Q:
I have recently been directed, when completing the PHQ-2 to 9, that if a resident acknowledges a symptom, but is unable to give a frequency, I should dash both questions (column 1 and 2). Is this correct?
A:
No, this is incorrect. If a resident answers “yes” to a symptom (column 1), then that column should be coded “yes.” If they are unable, however, to provide a frequency, then column 2 only should be dashed.
Example: A resident says “Yes, I’ve been feeling down,” but when asked “How often?” they cannot say. In this case:
Column 1 = “Yes” (symptom acknowledged)
Column 2 = dash (frequency unknown)
In addition, it is important to note, that the recent update to the RAI manual for October 1, 2025 specifically states, “CMS expects a dash response to be rare” (page D-7). A dash should only be used when all reasonable efforts to obtain the information have been exhausted.
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Written By:
Chris Calo
Clinical Consultant
Proactive LTC Consulting
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