OASIS Alert

Published on Wed Jul 31, 2013 PDF

Always consider what your patient can safely do.

You spend countless hours making certain you understand the directions for each OASIS item, but are you missing out on process improvement opportunities? Taking a consistent approach to the way you complete the OASIS can boost your accuracy — and your agency’s bottom line.

Try these five techniques to bolster your OASIS approach:

1. Don’t intervene before you assess. When you provide interventions to help improve your patient’s abilities before you assess, you miss out on an opportunity to take credit for that improvement. Instead, score your patient’s ability before you provide any interventions during the assessment visit. Capturing her baseline abilities gives you an opportunity to demonstrate how much better she is functioning after you provide interventions such as teaching or adaptive equipment.

2. Don’t downplay safety. Always choose your OASIS responses based on whether your patient can safely complete the required activity. Even if your patient lives alone, it’s important to consider safety. Remember to asses whether physical impairments, sensory impairments, behavioral/emotional or cognitive impairments, environmental barriers, or physician orders impact whether your patient is safe in completing a task.

3. Stay up-to-date. Instructions for completing each OASIS item are constantly being updated and clarified. Make sure you understand the data each is designed to collect, what you specifically need to consider, and what time frame to use. Look to the OASIS-C Guidance Manual and the Centers for Medicare & Medicaid Services’ OASIS Q&As whenever you have questions about an item.

Hint: Be sure you’re referencing the most current versions of these documents. You’ll find the most up-to-date OASIS-C Guidance Manual here: www.cms.gov/HomeHealthQualityInits/14_HHQIOASISUserManual.asp. Look for CMS’ annual compilation of OASIS Q&As, as well as quarterly answers to new questions here: www.oasisanswers.com/aboutoas_links.htm.

4. Collaborate with other disciplines. To get the best picture of your patient’s abilities and to select the most accurate OASIS responses, take the opportunity to collaborate with other disciplines that are providing services. You can’t simply accept the viewpoint of another discipline, but considering their findings and whether they reflect what you have seen can help improve your accuracy.

Caution: Only one person can actually complete the comprehensive assessment. So, that person must see the same things as any other disciplines with which they collaborate. You can’t just change your responses because someone else says they would score the item differently. Instead, consider what you observed along with what the other discipline saw. As you discuss the patient with the other discipline, you may find that you both saw the same thing, but interpreted it differently with regard to the OASIS. In such situations, be sure to refer to the official guidance in selecting the correct score.

5. Don’t rush. Use the full time period allowed for the assessment time point. On the first day of the assessment period, if you aren’t able to see a wound due to a dressing that cannot be removed, take the time available so that you can make an accurate selection once the dressing can come off. If you rush to lock the OASIS that first day, your agency could lose case mix points for wound healing status.

At start of care (SOC), you may also need some or all of the five days allowed to secure physician orders for interventions related to the process items in M2250 — Plan of care synopsis. Rush to complete the OASIS and you miss out on an opportunity to boost your Home Health Compare and the Process Based Quality Improvement scores.