0
No
if there is no evidence of acute mental status change from the resident’s
baseline.
DiraChart MDS item reference
C1310Section Cv1.20.1Manual page C-29
Signs and Symptoms of Delirium (from CAM©)
Adapted from: Inouye, S.K., et al. Ann Intern Med. 1990; 113: 941–948. Confusion Assessment Method. ©2003, Hospital Elder
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Instruction / group heading
1
Yes
if resident has an alteration in mental status observed in the observation
period that represents an acute change from baseline.
2
Behavior present, fluctuates
if inattention is noted during the interview or any source
reports that the resident had difficulty focusing attention, was easily distracted, or had difficulty
keeping track of what was said AND the inattention
varied during interview or during the look-back period
or if information sources disagree in assessing level of
attention.
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. Observe resident behavior during the BIMS items (C0200–
C0400) for the signs and symptoms of delirium. Some
experts suggest that increasing the frequency of assessment
(as often as daily for new admissions) will improve the
level of detection.
2. If the Staff Assessment for Mental Status items (C0700–
C1000) were completed instead of the BIMS, ask staff
members who conducted the interview about their
observations of signs and symptoms of delirium.
3. Review medical record documentation during the 7-day look-back period to determine the
resident’s baseline status, fluctuations in behavior, and behaviors that might have occurred
during the 7-day look-back period that were not observed during the BIMS.
4. Observe the resident’s behavior during interactions and consult with other staff, family
members/caregivers, and others in a position to observe the resident’s behavior during the 7-
day look-back period.
Additional guidance on the signs and symptoms of delirium can be found in Appendix C.
Coding Instructions
for C1310A, Acute Mental Status Change
•
Code 0, no: if there is no evidence of acute mental status change from the resident’s
baseline.
•
Code 1, yes: if resident has an alteration in mental status observed in the observation
period that represents an acute change from baseline.
Coding Tips
•
Manual page C-29MDS item matrixAssessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
19 relationships6 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
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
Program and Policy Use
D/C Items (Only when A0310F = 10 or 11)
Item Subset Required Use ISC Skip Patterns
Official CMS source
Verify in the CMS Source
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Reference details
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