MDS 3.0: Recommended Form - Ucla - GeroNet

Section JHealth ConditionsJ13. Should the Fall History on Admission or Fall History Since Last Assessment be Completed?EnterCodeWhat assessment type are you completing?1. Admission assessment Continue to J14, Fall History2. Follow-up assessment (quarterly or annual) Skip to J15, Any Falls Since Last AssessmentJ14. Fall History on Admission—complete only on admission assessment (A10a = 01)EnterCodea. Did the resident fall one or more times in the 30 days (i.e., month) before admission?0. No1. Yes9. Unable to determineEnterCodeb. Did the resident fall one or more times in the 31–180 days (i.e., 1–6 months) before admission?0. No1. Yes9. Unable to determineEnterCodec. Did the resident have any fracture related to a fall in the 6 months prior to admission?0. No1. Yes9. Unable to determineEnterd. Has the resident fallen since admission to the nursing home?0. No Skip to Section K, SwallowingCode1. Yes Skip to Section K, SwallowingJ15. Any Falls Since Last Assessment—complete on quarterly, annual, or significant change assessments (A10a = 02, 03, or 04)EnterHas the resident had any falls since the last assessment?0. No Skip to Section K, SwallowingCode1. Yes Continue to J16, Number of Falls Since Last AssessmentJ16. Number of Falls Since Last AssessmentCode the number of falls in each category since the last assessment.Coding:0. None1. One2. Two or more Enter Codes in Boxes EnterCodeEnterCodeEnterCodea. No injury—no evidence of any injury is noted on physical assessment by the nurse orprimary care clinician; no complaints of pain or injury by the resident; no change in theresident’s behavior is noted after the fallb. Injury (except major)—skin tears, abrasions, lacerations, superficial bruises,hematomas and sprains; or any fall-related injury that causes the resident to complainof painc. Major injury—bone fractures, joint dislocations, closed head injuries with alteredconsciousness, subdural hematomaRecommended MDS 3.0 20