0
No
if the resident shows no signs of constipation during the look-back period.
DiraChart MDS item reference
H0600Section Hv1.20.1Manual page H-14
Bowel Patterns
Item Rationale
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
Yes
if the resident shows signs of constipation during the look-back period.
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 or flow
sheets, nursing assessments and progress notes, physician
history and physical examination to determine if the
resident has had problems with constipation during the 7-
day look-back period.
2. Residents who are capable of reliably reporting their
continence and bowel habits should be interviewed. Speak
with family members or significant others if the resident is
unable to report on bowel habits.
3. Ask direct care staff who routinely work with the resident
on all shifts about problems with constipation.
DEFINITION
CONSTIPATION
If the resident has two or
fewer bowel movements
during the 7-day look-back
period or if for most bowel
movements their stool is hard
and difficult for them to pass
(no matter what the
frequency of bowel
movements).
DEFINITION
FECAL IMPACTION
A large mass of dry, hard
stool that can develop in the
rectum due to chronic
constipation. This mass may
be so hard that the resident is
unable to move it from the
rectum. Watery stool from
higher in the bowel or
irritation from the impaction
may move around the mass
and leak out, causing soiling,
often a sign of a fecal
impaction.
H0600: Bowel Patterns (cont.)
Coding Instructions
•
Code 0, no: if the resident shows no signs of constipation during the look-back period.
•
Code 1, yes: if the resident shows signs of constipation during the look-back period.
Coding Tips
and Special Populations
•
Fecal impaction is caused by chronic constipation. Fecal impaction is not synonymous
with constipation.
SECTION I: ACTIVE DIAGNOSES
Intent: The items in this section are intended to code diseases that have a direct relationship to
the resident’s current functional status, cognitive status, mood or behavior status, medical
treatments, nursing monitoring, or risk of death. One of the important functions of the MDS
assessment is to generate an updated, accurate picture of the resident’s current health status.
MDS item matrixAssessment Applicability
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6 relationships3 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
OBRA Stand Alone Assessments
Program and Policy Use
Official CMS source
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