Important Information on MDS for Residential Care and Adult Family Care Homes

MHCA has received important information from the Case Mix Manager and State RAI Coordinator in Maine regarding coding and scoring of item E1 on the MDS-RCA and MDS-ALS in the State of Maine. Please review the information from the MDS manual that all residential care facilities are required to follow and please consider making the appropriate updates to your software.
Based on the licensing rules and the MDS ALS/RCA Manual, facilities are required to code Section E1 items, based on a 28-day lookback period.  If the coding is found to be incorrect during a case mix quality review audit, the facility is at risk for being placed into sanctions which could result in a financial recoupment of 2%, 5%, or 10% of all MaineCare funds received for a three-month period of time. 
Here is an excerpt from the MDS-ALS/RCA Manual, June 2022

MDS-ALS/RCA Manual, page E-1
E1. Indicators of Depression, Anxiety, Sad Mood
Intent: To record the frequency of indicators observed and reported in the last 28 days (or since admission if less than 28 days), irrespective of the assumed cause of the sign or symptom (behavior). (6/1/17)
The change above was implemented 6/1/17, as noted above. 
MDS-ALS/RCA Manual, page E-3 and E-4
Coding: For each indicator apply one of the following codes based on interactions with and observations of the resident in the last 28 days. Remember to code
regardless of what you believe the cause to be. (3/1/18). For E1o and E1p, there must be documentation in the clinical record to support the coding of E1o and E1p as a clearly noted change. (6/2/22)
CODING: (3/1/18)
0. Indicator exhibited less than one day each week in last 28 days
1. Indicator exhibited one to five days per week during the past 28 days. Behavior must have occurred at least one day every week.
2. Indicator exhibited daily or almost daily (6 to 7 days each week) during the past 28 days or the average of the four weeks is 6.0 or greater.
NOTE: Average is defined as the total of the values for each week in the look back period divided by number of weeks in the look back period.
A screen shot from the E1 Calculator tool has been distributed to all facilities, and is available on our website, is distributed with all trainings and is available on Adobe Connect during the quarterly forum calls.  The instructions clearly define how the facilities are to be coding the E1 Indicators of Depression, Anxiety, and Sad Mood. 
If you have questions, please contact Suzanne Pinette RN, RAC-CT, Case Mix Manager/ State RAI Coordiantor at 207-287-3933 or via email at:
Staff contact: