Long-Term Care

Coding G0110: Activities of Daily Living (ADL) Assistance

MDS 3.0 Insider, May 2, 2011

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Coding ADLs on the MDS can be quite tricky. Fortunately, the RAI User’s Manual provides some very comprehensive guidance to help you ensure accurate ADL coding. When coding G0100, ADL Assistance, do the following for each activity:

  • Consider each episode of the activity that occurred during the seven-day look-back period.
  • In order to be able to promote the highest level of functioning among residents, clinical staff must first identify what the resident actually does for himself or herself, noting when assistance is received and clarifying the types of assistance provided (verbal cueing, physical support, etc.).
  • Code based on the resident’s level of assistance when using special adaptive devices such as a walker, device to assist with donning socks, dressing stick, long-handle reacher, or adaptive eating utensils.
  • A resident’s ADL self-performance may vary from day to day, shift to shift, or within shifts. There are many possible reasons for these variations, including mood, medical condition, relationship issues (e.g., willing to perform for a nursing assistant that he or she likes), and medications. The responsibility of the person completing the assessment, therefore, is to capture the total picture of the resident’s ADL self-performance over the seven-day period, 24 hours a day (i.e., not only how the evaluating clinician sees the resident, but how the resident performs on other shifts as well).
  • The ADL self-performance coding options are intended to reflect real world situations where slight variations in self-performance are common.
  • Although it is not necessary to know the actual number of times the activity occurred, it is necessary to know whether or not the activity occurred three or more times within the last seven days.
  • Because this section involves a two-part evaluation (ADL Self-Performance and ADL Support), each using its own scale, it is recommended that the Self-Performance evaluation be completed for all ADL activities before beginning the ADL Support evaluation. 

For more in-depth guidance on MDS 3.0 coding and processes, attend our MDS 3.0 Boot Camp. The MDS 3.0 Boot Camp is an intensive training program that focuses on accurate completion of the new MDS 3.0 assessment and links the assessment process to clinical standards of care, quality outcomes, and reimbursement.

Using a combination of lecture, class discussion, and exercises, this intensive, four-day course gives you:

  • Section-by-section guidance on MDS 3.0 completion
  • A system-wide approach to improving accuracy and the bottom line
  • Advice on how to use internal data, time management techniques, and internal review processes to reduce error rates
  • A method to benchmark the MDS process based on outcomes

For more information about our MDS 3.0 Boot Camp, download the brochure or call our customer service team at 800/780-0584.

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