Home Health & Hospice Week

Keep an eye out for a possible delay.

It may be hard to look past the current pandemic, but a significantly revamped OASIS tool will be hitting home health agencies in eight months.

Now HHAs can get a look at the new OASIS-E tool.On March 18, the Centers for Medicare & Medicaid Services posted the draft assessment instrument, noting that it “is not yet final” and that the Office of Management and Budget will have to officially approve the form later this year.

OASIS-E incorporates a number of changes related to cross-setting measures, notes consultant Charlotte Steniger with Qualidigm in Wethersfield, Connecticut.“This is a major revision to the OASIS that further aligns home health with the goals of the 2014 IMPACT Act,” Steniger says.

Recap: CMS will add 22 new standardized patient assessment data element (SPADE) items, some sub-items, and three new OASIS items, the agency confirmed in the home health final rule for 2020 published in the Nov.8, 2019 Federal Register. And CMS will take away one OASIS item on pain. (See details in Eli’s HCW, Vol. XXVIII, No. 41).

Given the final rule information, the draft OASIS-E tool CMS has unveiled doesn’t contain “any real surprises,” judges consultant Sherri Parson with Quality in Real-Time.“So many of the items, as we know, come from the MDS data set” for skilled nursing facilities, Parson points out.

What’s different: “Some of the items we are currently collecting have been revised to make them cross-setting and some items are new,” Steniger summarizes.

A new element will be the inclusion of Social Determinants of Health items like Health Literacy (B1300), Transportation (A1250) and Social Isolation (D0700).

Assessment staff will also have to get used to the fact that the OASIS items no longer will run in numerical order by section, Parson observes. For example, the form goes from M0110 (Episode Timing) to A1250 (Transportation) back to M1000 (Inpatient Discharge Facility).

Agencies should prepare for some serious OASIS training before OASIS-E takes effect. Providers should “be aware of how big a change this is to the OASIS data set,” Parson emphasizes.“HHAs will need to educate staff on assessment techniques and item intent for the new items.”

CMS has yet to issue the OASIS Guidance Manual for OASIS-E, which will contain the Item Intent and Response-Specific Instruction information, Parson points out. After CMS issues that document, HHAs will need to schedule staff education sessions.

“Planning the education and training of the agency’s clinicians is going to be key to a smooth and accurate transition to OASIS-E,” Parson advises.

Get ahead: However, agencies can go ahead and start training on the standardized assessment tools required in some of the new items, Steniger says — namely the Confusion Assessment Method (CAM), the Patient Health Questionnaire-2 to 9 (PHQ-2 to 9), and the Brief Interview for Mental Status (BIMS).

And watch for forthcoming CMS training on the new items, Steniger adds.

Unless: It’s possible CMS may delay the OASIS-E implementation date, depending on the COVID-19 impact, points out Cindy Krafft with Kornetti & Krafft Health Care Solutions.CMS already has delayed skilled nursing facilities’ MDS 3.0 transition, which was scheduled for Oct.1.

Note: The draft tool is at www.cms.gov/files/document/draft-oasis-e-all-items03122020.pdf.