A patient is observed to be unable to walk the entire 150 feet, how would we best describe how to accurately code on MDS 3.0 section GG for 1. Admission status 2. Goal status 3. Discharge status?”

Admission status: In this case where resident initiated walking however, the resident was unable to complete the task of ambulating 150. The Admission Status item should be coding as “88”

Not attempted due to medical condition or safety concerns.

However, Harmony Healthcare International (HHI), recommends further investigation of reason for why the resident was unable to walk.  The response to Section GG0170H1 “Does the resident walk?” will assist in assessor response for Goal Status.

Goal Status:  As for the goals please note the gate way question asks the assessor “does the resident walk?”  The purpose of this question is the establish skip criteria.  Section GG0170H1

Does the resident walk?

1. No, and walking goal is not clinically indicated. And then Skip to GG0170Q1, Does the resident use a wheelchair/scooter?

1. No, and walking goal is clinically indicated Code the resident's discharge goal(s) for items GG0170J and GG0170K.

1. Yes, continue to GG0170J Walk 50 feet with two turns.

When the assessor codes 0, “No” this indicates the resident does not walk and a walking goal for discharge is not clinically indicated.  This would likely be the response for a resident who was unable to ambulate prior to the onset of the current illness (perhaps because he is a longstanding double amputee with no prosthetics) In this case the coder is instructed to skip to the question about whether the resident uses a wheelchair.

When the assessor codes 01, “No” this indicates that resident did not ambulate during the assessment period but a discharge goal is appropriate.   In this case the resident may not have ambulated during the initial 3 days of the Medicare stay but based on the prior level of function and assessment it is appropriate to establish as discharge goal.  In this situation the functional assessment area for the two ambulation areas would not be completed but the goal would be coded (based on the instruction to proceed to the discharge goal item)

When the assessor codes 02, “YES” the instructions indicate the assessor should proceed to GG0170J and code the ability to walk 50 feet with two turns

In addition, there are many time when a patient does ambulate for example 10 feet at evaluation but is unable to ambulate 50 feet with two turns or 150 feet in a corridor for whatever reason.   In this case although the resident ambulated and gait was assessed the specific ambulation task coding in section GG “88” but there may be a long term goal for ambulation at discharge established and this long term goal would be coded in section GG

Discharge status is assessed and coded only on the discharge assessment and all items are answered regardless of whether a goal was set for the area.