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MDS 3.0/RUG IV Distance Learning Series March July 2012 ROUTE TO: Administrator; MDS Coordinator; Director of Nursing; Director of Social Services; Director of Activities; Director of Rehabilitation
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How to fill out MDS 30rug IV Distance:

01
Start by obtaining the MDS 30rug IV Distance form. This form is used to record the distance a resident can walk with or without the use of any assistive devices.
02
Begin by providing the necessary identification information of the resident, such as their name, date of birth, and resident ID number. This ensures that the form is correctly associated with the correct individual.
03
Proceed to Section A of the form, which pertains to the resident's self-performance. Here, you will need to assess the resident's walking ability without any assistance.
04
Indicate the exact distance the resident can walk independently. This should be measured in feet or meters.
05
If the resident is unable to walk independently, additional information can be recorded in Section C. This includes details about the type of assistance required, such as the use of a walker or wheelchair.
06
In Section B, document any devices or equipment used by the resident during the assessment. This could include items such as canes, crutches, or orthotics worn by the resident.
07
Moving on to Section D, this is where you will record any particular strategies or modifications in the environment that were employed during the assessment. These may include the use of handrails or ramps.
08
Lastly, sign and date the form to verify its accuracy and completion. This ensures that the information provided is valid and reliable for further assessment or evaluation.

Who needs MDS 30rug IV Distance?

01
Individuals who are residing in healthcare institutions, such as nursing homes, rehabilitation centers, or skilled nursing facilities, may require the completion of the MDS 30rug IV Distance form.
02
Residents who have experienced mobility issues or limitations, whether temporary or long-term, might need an assessment of their walking ability.
03
Healthcare professionals, including physicians, nurses, physical therapists, and occupational therapists, may use this form to determine the resident's functional status and develop appropriate care plans.
04
Insurance providers or government agencies may require the MDS 30rug IV Distance form to assess the resident's eligibility for specific services or benefits.
05
Family members or caregivers involved in the resident's care may also find value in understanding the resident's walking ability and any assistive devices or accommodations required.
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