OASIS Alert

Question: We have a patient who can safely get to and from the toilet using a walker, so the clinician scored her as "0" on M0680 (Toileting). But on M0690 (Trans-ferring) the patient scored "1" because she needed the assistive device to perform the transfers. It appears that in one question we are saying the patient is independent in transfers and in the next question we are saying she is not independent in transfers. Will this apparent contradiction cause us problems in surveys or medical review?

Answer: No. The apparent conflict arises because M0680 does not capture transfers while M0690 does, explains Deborah Chisholm, senior associate consultant with Redmond, WA-based OASIS Answers.

If the patient can get to and from the toilet location independently and safely with or without a device, she is a "0", Chisholm agrees. Remember, in its OASIS questions and answers, the Centers for Medicare & Medicaid Services says M0680 does not include the transfer on and off the toilet, Chisholm adds.

If the same patient requires minimal human assistance or an assistive device to perform the majority of transfers, she is a "1" for M0690, Chisholm says. When scoring M0690, CMS instructs clinicians to pick the response that is true in a majority of the transfers, with the greatest weight placed on the more frequently performed transfers, she explains.