OASIS-Central

Q: If the answer to the depression screening, M1730 is positive and the agency does not have psychiatric services, besides notification to the MD and a referral for MSW, what process should be in place for follow up? Should there be additional screening tools used such as the PHQ-9? Is it the nurse or the MSW that is expected to perform additional screening(s)?

A: For M1730 – Depression Screening, if a home care agency chooses to use the PHQ-2 scale for level-one screening, a response is selected for each row in the scale and the points added together. If the patient scores three points or more, then further evaluation for depression (level-two screening) is indicated, such as the PHQ-9© scale. This screen can identify whether the patient has signs of a minor or major depressive syndrome. An agency’s best practice should define its actions based on the patient’s score. Minor depression may be able to be effectively managed by the home health interdisciplinary team; although major depressive syndrome typically requires more aggressive interventions. This may involve a referral to the agency’s mental health team or psychiatric team, if those services are available, or the patient may need to be referred to resources external to the agency.