DiraChart MDS item reference
A1005Section Av1.20.1Manual page A-16
Ethnicity
Item Rationale
Quick codingAnswer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Instruction / group heading
This row introduces a grouped MDS item. Complete the applicable child items shown in the current item set.
Item-specific instructionsCoding Guidance
Review what the item asks, how to choose the response, and what should be verified before submission.
RAI Manual v1.20.1Steps for Assessment
: Interview
Instructions
1. Ask the resident to select the category or categories that most closely correspond to their
ethnicity from the list in A1005.
2. Ethnic category definitions are provided only if requested in order to answer the item.
3. Respondents should be offered the option of selecting one or more ethnic designations.
4. If the resident declines to respond, code Y, Resident declines to respond, and do not code
based on other resources (family, significant other, or guardian/legally authorized
representative or medical records).
5. If the resident is unable to respond, the assessor may ask a family member, significant other,
and/or guardian/legally authorized representative.
6. Only use medical record documentation to code A1005, Ethnicity if the resident is unable to
respond and no family member, significant other, and/or guardian/legally authorized
representative provides a response for this item.
DEFINITION
ETHNICITY
HISPANIC OR LATINO/A
A person of Cuban, Mexican,
Puerto Rican, South or Central
American or other Spanish
culture or origin regardless of
race. The term “Spanish Origin”
can be used in addition to
Hispanic or Latino/a.
A1005: Ethnicity (cont.)
Manual page A-16RAI Manual v1.20.1Coding Instructions
Check all that apply.
•
If the resident provides a response, check the box(es) indicating the ethnic category or
categories identified by the resident.
•
Code X, Resident unable to respond: if the resident is unable to respond.
— In the cases where the resident is unable to respond and the response is determined
via family, significant other, or legally authorized representative input or medical
record documentation, check all boxes that apply, including X. Resident unable to
respond.
— If the resident is unable to respond and no other resources (family, significant other,
or legally authorized representative or medical records) provided the necessary
information, code A1005 as X. Resident unable to respond.
•
Code Y, Resident declines to respond: if the resident declines to respond.
— When the resident declines to respond, code only Y. Resident declines to respond.
— When the resident declines to respond do not code based on other resources (family,
significant other, or legally authorized representative or medical records).
Manual page A-16 MDS item matrixAssessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
16 relationships6 groups+
OBRA Stand Alone Assessments
OBRA Admission A=01, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Quarterly A=02, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Annual / Sig Chg A=03, B=99, F=99, G=^, H=0 A= 04, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Discharge A=99, B=99, F=10, 11, G=1, 2, H=0
MDS Item Matrix v1.20.1 v4
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