Complete Guide to MDS 3.0 Section GG: Functional Abilities and Goals

Section GG is one of the most critical—and most frequently miscoded—sections of the MDS 3.0 assessment. Accurate coding directly impacts PDPM reimbursement, care planning, and quality measures. This comprehensive guide will help MDS Coordinators understand the nuances of Section GG and avoid common coding errors.

What is Section GG?

Section GG, "Functional Abilities and Goals," was introduced in MDS 3.0 to capture a resident's self-care and mobility performance. Unlike Section G (which focuses on ADL self-performance), Section GG uses standardized coding that aligns with other post-acute care settings, enabling better care transitions and outcome comparisons.

Section GG Coding Scale

Section GG uses a 6-point scale (plus additional codes) to rate functional performance. Understanding this scale is fundamental to accurate coding:

Code	Description	Clinical Meaning
06	Independent	Resident completes activity by self with no assistance from helper
05	Setup or clean-up assistance	Helper sets up or cleans up; resident completes activity
04	Supervision or touching assistance	Helper provides verbal cues or minimal physical contact
03	Partial/moderate assistance	Helper does less than half the effort; resident does more than half
02	Substantial/maximal assistance	Helper does more than half the effort; resident does less than half
01	Dependent	Helper does all of the effort; resident does none
07	Resident refused	Resident refused to complete the activity
09	Not applicable	Activity was not attempted and resident did not perform
10	Not attempted due to environmental limitations	Physical environment prevents activity
88	Not attempted due to medical condition or safety	Medical contraindication or safety concern

Self-Care Items (GG0130)

Section GG0130 captures self-care activities. Each item should be coded based on what the resident actually does, not what they could do:

GG0130A: Eating

The ability to use suitable utensils to bring food and/or liquid to the mouth and swallow food and/or liquid once the meal is placed before the resident.

• Includes: Bringing food to mouth, chewing, swallowing
• Does NOT include: Meal preparation, cutting meat, opening containers
• Common error: Coding based on setup needs rather than eating performance

GG0130B: Oral Hygiene

The ability to use suitable items to clean teeth. Dentures (if applicable): The ability to insert and remove dentures into and from the mouth, and manage denture soaking and rinsing with use of equipment.

GG0130C: Toileting Hygiene

The ability to maintain perineal hygiene, adjust clothes before and after voiding or having a bowel movement. If managing an ostomy, includes wiping the opening but not managing equipment.

GG0130E: Shower/Bathe Self

The ability to bathe self, including washing, rinsing, and drying self (excludes washing of back and hair). Does not include transferring in/out of tub/shower.

GG0130F: Upper Body Dressing

The ability to dress and undress above the waist; includes fasteners, if applicable.

GG0130G: Lower Body Dressing

The ability to dress and undress below the waist, including fasteners; does not include footwear.

GG0130H: Putting On/Taking Off Footwear

The ability to put on and take off socks and shoes or other footwear that is appropriate for safe mobility; includes fastening and unfastening, if applicable.

Mobility Items (GG0170)

Section GG0170 captures mobility activities. These items are critical for PT and OT PDPM classification.

GG0170A: Roll Left and Right

The ability to roll from lying on back to left and right side, and return to lying on back on the bed.

GG0170B: Sit to Lying

The ability to move from sitting on side of bed to lying flat on the bed.

GG0170C: Lying to Sitting on Side of Bed

The ability to move from lying on the back to sitting on the side of the bed with no back support.

GG0170D: Sit to Stand

The ability to come to a standing position from sitting in a chair, wheelchair, or on the side of the bed.

GG0170E: Chair/Bed-to-Chair Transfer

The ability to transfer to and from a bed to a chair (or wheelchair).

GG0170F: Toilet Transfer

The ability to get on and off a toilet or commode.

GG0170J: Walk 50 Feet with Two Turns

Once standing, the ability to walk at least 50 feet and make two turns.

GG0170K: Walk 150 Feet

Once standing, the ability to walk at least 150 feet in a corridor or similar space.

Common Section GG Coding Errors

Avoid these frequent mistakes that lead to inaccurate assessments and potential compliance issues:

1. Coding Potential vs. Actual Performance

Section GG captures what the resident actually did during the assessment period, not what they could do with encouragement or under ideal conditions. If a resident needed substantial assistance during observed activities, code it as such—even if therapy notes suggest higher capability.

2. Confusing Setup with Supervision

Setup assistance (code 05) means the helper prepares but then leaves. Supervision (code 04) means the helper remains present. If staff stay to monitor, it's supervision, not setup.

3. Inconsistent Documentation

Section GG codes must align with nursing notes, therapy documentation, and CNA records. Discrepancies between MDS coding and clinical documentation are a major audit trigger.

4. Misunderstanding "More Than Half" the Effort

The distinction between codes 02 and 03 is who does more than half the effort. This requires careful observation—not assumptions based on diagnosis.

5. Using 88 (Not Attempted) Inappropriately

Code 88 should only be used when there's a legitimate medical contraindication or safety concern documented. It should not be used simply because the activity wasn't observed.

Section GG Goal Setting

Section GG also requires discharge goal coding. Goals should be:

• Realistic: Based on clinical judgment and resident potential
• Higher than admission: Goals should show expected improvement
• Documented: Supported by therapy evaluations and care plan
• Achievable: Within the expected length of stay

Best Practices for Accurate Section GG Coding

1. Use an Interdisciplinary Approach

Section GG should be completed using input from nursing, therapy, and direct care staff. Don't rely on a single source of information.

2. Observe Multiple Occasions

Code based on what typically occurs, not a single observation. If performance varies, code the most dependent level that occurred at least twice.

3. Document Thoroughly

Support every code with specific documentation. "Resident required moderate assistance for lower body dressing on 3/5 observations" is better than "needs help with dressing."

4. Reconcile with Section G

While Sections G and GG measure different things, they should tell a consistent clinical story. Major discrepancies require explanation.

5. Train All Staff

CNAs and nurses providing direct care must understand Section GG coding so they document accurately. Their notes are your primary source.

Section GG and PDPM Classification

Under PDPM, Section GG scores directly impact reimbursement through the PT, OT, and SLP components. The specific items used are:

• PT Component: GG0170C, GG0170D, GG0170J, GG0170K
• OT Component: GG0130A, GG0170C, GG0170D
• SLP Component: GG0130A (Eating), along with swallowing and cognitive items

Inaccurate coding in these items can result in incorrect PDPM classification, leading to under- or over-payment.

Summary

Section GG is fundamental to accurate MDS assessment, PDPM reimbursement, and quality reporting. Key takeaways:

• Use the 6-point scale consistently based on actual performance
• Distinguish between setup, supervision, and hands-on assistance
• Code what happened, not what could happen
• Support all codes with thorough documentation
• Set realistic discharge goals that show expected improvement
• Use interdisciplinary input for accuracy

Mastering Section GG coding takes practice, but the investment pays off in accurate reimbursement, better care planning, and audit-ready documentation.

Additional Resources

• MDS Genie™ - AI-Powered MDS Assessment Software
• PDPM Reimbursement: 5 Common Classification Mistakes
• How Long Should an MDS Assessment Take?