OASIS Alert

Whereas smoking is likely to give clinicians the most repeated trouble on M0290, HHAs still have to keep in mind obesity and alcohol or drug dependency as potential high risk factors.

Definitions or guidelines for potentially obese patients should be available within the medical community, and patients who may have had a history of obesity but are presently within weight guidelines should still have their history noted on the OASIS form, directs consultant Pat Sevast of American Express Tax & Business Services in Timonium, MD.

However, alcohol or drug dependency is often "much trickier" to detect or label since many patients are unwilling to discuss such matters, notes consultant Terri Ayer of Annandale, VA-based Ayer Associates. Very often, staff will have to look for clues that might indicate drug or alcohol abuse, such as checking to see "if the trash can's full of empty beer cans or whiskey bottles," Ayers suggests.

Clinicians can also check the patient's breath for alcohol or observe if excessive drinking has created broken capillaries across the bridge of the nose and into the cheeks.

To determine whether a patient's current use of alcohol constitutes a high risk factor, clinicians should ask if the patient's drinking is affecting her medical regimen, avers Ayer. If the patient isn't taking her prescribed medication or fails to return phone calls, clinicians might begin to follow up with more questions, or perhaps even consult the patient's family. If a clinician suspects alcohol or drug dependency, she should call the patient's physician to discuss the situation, urges Ayer.