MDS Alert

Don’t jump to conclusions about a resident’s ability to be discharged.

Although completing Q0500 — Return to Community involves basically a “yes” or “no” answer, checking the right box isn’t as simple as it seems. You have more work to do on coding Q0500 if you want to get it right.

In a recent presentation for Quality Insights Delaware, Mary Rodger, RN, BSN outlines the following steps to interview the resident when completing Q0500:

1. Ask the resident if he would like to speak with someone about the possibility of returning to live in the community.
2. Inform the resident that answering “yes” to this item signals his request for more information and will initiate a contact by someone with more information about supports available for living in thecommunity.
3. Explain to the resident that answering “yes” does not commit him to leave the nursing home at a specific time, nor does it ensure that the resident will be able to move back to the community. And inform the resident that answering “no” is also not a permanent commitment.
4. Tell the resident that he can change his decision (about whether he wants to speak with someone) at any time.
5. Explore topics like what returning to the community means, the arrangements and planning that the nursing home can perform, and obtaining family input. You must talk with the resident about these topics before making a referral to the Aging and Disability Resource Center (ADRC). This step also helps the resident clarify his discharge goals and identify important information for the ADRC.

Mistake: Don’t assume that any particular resident is unable to be discharged, Rodger warned. You should code “No” (0) only after you’ve fully explored the resident’s preferences and possible home and community based(HCB) services or options. “Most likely, this will requirebconsultation with community resource experts at the local contact agency (LCA),” she noted.