Antipsychotic Medications in the Long Term Care Setting

Posted by LTCS on September 2, 2012

Poison symbol for inappropriate use of antipsychoticsThere are two new measures of antipsychotic medications that will be posted on the Nursing Home Compare (NHC) website beginning July 2012.

The new measures include an incidence measure that assesses the percentage of short-stay residents that are given an antipsychotic medication after admission to the nursing home, and a prevalence measure that assesses the percentage of long-stay residents that are receiving an antipsychotic medication.

The long-stay measure differs from the previous long-stay antipsychotic measure on the CASPER reports.

CMS Report on Antipsychotic Quality Measures

Medication care plans can be found in the book Nursing Care Plans for Long Term Care.

Find policies and procedures for safe medication administration in the book Nursing Policy for Long Term Care.

A complete long term care facility program for medication administration is included in the book Quality Assurance for Long Term Care.

Coding Section E of the MDS 3.0, Behavior

Posted by LTCS on May 16, 2012

Elderly man in home with care provider or survey taker for Activities Care PlansThe intent of section E  of the MDS 3.0  is to assess the presence and frequency of behavioral symptoms and their impact on the resident and others, and to assess the presence of psychosis.

Verbal and physical behaviors are examined as well as their impact on the resident and others.

Social Service care plans and nursing care plans that may be triggered from section E include:

Abusive, Physically

Abusive, Verbally

Hoards Objects

Refuses to Eat / Drink

Resists Care

Socially Inappropriate Behavior


Withdrawal from Care / Activities

Read more about section E of the MDS 3.0, significant changes, care area assessments, quality indicators, RUG IV categories, and skilled charting.

Section E Behavior of the MDS 3.0

Coding Section D of the MDS 3.0, Mood

Posted by LTCS on May 9, 2012

The Intent of section D of the MDS 3.0 is to assess the resident’s perception of his/her mood and psychosocial well-being, to record staff observations of indicators of the resident’s mood and psychosocial well-being, and to identify and immediately protect residents who may be at risk for self-harm.

Resident interview is included in the section.

Social Service care plans and Nursing care plans that might be triggered from section D are:








Social Isolation

Suicidal Ideation

Withdrawal from Care / Activities

Read more about coding this part of the MDS 3.0, and significant change in condition, quality indicators and measures, RUG IV categories, and skilled charting.

Coding Section D Mood of MDS 3.0

Coding Section C of the MDS 3.0, Cognitive Ability

Posted by LTCS on May 2, 2012

Assessing Elderly WomanThe intent of section C of the MDS 3.0 is to determine the resident’s ability to remember, think coherently, and organize daily self-care activities. The focus is on resident performance, including a demonstrated ability to remember recent and long-past events and to perform key decision-making skills.

The section includes the Brief Interview for Mental Status, and examines short term and long term memory and the resident’s ability to make decisions.

Whether or not the resident shows signs of delirium is examined in this section.

Social Service Care Plans that might be generated from section C are:

Cognitive Deficit, Decision-Making Impaired

Cognitive Deficit, Disordered Thinking

Cognitive Deficit, Memory Problem

Read the complete guide to coding section C of the MDS 3.0, including information on care area assessment triggers and RUG IV categories.

Coding Section C Cognitive Patterns of the MDS 3.0