1A;

o Resident's incontinence pattern changes from 0 or 1 to 2, 3 or 4 (Item H1a or b), or there was placement of an indwelling catheter (Item H3d);

o Emergence of unplanned weight loss problem (5 percent change in 30 days or 10 percent change in 180 days) (Item K3a);

o Emergence of a pressure ulcer at Stage II or higher, when no pressure ulcers were previously present at Stage II or higher (Item M2a);

o Resident begins to use trunk restraint or a chair that prevents rising when it was not used before (Items P4c and e);

o Overall deterioration of resident's condition; resident receives more support (e.g., in ADLs or decision-making) (Item Q2 = 2);

o Emergence of a condition or disease in which a resident is judged to be unstable (Item J5a).