0
Adequate
if the resident sees fine detail, including regular print in
newspapers/books.
DiraChart MDS item reference
B1000Section Bv1.20.1Manual page B-10
Vision
Item Rationale
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
Impaired
if the resident sees large print, but not regular print in
newspapers/books.
2
Moderately impaired
if the resident has limited vision and is not able to
see newspaper headlines but can identify objects nearby in their environment.
3
Highly impaired
if the resident’s ability to identify objects nearby in their
environment is in question, but the resident’s eye movements appear to be following
objects (especially people walking by).
4
Severely impaired
if the resident has no vision, sees only light, colors or
shapes, or does not appear to follow objects with eyes.
Item-specific instructions
Coding Guidance
Review what the item asks, how to choose the response, and what should be verified before submission.
Steps for Assessment
1. Ask family, caregivers, and/or direct care staff over all shifts, if possible, about the resident’s
usual vision patterns during the 7-day look-back period (e.g., is the resident able to see
newsprint, menus, greeting cards?).
2. Then ask the resident about their visual abilities.
3. Test the accuracy of your findings:
•
Ensure that the resident’s customary visual appliance for close vision is in place (e.g.,
eyeglasses, magnifying glass).
•
Ensure adequate lighting.
•
Ask the resident to look at regular-size print in a book or newspaper. Then ask the
resident to read aloud, starting with larger headlines and ending with the finest, smallest
print. If the resident is unable to read a newspaper, provide material with larger print,
such as a flyer or large textbook.
•
When the resident is unable to read out loud (e.g. due to aphasia, illiteracy), you should
test this by another means such as, but not limited to:
— Substituting numbers or pictures for words that are displayed in the appropriate print
size (regular-size print in a book or newspaper).
Coding Instructions
•
Code 0, adequate: if the resident sees fine detail, including regular print in
newspapers/books.
•
Code 1, impaired: if the resident sees large print, but not regular print in
newspapers/books.
•
Code 2, moderately impaired: if the resident has limited vision and is not able to
see newspaper headlines but can identify objects nearby in their environment.
•
Code 3, highly impaired: if the resident’s ability to identify objects nearby in their
environment is in question, but the resident’s eye movements appear to be following
objects (especially people walking by).
•
Code 4, severely impaired: if the resident has no vision, sees only light, colors or
shapes, or does not appear to follow objects with eyes.
Coding Tips
and Special Populations
•
Some residents have never learned to read or are unable to read English. In such cases,
ask the resident to read numbers, such as dates or page numbers, or to name items in
small pictures. Be sure to display this information in two sizes (equivalent to regular and
large print).
B1000: Vision (cont.)
•
If the resident is unable to communicate or follow your directions for testing vision,
observe the resident’s eye movements to see if their eyes seem to follow movement of
objects or people. Though these are gross measures of visual acuity, they may assist you
in assessing whether or not the resident has any visual ability. For residents who appear
to do this, code 3, highly impaired.
MDS item matrixAssessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
12 relationships5 groups+
Assessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
Nursing Home Subsets
Swing Bed Subsets
OBRA Stand Alone Assessments
Program and Policy Use
Item Subset Required Use ISC Skip Patterns
Official CMS source
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Reference details
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