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DiraChart MDS item reference
P0200ESection Pv1.20.1Manual page P-9
Wander/elopement alarm
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
used less than daily
Manual page P-92
used daily
Manual page P-9Item-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. Review the resident’s medical record (e.g., physician orders, nurses’ notes, nursing assistant
documentation) to determine if alarms were used during the 7-day look-back period.
2. Consult the nursing staff to determine the resident’s cognitive and physical status/limitations.
3. Evaluate whether the alarm affects the resident’s freedom of movement when the
alarm/device is in place. For example, does the resident avoid standing up or repositioning
themself due to fear of setting off the alarm?
Coding Instructions
Identify all alarms that were used at any time (day or night) during the 7-day look-back period.
After determining whether or not an item listed in P0200 was used during the 7-day look-back
period, code the frequency of use:
•
Code 0, not used: if the device was not used during the 7-day look-back period.
•
Code 1, used less than daily: if the device was used less than daily.
•
Code 2, used daily: if the device was used on a daily basis during the look-back
period.
Coding Tips
•
Bed alarm includes devices such as a sensor pad placed on the bed or a device that clips
to the resident’s clothing.
•
Chair alarm includes devices such as a sensor pad placed on the chair or wheelchair or a
device that clips to the resident’s clothing.
•
Floor mat alarm includes devices such as a sensor pad placed on the floor beside the
bed.
•
Motion sensor alarm includes infrared beam motion detectors.
P0200: Alarms (cont.)
•
Wander/elopement alarm includes devices such as bracelets, pins/buttons worn on the
resident’s clothing, sensors in shoes, or building/unit exit sensors worn by/attached to the
resident that activate an alarm and/or alert the staff when the resident nears or exits a
specific area or the building. This includes devices that are attached to the resident’s
assistive device (e.g., walker, wheelchair, cane) or other belongings.
•
Other alarm includes devices such as alarms on the resident’s bathroom and/or bedroom
door, toilet seat alarms, or seatbelt alarms.
•
Code any type of alarm, audible or inaudible, used during the look-back period in this
section.
•
If an alarm meets the criteria as a restraint, code the alarm use in both P0100, Physical
Restraints, and P0200, Alarms.
•
Motion sensors and wrist sensors worn by the resident to track the resident’s sleep
patterns should not be coded in this section.
•
Wandering is random or repetitive locomotion. This movement may be goal-directed
(e.g., the resident appears to be searching for something such as an exit) or may be non-
goal directed or aimless. Non-goal directed wandering requires a response in a manner
that addresses both safety issues and an evaluation to identify root causes to the degree
possible.
•
While wander, door, or building alarms can help monitor a resident’s activities, staff must
be vigilant in order to respond to them in a timely manner. Alarms do not replace
necessary supervision.
•
Bracelets or devices worn by or attached to the resident and/or their belongings that
signal a door to lock when the resident approaches should be coded in P0200E
Wander/elopement alarm, whether or not the device activates a sound or alerts the staff.
•
Do not code a universal building exit alarm applied to an exit door that is intended to
alert staff when anyone (including visitors or staff members) exits the door.
•
When determining whether the use of an alarm also meets the criteria of a restraint, refer
to the section “Determination of the Use of Position Change Alarms as Restraints” of
F604 in Appendix PP of the State Operations Manual available at
https://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf.
SECTION Q: PARTICIPATION IN ASSESSMENT AND GOAL
SETTING
Intent: Interviewing the resident or designated individuals places the resident or their family at
the center of decision-making. The items in this section are intended to record the participation
and expectations of the resident, family members, or significant other(s) in the assessment, and to
understand the resident’s overall goals. Discharge planning follow-up is already a regulatory
requirement (CFR 483.21(c)(1)). Section Q of the MDS uses a person-centered approach to
ensure that all individuals have the opportunity to learn about home- and community-based
services and to receive long term care in the least restrictive setting possible. This may not be a
nursing home. This is also a civil right for all residents.
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