MDS Alert

Hint: Don’t include clearing the table after eating as part of clean-up.

The current RAI Manual version provides only one example each under items GG0130 — Self-Care and GG0170 — Mobility for coding 05 — Setup or clean-up assistance. And if this lack of extra clarification has left you feeling a little confused, you’re not alone.

CMS provided several more examples to help illustrate when you should — and should not — code 05 in the Section GG items:

Focus on What the Resident Does

Example 1: For item GG0130B — Oral hygiene, the resident is able to gather supplies for brushing/cleaning dentures. Upon completion of this task, the resident leaves out the toothbrush, toothpaste and denture cup, and does not return them to the bedside dresser or holder. The helper assisted the resident with putting the toothpaste on the toothbrush and opening the denture packet.

How to code: In this scenario, you would code item GG0130B as 05 — Setup or clean-up assistance.

Example 2: The resident goes through the buffet line for breakfast and eats independently but does not clear the table when he’s finished eating.

How to code: In this scenario, you would code GG0130A — Eating as 06 — Independent. “Placing a tray on a table or removing a tray from a table is not included in the eating activity, because this is commonly done by staff in institutional settings,” CMS explains.

But if the resident needed a helper to assist with opening his containers and/or cutting up his meat, for instance, then you would code this as 05.

Ignore Details that Don’t Apply to Oral Hygiene Activity

Example 3: The resident begins to brush his teeth after the helper applies toothpaste onto his toothbrush. He brushes his upper teeth, and then decides to take a break due to fatigue. After a short break, the resident completes the oral hygiene activity by brushing his lower teeth.

How to code: You would code this scenario as 05 for item GG0130B. The helper provided setup assistance when putting toothpaste on the resident’s toothbrush. Although the resident took a break between brushing his upper and lower teeth, he still completed the activity.

Example 4: The nurse provides steadying assistance to the resident as he walks to the bathroom. The nurse applies toothpaste to the resident’s toothbrush, and then the resident brushes his teeth at the sink in the bathroom without physical assistance or supervision. Once the resident is finished brushing his teeth and washing his hands and face, the nurse returns and provides steadying assistance as the resident walks back to his bed.

How to code: You would code this example as 05 for GG0130B. The helper provided setup assistance by putting toothpaste on the toothbrush before the resident brushed his teeth. Here, you wouldn’t consider the assistance that the nurse provided to the resident for getting to or from the bathroom for scoring the oral hygiene activity.