How should we code rejection of care for dementia residents?

Q: We are struggling with the question regarding rejection of care with our dementia residents who are resistive to care due to their dementia. Does this question include that type of resistance of care or is it for those who are declining an aspect of care and we’ve worked through education of risk factors, etc?

A: Item E0800, Rejection of Care, does not include behaviors that have already been addressed and/or determined to be consistent with resident values, preferences, or goals. So if “working through” it means that interventions are on the care plan and implemented to accomplish the care, then it would be coded as a “0”, “behavior not exhibited”. You will only code a 1, 2, or 3 for those behaviors that have not been addressed and in which the care being rejected is needed to achieve the resident’s goals for health and well being.

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