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.
3 matrix group(s) are already attached for review on this item.
2 governed answer row(s) are attached for this item.
Item Rationale
Use this item when the facility is completing content tied to Section H 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.
Severe constipation can cause abdominal pain, anorexia, vomiting, bowel incontinence, and delirium. If unaddressed, constipation can lead to fecal impaction.
This item identifies residents who may need further evaluation of and intervention on bowel habits. Constipation may be a manifestation of serious conditions such as — dehydration due to a medical condition or inadequate access to and intake of fluid, and — side effects of medications.
1. Review the medical record for bowel records or flow
sheets, nursing assessments and progress notes, physician history and physical examination to determine if the resident has had problems with constipation during the 7- day look-back period.
2. Residents who are capable of reliably reporting their
continence and bowel habits should be interviewed. Speak with family members or significant others if the resident is unable to report on bowel habits.
3. Ask direct care staff who routinely work with the resident
on all shifts about problems with constipation.
CONSTIPATION If the resident has two or fewer bowel movements during the 7-day look-back period or if for most bowel movements their stool is hard and difficult for them to pass (no matter what the frequency of bowel movements).
FECAL IMPACTION A large mass of dry, hard stool that can develop in the rectum due to chronic constipation. This mass may be so hard that the resident is unable to move it from the rectum. Watery stool from higher in the bowel or irritation from the impaction may move around the mass and leak out, causing soiling, often a sign of a fecal impaction.
Code 0, no: if the resident shows no signs of constipation during the look-back period.
Code 1, yes: if the resident shows signs of constipation during the look-back period.
Fecal impaction is caused by chronic constipation. Fecal impaction is not synonymous with constipation. Intent: The items in this section are intended to code diseases that have a direct relationship to the resident’s current functional status, cognitive status, mood or behavior status, medical treatments, nursing monitoring, or risk of death. One of the important functions of the MDS assessment is to generate an updated, accurate picture of the resident’s current health status.