Section K. Swallowing / Nutritional Status MDS 3.0 By: Shelly Proctor RN, RAC-CT Valley Vista Care. Objectives:. State the intent of Section K. Describe the process for conducting a resident ’ s nutritional assessment. Calculate a resident ’ s weight change correctly.
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Swallowing / Nutritional Status
By: Shelly Proctor RN, RAC-CT
Valley Vista Care
Rationale:Safe swallowing ability can be affected by functional decline and several different disease processes. An alteration in a resident’s ability to swallow can result in choking &/or aspiration which can in turn, increase their risk for malnutrition, dehydration, and aspiration pneumonia.
Check all that apply
Rationale: Diminished nutritional and hydration status can lead to debility that can adversely affect a resident’s health and safety as well as their quality of life.
-Measure resident upon admission in inches.
-Consistent measurements over time.
-If last height recorded was > 1 year,
-Example: 62.5 inches would be
rounded to 63 inches.
-Weigh resident on admission.
-For subsequent assessments, record
weight taken w/in 30 days of the ARD.
-If >30 days, re-weigh.
-Record weight closest to ARD.
5% weight loss in 30 days:
-Determine the resident’s weight closest to 30 days ago & multiply it by 0.95 or 95%. The resulting # represents a 5% loss from the weight 30 days ago. If the resident’s current weight is = to or < than the resulting #, the resident has lost more than 5% of his/her body weight.
10 % weight loss in 180 days
-Determine the resident’s weight closest to 180 days
ago & multiply it by 0.90 or 90%. This # represents a
10% loss from the weight 180 days ago. If the current
weight is = to or < than the #, then the resident has
lost 10% or more body weight.
-At a point closest to 30 days preceding the current
-At a point closest to 180 days preceding the current
This item does NOT consider weight fluctuations
outside of these two time points.
Mathematically round weights before doing the calculation.
How should you code K0300?
How should you code K0300?
Approaches that vary from the “norm” or that rely on alternative methods can diminish one’s sense of dignity & self-worth. They can also diminish pleasure in eating. A resident’s clinical condition may benefit from approaches included here. It is important to work with the resident/family to establish nutritional support goals that balance preference & overall clinical goals.
Complete only if K0500A or K0500B is checked. Otherwise, skip to Section L.
Sunday 500 2,000
Monday 250 2,250
Tuesday 250 2,250
Wednesday 350 2,250
Thursday 500 2,000
Friday 250 2,250
Saturday 350 2,000
6300 / 7 = 900cc/day
* Because 900cc is > than 500cc, you should code 2, 501cc/day or more.
Appendix C, RAI Manual, 3.0 Version, June 2010
CMS MDS 3.0 Information Site