Your OASIS-D Cliffs Notes
Another summer is coming to an end, and another CMS regulatory change is looming over us. OASIS-D. I’ve spent the last 14 years scrambling to ensure home health and hospice providers have the resources required to navigate regulatory shifts with as little disruption as possible. That’s also my goal for this OASIS-D transition.
With that in mind, here’s my OASIS-D summary. I hope it can serve as your Cliffs Notes. If you find you need additional insights, don’t hesitate to email me directly.
Without further ado…
As we all remember, less than two years ago we implemented the OASIS-C2 data set. It was developed from OASIS-C1/ICD-10 to accommodate new data being collected for the Home Health Quality Reporting Program in support of the IMPACT Act. The OASIS-C2 data item was approved by the Office of Management and Budget (OMB) December 9, 2016 and was implemented January 1, 2017.
Fast forward to fall 2018. Now we need to get our clinicians ready for the new data set, OASIS-D. The OASIS-D set will be effective for all Medicare Homecare patients January 1, 2019. That’s only approximately 20 short weeks from today.
Are you and your team ready?
Many of the changes will require retraining your team to ensure they understand:
Which questions differ and why. The OASIS-D changes will focus on comparing quality indicators — all in an effort to enable CMS to compare locations of services (Homecare, Skilled Nursing Facilities, Etc.) to one another.
How the questions will impact the time and effort required to document a start of care. The changes include more functional items that will require your clinicians to focus and understand the impact. These questions are historically addressed by the evaluating therapist but will now be included in the nursing assessment. There are new fall history questions that have been added to the data set as well as well as modifications to the pressure ulcer questions, which will require more details to the care of these items.
For quick reference, below you’ll find lists of added and removed questions:
Removed:
M1011-list the diagnoses that actively received treatment in an inpatient facility within the past 14 days
M1017 Diagnoses, Treatment Regimen Change
M1018 Conditions Prior, M1025 Optional Diagnoses
M1034 Overall Status
M1036 Risk Factors,
M1210 Ability to Hear
M1220 Understanding Verbal Content
M1230 Speech and Oral Expression
M1240 Pain Assessment
M1300 Pressure Ulcers Assessment
M1302 Risk of Developing Pressure Ulcers
M1313 Worsening in Pressure Ulcers Status
M1320 Status of Most Problematic Pressure Ulcers
M1350 Skin Lesion or Open Wound
M1410 Respiratory Treatments
M1501 Symptoms in Heart Failure Patients
M1511 Heart Failure Follow-up
M1750 Psychiatric Nursing Services
M1880 Ability to Plan and Prepare Light Meals
M1890 Ability to Use Telephone
M1900 Prior Functioning
M2040 Prior Medication Management
M2110 How Often does the patient receive ADL* or IADL assistance
M2250 Plan of Care Synopsis
M2430 Reason for Hospitalization
M0903 Date of Last Home Visit
Added:
GG0100 Prior Functioning
GG0110 Prior Device Use
GG0130 Self-Care
GG0170 Mobility
J1800 Any Falls
J1900 Number of Falls
The most common related question we receive at MHA is, Will the OASIS-D impact the case mix calculations? For the most part, all of the changes to the data set only impact data collection and do not impact the case mix calculations.
Another note: Careful considerations should be made to add validations to Oasis-to-Oasis questions and Oasis to non-Oasis questions. If not addressed timely, many of the additional questions will add duplicative work for the caregivers and could result in inaccurate data collection.
Next steps
First and foremost, make sure your visiting clinicians, quality assurance teams and performance improvement teams thoroughly understated the changes required to ensure compliance. If you find yourself in need of additional assistance we’re here. (After all, your team members already have jobs to do. Who internally has the time to give this shift the time and attention it requires?)
MHA has many trained experts who can guide you through the training process, assist in forms review and help you complete the required validations to ensure you are collecting timely and accurate information.
If you have any additional questions or would like to learn more about how the MHA team can help with this transition, feel free to reach out to me directly at tom@maxwellhealthcareassociates.com. I hope to hear from you.
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