Home Health & Hospice Week

New OASIS-C1 M0 items on wounds, vaccinations, and synopses are among those with much-anticipated revisions.

You won’t see revisions to the diagnosis coding items when the modified OASIS-C1 takes effect in the new year, but you will still see plenty of other welcome changes.

Wording changes in 44 OASIS items aim to make the language clearer. Expect more straightforward directions and response options and more specific data collection periods. You can also say goodbye to confusing abbreviations, as “for example” replaces “e.g.” and “specifically” takes the place of “i.e.” throughout the OASIS.

CMS also revised many response items to be consistent with information contained in the OASIS-C Guidance Manual.

Despite the hassle of changing OASIS tools, here are some item changes many home health agencies will welcome with open arms:

• Pressure ulcers. CMS has revamped the pressure ulcer item M1308 (see related story, p. 148). And CMS is eliminating M1310, M1312, and M1314 which report the length, width, and depth of the pressure ulcer with the largest surface dimension. The intent of these items was to show whether a pressure ulcer improved, but they didn’t always track the same ulcer from one OASIS to the next, so the items weren’t as useful as hoped, said OASIS expert Judy Adams with Adams Home Care Consulting in Asheville, N.C. in an Eli-sponsored audioconference on the changes.

“I think they have finally found a way to make the integumentary status questions work,” praises Chicago-based regulatory consultant Rebecca Friedman Zuber. “It has been a long and confusing slog, but finally they have clarity and make intuitive sense.”

• Other wound items. Taking out the newly epithelialized option in M1334 is very helpful, Selman-Holman cheers (see related story, p. 149).
These ulcers are no longer reported once epithelialized, so the option ‘0’ for newly epithelialized did not make much sense, say OASIS experts.

• Vaccination items. CMS also renumbers vaccine items M1040-M1055 as M1041-M1056. The agency reorganizes vaccination information to de-emphasize where the patient received the vaccine.

“The improved question M1041 replacing M1040 should really be helpful to HHAs since many people were confused about how to answer that question,” Adams says. The new wording, “Does this episode of care (SOC/ROC to Transfer/Discharge) include any dates on or between October 1 and March 31?” should “play a role in raising the rates” on the flu process item, Adams tells Eli. Changes to M1051, replacing M1050 will likely have a similar impact on the accuracy of the pneumonia vaccine data and process measure item as well.

“I like that they clarified the vaccination question to ask if we have determined if anyone gave them the vaccine, rather than if we gave it to them,” Craig Steffel with A Plus Home Health Care in Highland, Ind., said when the change was unveiled.

• Synopsis items. Better language under the “NA” columns in M2250 — Plan of care synopsis and M2400 — Intervention synopsis are good news, Selman-Holman says. OASIS guidance evolving over time helped with these items, she notes.

For example: M2500(a)’s “NA” option will say “Physician has chosen not to establish patient-specific parameters for this patient. Agency will use standardized clinical guidelines accessible for all care providers to reference.” Currently, you must review the parameters with the physician and the physician must agree to the parameters for you to be able to mark “NA.”