OASIS Alert

Q: How do you answer the M0 wound questions when a patient had a pressure ulcer in a previous home health episode, but the ulcer has now completely healed and the patient has no other lesions? The earlier ulcer is no longer observable, but we know it was there because we treated this patient in the prior episode.

A: "Let's use common sense" - if a pressure ulcer has healed and is no longer observable, don't count it, advises consultant Beth Carpenter with Lake Barrington, IL-based Beth Carpenter & Associates. This is especially true at discharge, since it would lend itself to adverse events, she adds. There might be some confusion about this since some clinicians refer to a healed stage 4 ulcer "to give some historical perspective for planning preventive care," she notes.

The correct answer in this case is "NA" - no observable ulcer - instructs wound care expert Liza Ovington with Pittsburgh-based Ovington & Associates. This is always an option in the M0 questions about pressure or stasis ulcers, she adds.

Q: How do we document a situation in which a pressure ulcer was healed and this fact was documented on the re-cert OASIS and the clinical notes, but then a new pressure ulcer developed in the same area six days later?

A: Complete an "Other Follow-up" OASIS assessment because this is a change in the patient's condition that would alter an answer on the OASIS form, and because the change in the patient's condition requires new doctor's orders, instructs consultant Melinda Gaboury with Healthcare Provider Solutions in Nashville, TN.