MDS 3.0: Recommended Form - Ucla - GeroNet

Section O Special Treatments and ProceduresO5. Nursing Rehabilitation/ Restorative CareRecord the number of days each of the following rehabilitative or restorative techniques was administered (for at least 15minutes a day) in the last 7 calendar days (enter 0 if none or less than 15 minutes daily).Numberof Days Techniquea. Range of motion (passive)b. Range of motion (active)c. Splint or brace assistanceNumberof DaysTraining and skill practice in:Numberof Daysd. Bed mobility h. Eating or swallowinge. Transfer i. Amputation/prostheses caref. Walking j. Communicationg. Dressing or groomingO6. Physician ExaminationsDaysOver the last 14 days, on how many days did the physician (or authorized assistant or practitioner) examinethe resident?O7. Physician OrdersDaysOver the last 14 days, on how many days did the physician (or authorized assistant or practitioner) changethe resident’s orders?Section PRestraintsP1. Physical Restraints—Code for last 5 days:Physical restraints are any manual method, physical or mechanical device, material or equipment attached or adjacent to theresident’s body that the individual cannot remove easily, which restricts freedom of movement or normal access to one’sbody.Used in BedEnter Codea. Bed rail (any type; e.g., full, half, one side)Coding:0. Not used1. Used less than daily2. Used daily Enter Codes in Boxes Enter CodeEnter CodeEnter CodeEnter CodeEnter CodeEnter Codeb. Trunk restraintc. Limb restraintd. OtherUsed in Chair or Out of Bede. Trunk restraintf. Limb restraintg. Chair prevents risingEnter Codeh. OtherRecommended MDS 3.0 26