OASIS-D is Coming. Make Sure Your Staff is Ready!

Over the past two decades, the Outcome and Assessment Information Set (OASIS) has been developed, tested and refined, and major changes continue to occur.  Now home health agencies (HHAs) need to be prepared for OASIS-D, which will go into effect on January 1, 2019.

Reasons Behind the Introduction of OASIS-D

The main reason behind the introduction of OASIS-D is the IMPACT Act (Improving Medicare Post-Acute Care Transformation Act of 2014).

  • The purpose of the IMPACT Act is to standardize patient assessment data collected for Post-Acute Care (PAC) providers, specifically Long-Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs). The standardization of data develops an improved quality measure (QM).  Plus, the data can be utilized to compare all four PAC providers for quality.   
  • Another key area the IMPACT Act seeks to improve is the coordination of care and discharge planning between the post-acute care providers and the transition from acute care to post-acute care.
  • The changes in OASIS-D for the Impact Act are making it feasible to obtain reports of “what happens where to a patient”. For example – did a new or worsening pressure ulcer occur during a home health admission or a long-term care admission?  Were functional abilities improved during home health for a patient as the agency projected they would improve?

OASIS-D Changes

OASIS-D does have a lot of deletions, causing CMS to estimate that the amount of time required to complete the data set will decrease, but as we know, not all OASIS items are equal. 

OASIS-D Deletions OASIS-D Additions
M0903: Date of Last / Most Recent Home Visit GG0100: Prior Functioning: Everyday Activities
M1011: Inpatient Diagnosis GG0110: Prior Device Use
M1017: Diagnosis Requiring Medical or Treatment Regimen Change Within Past 14 Days GG0130: Self-Care

 

M1018: Conditions Prior to Medical or Treatment Regimen Change or Inpatient Stay Within Past 14 Days GG0170: Mobility

 

M1025: Optional Payment Diagnosis J1800: Any Falls Since SOC / ROC
M1034: Overall Status J1900: Number of Falls Since SOC/ROC
M1036: Risk Factors
M1210: Ability to Hear
M1220: Understanding Verbal Content
M1230: Speech & Oral (Verbal) Expression of Language
M1240: Pain Assessment
M1300: Assessment for Pressure Ulcer Risk
M1302: Risk for Pressure Ulcers Identified
M1313: Worsening in Pressure Ulcer Status
M1320: Healing Status of Most Problematic Pressure Ulcer
M1350: Skin Lesion or Open Wound
M1410: Respiratory Treatments
M1501: Symptoms in Heart Failure
M1511: Heart Failure Follow-up
M1615: When Does Urinary Incontinence Occur
M1750: Psychiatric Nursing Services
M1880: Ability to Plan and Prepare Light Meals
M1890: Ability to Use the Telephone
M1900: Prior Functioning ADL/IADL
M2040: Prior Medication Management
M2110: How Often Does the Patient Receive ADL or IADL Assistance from Caregiver
M2250: Plan of Care Synopsis
M2430: Reason for Hospitalization

 

The GG items are set up very much like the GG0170 item that was introduced last year in that OASIS iteration (lying in bed to sitting on side of bed with feet on the floor). They all have the six-point scale with which to score depending on the type of assistance the patient needs to perform each task.  And, they all have the projected score for each item at discharge.

The difference is that there are many more items to assess for each GG item and this will take time, assessment strategies, and more than one visit – so utilization of the five-day assessment period with collaboration of the varied disciplines in the team.

When you read the GG items for the first time, you will be surprised at the level of detail in many of the items.  Here is the synopsis of each one:

GG0100: Prior Functioning: Everyday Activities

Self-care items – bathing, dressing, toileting, and eating.

GG0110: Prior Device Use

This is just to select the device.

GG03130: Self Care

This item is a very specific one with eating, oral hygiene, toileting hygiene, shower/bathe self, upper body dressing, and putting on/taking off footwear. All have specifics for each section and this is for assessment SOC/ROC and discharge and follow up when applicable.

GG00170: Mobility

This item is beyond specific and includes:

Roll left and right

Sit to lying

Lying to sitting on side of bed, which we already have been doing for the past year

Sit to stand

Chair/bed to transfer

Toilet transfer

Car transfer

Walk 10 feet

Walk 50 feet with 2 turns

Walk 150 feet

Walking 10 feet on uneven surfaces

1 Step (curb)

4 Steps

Picking up object

Wheel 50 feet with 2 turns

Wheel 150 feet

So, in reading the new GG items, you can understand why the collaboration of the multi-disciplinary team and the five-day assessment window are necessary in order to accurately identify what your patients are able to do, as well as what their discharge goals are.

JJ Items are looking at falls, asking in JJ1800 if there have been falls since the most recent SOC/ROC, and then in J1900, how many falls have there been.

The CMS OASIS Guidance Manual has very specific examples for the GG and JJ items and are very helpful to train your clinicians.

You do not Need to be Overwhelmed!

5 Star Consultants is here to help you navigate the changes OASIS-D will bring to your HHA.  Our home health experts are providing OASIS-D training and can do so for your agency!  Find out today about how we can help ensure your team is ready for OASIS-D on January 1, 2019.  To learn more, please contact us at [email protected] or 866-428-4040.

Southern Web SupportOASIS-D is Coming. Make Sure Your Staff is Ready!
Share this post