Source anchor
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
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MDS Lookup
Wandering—Impact
Answer this item only if E0900, Wandering—Presence & Frequency, was coded 1 (behavior of
Matrix review
2 matrix group(s) are already attached for review on this item.
Answer coverage
2 governed answer row(s) are attached for this item.
Answer Codes
Code 0
No
if wandering does not place the resident at significant risk.
Code 1
Yes
if the wandering places the resident at significant risk of getting to a dangerous place (e.g., wandering outside the facility where there...
What this item is
Answer this item only if E0900, Wandering—Presence & Frequency, was coded 1 (behavior of
When to use it
Use this item when the facility is completing content tied to Section E and needs to stay anchored to v1.20.1.
Reminders
- Current source status: Published.
- Item locator: Manual page E-20
- CMS exact locator: Manual page E-20
- This item has 2 governed answer row(s) attached.
Source awareness
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.
Source & Review
Manual
CMS MDS 3.0 RAI Manual v1.20.1
Status
Published
Effective start
2025-10-01
Item locator
Manual page E-20
CMS exact locator
Manual page E-20
Full CMS Text
Answer this item only if E0900, Wandering—Presence & Frequency, was coded 1 (behavior of this type occurred 1-3 days), 2 (behavior of this type occurred 4-6 days, but less than daily), or 3 (behavior of this type occurred daily).
Item Rationale
Health-related Quality of Life
Not all wandering is harmful. Some residents who wander are at potentially higher risk for entering an unsafe situation. Some residents who wander can cause significant disruption to other residents.
Planning for Care
Care plans should consider the impact of wandering on resident safety and disruption to others. Care planning should be focused on minimizing these issues. Determine the need for environmental modifications (door alarms, door barriers, etc.) that enhance resident safety if wandering places the resident at risk. Determine when wandering requires interventions to reduce unwanted intrusions on other residents or disruption of the living environment.
Steps for Assessment
1. Consider the previous review of the resident’s wandering behaviors identified in E0900 for
the 7-day look-back period.
2. Determine whether those behaviors put the resident at significant risk of getting into
potentially dangerous places and/or whether wandering significantly intrudes on the privacy or activities of others based on clinical judgment for the individual resident. Coding Instructions for E1000A. Does the Wandering Place the Resident at Significant Risk of Getting to a Potentially Dangerous Place?
Code 0, no: if wandering does not place the resident at significant risk.
Code 1, yes: if the wandering places the resident at significant risk of getting to a
dangerous place (e.g., wandering outside the facility where there is heavy traffic) or encountering a dangerous situation (e.g., wandering into the room of another resident with dementia who is known to become physically aggressive toward intruders). Coding Instructions for E1000B. Does the Wandering Significantly Intrude on the Privacy or Activities of Others?
Code 0, no: if the wandering does not intrude on the privacy or activity of others.
Code 1, yes: if the wandering intrudes on the privacy or activities of others (i.e., if the
wandering violates other residents’ privacy or interrupts other residents’ performance of activities of daily living or limits engagement in or enjoyment of social or recreational activities), whether or not the other resident complains or communicates displeasure or annoyance.
Examples
1. A resident wanders away from the nursing home in their pajamas at 3 a.m. When staff
members talk to them, they insist they looking for their spouse. This elopement behavior had occurred when they were living at home, and on one occasion they became lost and were missing for 3 days, leading their family to choose nursing home admission for their personal safety.
Coding: E1000A would be coded 1, yes.
Rationale: Wandering that results in elopement from the nursing home places the
resident at significant risk of getting into a dangerous situation.
2. A resident wanders away from the nursing facility at 7 a.m. Staff find them crossing a busy
street against a red light. When staff try to persuade them to return, they become angry and say, “My boss called, and I have to get to the office.” When staff remind them that they have been retired for many years, they continue to insist that they must get to work.
Coding: E1000A would be coded 1, yes.
Rationale: This resident’s wandering is associated with elopement from the nursing
home and into a dangerous traffic situation. Therefore, this is coded as placing the resident at significant risk of getting to a place that poses a danger. In addition, delusions would be checked in item E0100.
3. A resident propels themself in their wheelchair into the room of another resident, blocking
the door to the other resident’s bathroom.
Coding: E1000B would be coded 1, yes.
Rationale: Moving about in this manner with the use of a wheelchair meets the
definition of wandering, and the resident has intruded on the privacy of another resident and has interfered with that resident’s ability to use the bathroom.
Matrix Applicability
Nursing Home Subsets
NC - Comprehensive
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
NQ - Quarterly
Marker: s
state optional
Locator: MDS Item Matrix v1.20.1 v4
NP - PPS 5 Day
Marker: s
state optional
Locator: MDS Item Matrix v1.20.1 v4
OBRA Stand Alone Assessments
OBRA Admission A=01, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Annual / Sig Chg A=03, B=99, F=99, G=^, H=0 A= 04, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4