0
Always continent
if during the 7-day look-back period the resident has
been continent of bowel on all occasions of bowel movements, without any episodes of
incontinence.
DiraChart MDS item reference
H0400Section Hv1.20.1Manual page H-11
Bowel Continence
Item Rationale
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
Occasionally incontinent
if during the 7-day look-back period the resident was incontinent of stool once. This includes incontinence of any amount of stool day or
night.
2
Frequently incontinent
if during the 7-day look-back period, the resident
was incontinent of bowel more than once, but had at least one continent bowel
movement. This includes incontinence of any amount of stool day or night.
3
Always incontinent
if during the 7-day look-back period, the resident was
incontinent of bowel for all bowel movements and had no continent bowel movements.
9
Not rated
if during the 7-day look-back period the resident had an ostomy or
did not have a bowel movement for the entire 7 days. (Note that these residents should be
checked for fecal impaction and evaluated for constipation.)
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. Review the medical record for bowel records and incontinence flow sheets, nursing
assessments and progress notes, physician history and physical examination.
2. Interview the resident if they are capable of reliably reporting their bowel habits. Speak with
family members or significant other if the resident is unable to report on continence.
3. Ask direct care staff who routinely work with the resident on all shifts about incontinence
episodes.
Coding Instructions
•
Code 0, always continent: if during the 7-day look-back period the resident has
been continent of bowel on all occasions of bowel movements, without any episodes of
incontinence.
•
Code 1, occasionally incontinent: if during the 7-day look-back period the resident
was incontinent of stool once. This includes incontinence of any amount of stool day or
night.
•
Code 2, frequently incontinent: if during the 7-day look-back period, the resident
was incontinent of bowel more than once, but had at least one continent bowel
movement. This includes incontinence of any amount of stool day or night.
•
Code 3, always incontinent: if during the 7-day look-back period, the resident was
incontinent of bowel for all bowel movements and had no continent bowel movements.
•
Code 9, not rated: if during the 7-day look-back period the resident had an ostomy or
did not have a bowel movement for the entire 7 days. (Note that these residents should be
checked for fecal impaction and evaluated for constipation.)
Coding Tips
and Special Populations
•
Bowel incontinence precipitated by loose stools or diarrhea from any cause (including
laxatives) would count as incontinence.
MDS item matrixAssessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
18 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
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Reference details
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