Home Health & Hospice Week

Get ready for a drastically revised assessment tool -- sooner than you think.

Home health agencies will be one step closer to a significantly revamped OASIS tool in October.

Field testing of the new assessment tool was scheduled to wrap up in August, Debbie Terkay of the Centers for Medicare & Medicaid Services said at the most recent Open Door Forum for home care (see Eli’s HCW, Vol. XVII, No. 30, p. 235).

Following the testing, CMS will conduct data analysis, testing, and interviews with the pilot agencies to refine the data set -- and then they’ll turn those results over to you, says Linda Krulish of Redmond, WA-based OASIS Answers and the OA-SIS Certificate & Competency Board. CMS plans to open the public comment period next month.

Background: CMS released the test version of the OASIS-C in the Oct. 19, 2007 Federal Regi-ster. The changes from the current OASIS data set included the addition of 30 process-based measures on items such as prevention programs and vaccinations. Pilot testing of the new format began in May.

Upside: While the final data set isn’t out yet, experts are certain that the new tool will swap the "more cumbersome and less useful questions" with more meaningful approaches, says Chicago-based regulatory consultant Rebecca Friedman Zuber. For instance, rather than listing columns for ADL and IADL, the new tool will ask agencies to determine patients’ level of functioning prior to the current episode of care, she shares with Eli.

Also, rather than asking patients about vaccinations, falls or depression, the revised "OASIS-C will check whether the patient was assessed and what came of that assessment," Zuber says.

Downside: HHAs hoping for a reduced as-sessment burden may be disappointed, warns Chapel Hill, NC-based Judy Adams of LarsonAllen. "The new tool has the potential to add considerably to the time you’ll need to complete the assessments," she warns providers.

Agencies must thoroughly review and provide feedback on the new data set because the final assessment tool promises to have items that are "quite different than the ones we’re using," Krulish points out. Providers and home health experts have insight that CMS wants and needs -- and this is the best opportunity to ask questions, make suggestions and help to guide the process, she says.

Provider input is so critical that the OCCB is devoting its annual November conference to OASIS-C education, Krulish reveals to Eli. For example, the conference will provide structured work groups to help providers develop and submit comments, and CMS representatives will be on hand to outline the public comment process.

Bottom line: Speak up with your thoughts, experience -- and any sticking points -- because "you’ll be expected to implement this tool," which may be an easier transition if you are familiar with the changes through your involvement in the refinement process, Krulish asserts.

After the public comment period, CMS will submit any new quality measures to the National Quality Forum for endorsement, Terkay said. Agencies will begin using the new OASIS document by January 2010 if all goes as planned.