OASIS Alert

Home health agencies can drive themselves bananas if they try to account for every possible patient scenario when completing OASIS, and M0700 is a case in point.

This item asks about the patient's "ability to safely walk, once in a standing position, or use a wheelchair, once in a seated position on a variety of surfaces," and many clinicians become confused about how to answer it for patients who use motorized wheelchairs, experts observe.

Specifically, clinicians scratch their heads over whether to check box 3 ("chairfast, unable to ambulate but is able to wheel self independently") or box 4 ("chairfast, unable to ambulate and is unable to wheel self").

The sticking point is that many clinicians ask themselves whether the patient would be able to wheel himself manually in the event that his motorized chair broke down. If the answer is no, many clinicians convince themselves that they should mark box 4, even though the patient gets along fine in his chair as long as it's working.

But this kind of speculation has no place in the OASIS assessment, urges consultant Pat Sevast with American Express Tax & Business Service in Timonium, MD. The items on OASIS, including M0700, "ask for the patient's functional ability based on what they normally do," she explains. So assuming the patient's motorized chair normally is in good working order, clinicians should base their response on what the patient can do under those circumstances, she explains.

The OASIS instrument is designed to collect data on a patient's "current functional level," Sevast reminds agencies. That means clinicians shouldn't make things more difficult than need be by asking "what if"-type questions when answering item M0700. The same goes for the questions relating to bathing, eating or other functional ability assessments, Sevast adds.