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DiraChart MDS item reference
E0500BSection Ev1.20.1Manual page E-8
Behavioral symptoms interfere with resident care
This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
yes
Manual page E-8Item-specific instructions
Coding Guidance
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Steps for Assessment
1. Consider the previous review of the medical record, staff interviews across all shifts and
disciplines, interviews with others who had close interactions with the resident and previous
observations of the behaviors identified in E0200 for the 7-day look-back period.
2. Code E0500A, E0500B, and E0500C based on all of the behavioral symptoms coded in
E0200.
3. Determine whether those behaviors put the resident at significant risk of physical illness or
injury, whether the behaviors significantly interfered with the resident’s care, and/or whether
the behaviors significantly interfered with the resident’s participation in activities or social
interactions.
Coding Instructions
for E0500A. Did Any of the Identified Symptom(s)
Put the Resident at Significant Risk for Physical Illness or
Injury?
•
Code 0, no: if none of the identified behavioral symptom(s) placed the resident at
clinically significant risk for a physical illness or injury.
•
Code 1, yes: if any of the identified behavioral symptom(s) placed the resident at
clinically significant risk for a physical illness or injury, even if no injury occurred.
E0500: Impact on Resident (cont.)
Coding Instructions for E0500B. Did Any of the Identified Symptom(s)
Significantly Interfere with the Resident’s Care?
•
Code 0, no: if none of the identified behavioral symptom(s) significantly interfered
with the resident’s care.
•
Code 1, yes: if any of the identified behavioral symptom(s) impeded the delivery of
essential medical, nursing, rehabilitative or personal care, including but not limited to
assistance with activities of daily living, such as bathing, dressing, feeding, or toileting.
Coding Instructions for E0500C. Did Any of the Identified Symptom(s)
Significantly Interfere with the Resident’s Participation in
Activities or Social Interactions?
•
Code 0, no: if none of the identified symptom(s) significantly interfered with the
resident’s participation in activities or social interactions.
•
Code 1, yes: if any of the identified behavioral symptom(s) significantly interfered
with or decreased the resident’s participation or caused staff not to include residents in
activities or social interactions.
Coding Tips
and Special Populations
•
For E0500A, code based on whether the risk for physical injury or illness is known to
occur commonly under similar circumstances (i.e., with residents who exhibit similar
behavior in a similar environment). Physical injury is trauma that results in pain or other
distressing physical symptoms, impaired organ function, physical disability, or other
adverse consequences, regardless of the need for medical, surgical, nursing, or
rehabilitative intervention.
•
For E0500B, code if the impact of the resident’s behavior is impeding the delivery of care
to such an extent that necessary or essential care (medical, nursing, rehabilitative or
personal that is required to achieve the resident’s goals for health and well-being) cannot
be received safely, completely, or in a timely way without more than a minimal
accommodation, such as simple change in care routines or environment.
•
For E0500C, code if the impact of the resident’s behavior is limiting or keeping the
resident from engaging in solitary activities or hobbies, joining groups, or attending
programmed activities or having positive social encounters with visitors, other residents,
or staff.
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