For other Medicare assessments, the period will be within seven days of the assessment reference date. Residents who are very dependent in their ADL's can be assessed in a shorter time frame than those residents whose ADL performance varies from day to day or who are relatively independent. One important concept of the MDS coding system is that the resident is assessed at their most dependent. A resident who normally was able to propel a wheel chair without assistance asked staff to push them back to their room from the dining because she was short of breath. Staff on all three shifts should provide information to the Registered Nurse concerning the resident's functioning on their particular shift.
Residents are often more dependent late in the day and during the night than during day time hours.
Providing nurse aides with a simple form to complete each shift indicating the level of assistance the resident received during the assessment period would significantly improve the accurate coding of items in this section. Coding Section G accurately requires that the registered nurse understand the operational definitions and apply them correctly. The following is a review of the definitions used to complete Section G. Additional explanatory information is provided in italics and the use of bold print within the MDS definitions. To accurately assess that an individual met the definition for independent in an activity of daily living, the full assessment period may need to be utilized. Medicare 5 day and Medicare Readmission assessments may not cover a 7 day period.