OASIS Alert

Stay current with OASIS updates.

Answering the OASIS ADL/IADL items involves understanding some basic OASIS considerations. Make sure you’re on track with this handy list.

OASIS ADL/IADL items M1800 — Grooming, M1810 — Ability to dress upper body, M1820 — Ability to dress lower body, M1830 — Bathing, M1840 — Toilet transferring, M1845 — Toileting hygiene, M1850 — Transferring, M1860 — Ambulation/locomotion, M1870 — Feeding or eating, M1880 — Ability to plan and prepare light meals, and M1890 — Ability to use telephone all include guidance regarding the impact of medical restrictions, says Thelma Bowen, MSN, RN, with HealthCare Compliance Services in San Antonio, Texas.

In other words, medical restrictions can impact your response for each of these items, Bowen says. Before you can select the correct OASIS response for these items you must:

1. Understand the definition of a medical restriction/limitation. In relation to the OASIS, this means not only a medical restriction but also a medical limitation, Bowen says. “Medical restrictions include those activities which the patient is not permitted to perform. On the other hand, medical limitations are those activities which a patient may perform to a limited extent.”

These restrictions and limitations must be documented by the physician, Bowen says. You can’t assume a patient has medical restrictions or limitations. Instead, query the physician regarding specific restrictions or limitations and how long they will be in place, Bowen says.

For example: The physician may limit the amount of weight a patient can place on a leg after surgery. This must be documented by the physician in the medical record.

Another example: Don’t assume a patient who is receiving chemotherapy that compromises his immune system is medically restricted from leaving the home. Instead, look for physician documentation of any medical restriction or limitation.

2. Understand how to objectively determine the patient’s ability to safely perform a task as specifically described in the OASIS item at the time of the assessment. “In some cases, this may include a combination of observation, demonstration, interview, physical and environmental assessment,” Bowen says.

3. Access the recommendations for optimal methods for obtaining the required data. You’ll find such guidance in the OASIS-C Guidance Manual available at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html.

4. Stay current with regular instructions and approved updates to clarifications by the Centers for Medicare & Medicaid Services (CMS). The folks at OASIS Answers keep a regularly-updated list of guidance at www.oasisanswers.com/aboutoas_links.htm.

5. Ask questions whenever a confusing situation arises.