Mds 3.0 Adl Decision Flow Sheet
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1MDS 3.0 ADL Decision Flow Sheet (April 22, 2010)
START HERE
Did the activity occur at least
No
Code 8
1 time?
Activity did
not occur
Yes
Did activity occur 3 or more times?
No
Code 7
Activity
Yes
Occurred only
1 or 2 times
Yes
Did resident fully perform the ADL
Code 0
activity without ANY help or
Independent
oversight from staff every time?
Ø
INSTRUCTIONS
No
Follow the arrows on the flowchart to
determine correct coding, starting at
Yes
Did resident require full staff
the “Did Activity Occur?” box.
Code 4
performance every time?
Total
Dependence
Instructions for Rule 3
No
•
When an activity occurs three times at
Did resident require full staff
any one given level, code that level.
Yes
performance at least 3 times but not
•
When an activity occurs three times at
every time?
Code 3
multiple levels, code the most
Extensive
No
dependent. Exceptions are: total
Assistance
dependence (4) – activity must
Did resident require a combination
require full assist every time; and
of full staff performance and weight
activity did not occur (8) – activity
Yes
bearing assistance 3 or more times?
must not have occurred at all.
Example, three times extensive
No
assistance (3) and three times limited
assistance (2) – code extensive
assistance (3).
Did resident require non-weight
Yes
•
When an activity occurs at more than
bearing assistance 3 or more times?
Code 2
one level but not three times at any
Limited
one level, apply the following:
Assistance
No
-
Episodes of full staff performance
are considered to be weight-
Did resident require a combination
bearing assistance (when every
Yes
of full staff performance/weight
episode is full staff performance -
bearing assistance and non-weight
this is total dependence).
bearing assistance 3 or more times?
-
When there are 3 or more
episodes of a combination of full
No
staff performance and weight-
bearing assistance - code
Did resident require oversight,
Yes
Code 1
extensive assistance (3).
encouragement, or cueing 3 or
Supervision
-
When there are 3 or more
more times?
episodes of a combination of full
staff performance/weight bearing
No
assistance, and non-weight
bearing assistance, code limited
If none of the Rule of 3 conditions
assistance (2).
are met, Code 1 Supervision.
If none of the above are met, code
supervision
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