Home Health & Hospice Week

Warning: M1800 vs. GG items are big risk areas.

If you’re finding the road to OASIS-D implementation bumpy, you’re not alone. But you can take some steps to ease your transition difficulties.

The new assessment tool, in particular the addition of the GG items required by the IMPACT Act to track outcomes across post-acute settings, is adding significantly to OASIS staff’s workload.

Reminder: As of Jan. 1, the Centers for Medicare & Medicaid Services significantly expanded the GG0170 (Mobility) item and added three new GG items, GG0100 (Prior Functioning: Everyday Activities) converting over from the former M1900: Prior Function; GG0110 (Prior Device Use); and GG0130 Self-Care to the OASIS tool. CMS also added items in Section J: Health Conditions, J1800 (Any Falls Since SOC/ROC, whichever is more recent) and J1900 (Number of Falls since SOC/ROC, whichever is more recent).

“The nurses I deal with struggle with the added amount of time it is taking them to assess the patient,” reports consultant Pam Warmack with Clinic Connections in Ruston, Louisiana. “Specifically with the need to ambulate the patient outside to their car, up and down a curb, etc.,” which are GG0170 items.

OASIS-completing staff “have lots of questions about how to complete the Functional Abilities items in the home environment that is most often not conducive to doing so,” Warmack adds.

“Agencies are having particular difficulties with the M1800 items versus GG items,” observes consultant J’non Griffin with Home Health Solutions in Carbon Hill, Alabama. M1800-M1870 cover

Activities of Daily Living ranging from grooming to eating, but often use different measurement parameters than the same or similar items in the GG section.

For example: M1830 (Bathing) “includes getting in and out of the shower/tub, includes washing back, and excludes drying off,” points out Sherri Parson with Quality in Real Time in Floral Park, New York. GG0130E (Self-Care: Shower/bathe self) “excludes getting in and out of shower/tub, excludes washing back, and includes drying off.”

Clinicians try to “apply ADL M question guidance to the GG items,” Parson says. That leads to inaccurate OASIS coding, because “they don’t cross over completely even though the item may appear similar.”

Time drain: Since the M1800 items and the GG items “don’t measure exactly the same thing, agency personnel state it is taking an additional 30 minutes to complete the OASIS,” Griffin tells Eli.

It’s not just the employees completing the OASIS that see additional burden. Agency staff auditing the completed OASIS files “are also struggling to ensure consistency and accuracy between the M1800 items and the new functional items,” Warmack says. “There are, of course, similarities but also significant differences.”