CHAPTER 11 | Apply Standards of Nutrition Care & Review Effectiveness of the Nutrition Care Plan


MDS will be developed further into CAAs; this will be discussed later in this chapter. Interventions for the CAAs will then be monitored by the care plan to ensure the ongoing health and safety of the client. The summary in this paragraph paints the picture of how the MDS is the basis for the RAI.


Focusing again on the MDS form, it has key elements that must be accurately documented so they can be coded appropriately. The purpose of coding is essential to capturing any problems or deficits associated with malnutrition. Malnutrition in older adults can cause both an increased risk of illness (morbidity) and increased risk of death (mortality) (Norman et al., 2021). According to Perry et al., “Malnutrition is widespread in those with dementia living in long-term care” (2023). Bellanti et al. (2022) state malnutrition increases the length of stay in hospitalized clients by as much as 40-70 percent, and this results in increased costs and increased risks of complications. Length of Stay (LOS) is negatively impacted by poor nutritional status, with consequent high costs and risk of complications. The RDN/NDTR is trained in completing the nutrition-focused physical exam (NPFE) that assists in revealing hidden signs and symptoms of malnutrition, and will include this in the comprehensive nutrition assessment.


Coding and Section K


The process of coding is the proper method of accurately recording each response in the MDS. Coding tells the story of the client, but it also is linked to payment systems to the facility. There are 20 sections of the MDS form. Section K of the MDS form is the section that focuses on identifying areas of concern regarding swallowing and nutritional status and the client’s ability to maintain adequate nutrition and hydration (CMS, 2023a). Capturing evidence of


Figure 11.1 Overview of the Resident Assessment Instrument (RAI) and Care Area Assessments (CAAs)


301


The MDS forms the foundation of a care plan, identifying issues that evolve into actionable interventions for client safety.


Assessment (MDS)


Decision Making (CAA)


Care Plan Development


Care Plan Implementation


Source: CMS, 2023c Nutrition Fundamentals and Medical Nutrition Therapy


VIEW RESOURCE: Evaluation


Section K Virtual Training


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