Source anchor
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
Item Rationale
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
6 matrix group(s) are already attached for review on this item.
No governed answer rows are attached yet. Add sub-items to populate the answer-codes view.
Item Rationale
Use this item when the facility is completing content tied to Section N and needs to stay anchored to v1.20.1.
This page is grounded in CMS MDS 3.0 RAI Manual v1.20.1. Review the exact text and locators before treating the item as final reference content.
Insulin is a medication used to treat diabetes mellitus (DM). Individualized meal plans should be created with the resident’s input to ensure appropriate meal intake. Residents are more likely to be compliant with their DM diet if they have input related to food choices.
Orders for insulin may have to change depending on the resident’s condition (e.g., fever or other illness) and/or laboratory results. Ensure that dosage and time of injections take into account meals, activity, etc., based on individualized resident assessment. Monitor for adverse effects of insulin injections (e.g., hypoglycemia). Monitor HbA1c and blood glucose levels to ensure appropriate amounts of insulin are being administered.
1. Review the resident’s medication administration records for the 7-day look-back period (or
since admission/entry or reentry if less than 7 days).
2. Determine if the resident received insulin injections during the look-back period.
3. Determine if the physician (or nurse practitioner, physician assistant, or clinical nurse
specialist if allowable under state licensure laws) changed the resident’s insulin orders during the look-back period.
4. Count the number of days insulin injections were received and/or insulin orders changed.
Enter in Item N0350A, the number of days during the 7-day look-back period (or since admission/entry or reentry if less than 7 days) that insulin injections were received.
Enter in Item N0350B, the number of days during the 7-day look-back period (or since admission/entry or reentry if less than 7 days) that the physician (nurse practitioner, physician assistant, or clinical nurse specialist if allowable under state licensure laws) changed the resident’s insulin orders.
For sliding scale orders: — A sliding scale dosage schedule that is written to cover different dosages depending on lab values does not count as an order change simply because a different dose is administered based on the sliding scale guidelines. — If the sliding scale order is new, discontinued, or is the first sliding scale order for the resident, these days can be counted and coded. For subcutaneous insulin pumps, code only the number of days that the resident actually required a subcutaneous injection to restart the pump.