Source anchor
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
Item Rationale
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
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Item Rationale
Use this item when the facility is completing content tied to Section A and needs to stay anchored to v1.20.1.
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.
Standardizing self-reported data collection for ethnicity allows for the comparison of data within and across multiple healthcare settings and is an important step in improving quality of care and health outcomes. These categories are NOT used to determine eligibility for participation in any Federal program.
Instructions 1. Ask the resident to select the category or categories that most closely correspond to their ethnicity from the list in A1005.
2. Ethnic category definitions are provided only if requested in order to answer the item.
3. Respondents should be offered the option of selecting one or more ethnic designations.
4. If the resident declines to respond, code Y, Resident declines to respond, and do not code
based on other resources (family, significant other, or guardian/legally authorized representative or medical records).
5. If the resident is unable to respond, the assessor may ask a family member, significant other,
and/or guardian/legally authorized representative.
6. Only use medical record documentation to code A1005, Ethnicity if the resident is unable to
respond and no family member, significant other, and/or guardian/legally authorized representative provides a response for this item.
ETHNICITY HISPANIC OR LATINO/A A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race. The term “Spanish Origin” can be used in addition to Hispanic or Latino/a.
Check all that apply. If the resident provides a response, check the box(es) indicating the ethnic category or categories identified by the resident. Code X, Resident unable to respond: if the resident is unable to respond. — In the cases where the resident is unable to respond and the response is determined via family, significant other, or legally authorized representative input or medical record documentation, check all boxes that apply, including X. Resident unable to respond. — If the resident is unable to respond and no other resources (family, significant other, or legally authorized representative or medical records) provided the necessary information, code A1005 as X. Resident unable to respond. Code Y, Resident declines to respond: if the resident declines to respond. — When the resident declines to respond, code only Y. Resident declines to respond. — When the resident declines to respond do not code based on other resources (family, significant other, or legally authorized representative or medical records).
1. Resident R is admitted following an acute cerebral vascular accident (CVA) with mental
status changes and is unable to respond to questions regarding their ethnicity. Their spouse informs the nurse that Resident R is Cuban.
Coding: A1005 would be coded as D. Yes, Cuban and X. Resident unable to respond.
Rationale: If Resident R is unable to respond but their family, significant other, or
legally authorized representative provided the response, code both that response and
X. Resident unable to respond.
2. Resident K is admitted following a total hip arthroplasty and declines to respond when asked
their ethnicity.
Coding: A1005, Ethnicity would be coded as Y. Resident declines to respond.
Rationale: If a resident declines to respond to this item, code only Y. Resident declines
to respond. Do not use other resources (family, significant other, or legally authorized representative or medical record documentation) to complete A1005, Ethnicity when a resident declines to respond.