Source anchor
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
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MDS Lookup
Weight Gain
Item Rationale
Matrix review
4 matrix group(s) are already attached for review on this item.
Answer coverage
3 governed answer row(s) are attached for this item.
Answer Codes
Code 0
No or unknown
if the resident has not experienced weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days or if information abo...
Code 1
Yes on physician-prescribed weight-gain regimen
if the resident has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain wa...
Code 2
Yes, not on physician-prescribed weight-gain regimen
if the resident has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain wa...
What this item is
Item Rationale
When to use it
Use this item when the facility is completing content tied to Section K and needs to stay anchored to v1.20.1.
Reminders
- Current source status: Published.
- Item locator: Manual page K-9
- CMS exact locator: Manual page K-9
- This item has 3 governed answer row(s) attached.
Source awareness
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.
Source & Review
Manual
CMS MDS 3.0 RAI Manual v1.20.1
Status
Published
Effective start
2025-10-01
Item locator
Manual page K-9
CMS exact locator
Manual page K-9
Full CMS Text
Item Rationale
Health-related Quality of Life
Weight gain can result in debility and adversely affect health, safety, and quality of life.
Planning for Care
Weight gain may be an important indicator of a change in the resident’s health status or environment. If significant weight gain is noted, the interdisciplinary team should review for possible causes of changed intake, changed caloric need, change in medication (e.g., steroidals), or changed fluid volume status. Weight should be monitored on a continuing basis; weight gain should be assessed and care planned at the time of detection and not delayed until the next MDS assessment.
Steps for Assessment
This item compares the resident’s weight in the current observation period with their weight at two snapshots in time: At a point closest to 30 days preceding the current weight. At a point closest to 180 days preceding the current weight. The resident’s weight captured closest to these two time points are the only two weights considered for this item, but the resident’s weight should be monitored on a continual basis and weight gain assessed and addressed on the care plan as necessary. For a New Admission 1. Ask the resident, family, or significant other about weight gain over the past 30 and 180 days.
2. Consult the resident’s physician, review transfer documentation, and compare with admission
weight.
3. If the admission weight is more than the previous weight, calculate the percentage of weight
gain.
4. Complete the same process to determine and calculate weight gain comparing the admission
weight to the weight 30 and 180 days ago.
DEFINITIONS
5% WEIGHT GAIN IN 30 DAYS Start with the resident’s weight closest to 30 days ago and multiply it by 1.05 (or 105%). The resulting figure represents a 5% gain from the weight 30 days ago. If the resident’s current weight is equal to or more than the resulting figure, the resident has gained more than 5% body weight. 10% WEIGHT GAIN IN 180 DAYS Start with the resident’s weight closest to 180 days ago and multiply it by 1.10 (or 110%). The resulting figure represents a 10% gain from the weight 180 days ago. If the resident’s current weight is equal to or more than the resulting figure, the resident has gained more than 10% body weight. For Subsequent Assessments 1. From the medical record, compare the resident’s weight in the current observation period to their weight in the observation period 30 days ago.
2. If the current weight is more than the weight in the observation period 30 days ago, calculate
the percentage of weight gain.
3. From the medical record, compare the resident’s weight in the current observation period to
their weight in the observation period 180 days ago.
4. If the current weight is more than the weight in the observation period 180 days ago,
calculate the percentage of weight gain. Weight Comparison Examples *Weight as determined in item K0200B. Based on an ARD of 10/15/25.
Coding Instructions
Mathematically round weights as described in Section K0200B before completing the weight gain calculation.
Code 0, no or unknown: if the resident has not experienced weight gain of 5% or
more in the past 30 days or 10% or more in the last 180 days or if information about prior weight is not available.
Code 1, yes on physician-prescribed weight-gain regimen: if the resident
has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain was planned and pursuant to a physician’s order. In cases where a resident has a weight gain of 5% or more in 30 days or 10% or more in 180 days as a result of any physician ordered diet plan, K0310 can be coded as 1.
Code 2, yes, not on physician-prescribed weight-gain regimen: if the
resident has experienced a weight gain of 5% or more in the past 30 days or 10% or more in the last 180 days, and the weight gain was not planned and prescribed by a physician.
Coding Tips
A resident may experience weight variances in between the snapshot time periods. Although these require follow up at the time, they are not captured on the MDS. In cases in which multiple weights for the resident may exist during the time period being evaluated, select the weight on the date closest to the appropriate time point. If the resident is gaining a significant amount of weight, the facility should not wait for the 30- or 180-day timeframe to address the problem. Weight changes of 5% in 1 month, 7.5% in 3 months, or 10% in 6 months should prompt a thorough assessment of the resident’s nutritional status. To code K0310 as 1, yes, the expressed goal of the weight gain diet must be documented.
Matrix Applicability
Nursing Home Subsets
NC - Comprehensive
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
NQ - Quarterly
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
ND - Discharge
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
NP - PPS 5 Day
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
Swing Bed Subsets
SP - PPS 5 Day
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
SD - Discharge
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Stand Alone Assessments
OBRA Admission A=01, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Quarterly A=02, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Annual / Sig Chg A=03, B=99, F=99, G=^, H=0 A= 04, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Discharge A=99, B=99, F=10, 11, G=1, 2, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
D/C Items (Only when A0310F = 10 or 11)
A0310G=1 PDC
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
A0310G=2 UPD
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4