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.
4 governed answer row(s) are attached for this item.
Item Rationale
Use this item when the facility is completing content tied to Section B 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.
Problems making self understood can be very frustrating for the resident and can contribute to social isolation and mood and behavior disorders. Unaddressed communication problems can be inappropriately mistaken for confusion or cognitive impairment.
Ability to make self understood can be optimized by not rushing the resident, breaking longer questions into parts and waiting for reply, and maintaining eye contact (if appropriate). If a resident has difficulty making self understood: — Identify the underlying cause or causes. — Identify the best methods to facilitate communication for that resident.
MAKES SELF UNDERSTOOD Able to express or communicate requests, needs, opinions, and to conduct social conversation in their primary language, whether in speech, writing, sign language, gestures, or a combination of these. Deficits in the ability to make one’s self understood (expressive communication deficits) can include reduced voice volume and difficulty in producing sounds, or difficulty in finding the right word, making sentences, writing, and/or gesturing.
Assess using the resident’s preferred language or method of communication. Interact with the resident. Be sure they can hear you or have access to their preferred method for communication. If the resident seems unable to communicate, offer alternatives such as writing, pointing, sign language, or using cue cards. Observe their interactions with others in different settings and circumstances. Consult with the primary nurse assistants (over all shifts) and the resident’s family and speech-language pathologist.
Code 0, understood: if the resident expresses requests and ideas clearly.
Code 1, usually understood: if the resident has difficulty communicating some
words or finishing thoughts but is able if prompted or given time. They may have delayed responses or may require some prompting to make self understood.
Code 2, sometimes understood: if the resident has limited ability but is able to
express concrete requests regarding at least basic needs (e.g., food, drink, sleep, toilet).
Code 3, rarely or never understood: if, at best, the resident’s understanding is
limited to staff interpretation of highly individual, resident-specific sounds or body language (e.g., indicated presence of pain or need to toilet).
This item cannot be coded as Rarely/Never Understood if the resident completed any of the resident interviews, as the interviews are conducted during the look-back period for this item and should be factored in when determining the residents’ ability to make self understood during the entire 7-day look-back period. While B0700 and the resident interview items are not directly dependent upon one another, inconsistencies in coding among these items should be evaluated.