As many clinicians have discovered, it's not always easy to sort out just how much the patient hears and understands, especially at Start of Care, when everything can seem overwhelming. It's even more difficult if the primary language is different from yours. Cognitive deficits are also challenging. This is when you might need to check with a caregiver. Is this the patient's usual ability? Even when you respond to M0400 you'll probably need to describe any specifics in other documentation to corroborate or support findings. Be sure to note if an interpreter was used.