OASIS Alert

Note patients' ability to get into the tub or shower to choose correct number.

The Centers for Medicare & Medicaid Services made its bathing item (M1830) safer for patients, but it removed most of the clarifying language that accompanied the old item (M0670) -- leaving you in a lurch.

One scenario that causes confusion is figuring out how to respond when a patient has no tub and only needs bathing help when trying to wash areas that are hard to reach, CMS says in its OASIS C instructions. Many agencies aren't sure whether to select a "4" for independent bathing outside of the tub or shower or a "5" for bathing that requires supervision or assistance outside of the tub or shower.

Do this: Note whether there's a barrier that prevents your patient from safely bathing in the tub or shower, and whether your patient needs any assistance at all washing their body at the sink, in a chair or on the commode. If either of those are true, you'd choose 5 -- even if the assistance is only intermittent, like in the above scenario.

To score a 4, your patient must able to bathe without any human assistance at all at the site that's not their tub or shower, CMS says.