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How Prepared Is Your Home Health Agency for OASIS-D?

May 11, 2018
Documentation, Billing, & Coding By Patty Klinefelter, Director

On January 1, 2019, the Centers for Medicare and Medicaid Services (CMS) will implement the revision to the home health assessment data collection tool, The Outcome and Assessment Information Set (OASIS-D). This tool reduces data collection burden and includes updates that are consistent with the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). The IMPACT Act requires the standardization of patient assessment data. The standardized data will allow cross-setting data collection, outcome comparison, exchangeable data, and comparison of quality within and across PAC settings.

The comment deadline is scheduled for May 11th, 2018  with The OASIS-D Draft Guidance Manual release date in July 2018.  The final version of  OASIS D  will be completed in November 2018.

 

OASIS-D


A Look at OASIS-D Data Elements

CMS has decided that factors not meeting the below criteria will no longer be collected:

  • Items used to calculate a measure finalized for the Home Health Quality Reporting Program (HH QRP) in the Home Health Prospective Payment System (PPS)  

  • Items used in the survey process for Medicare certification

  • Items used to calculate a measure in the Home Health Value-Based Purchasing (HH VPB) demonstration

  • Items used as a critical risk-adjustment
  • Items incorporated into the OASIS to fulfill a data category as part of the Conditions of Participation in the CY 2018 Home Health PPS proposed rule

The comment deadline for the proposed OASIS D assessment tool is January 1, 2019. There will be 28 M-items removed from OASIS-D, 1 M-Item revised and 4 GG-items and 1 J-item added. CMS has released a Supporting Statement  for OASIS-D which outlines changes and comparisons to previous revisions of OASIS for Home Health Agencies (HHA).

New OASIS-D standardized items include:

  • GG0100 Prior functional level

  • GG0110 Prior Device Use

  • GG0130 Self care

  • GG0170 Mobility

  • JJ1800  Falls

  • JJ1900   Number of falls per severity level

OASIS items to be removed include:

  • M1011 Inpatient diagnosis
  • M1017 Diagnosis requiring treatment change
  • M1025 Optional payment diagnosis
  • M1034 Overall status
  • M1210 Hearing
  • M1220 Ability to speak
  • M1300 Assessment for pressure ulcer risk
  • M1302 Risk for pressure ulcers identified
  • M1313 Worsening in pressure ulcer status
  • M1350 Skin lesion or open wound
  • M1410 Respiratory treatments
  • M1501 Symptoms in heat failure
  • M1511 Heart failure follow-up
  • M1615 When does urinary incontinence occur
  • M1750 Psychiatric nursing services
  • M1880 Ability to plan and prepare meals
  • M1890 Ability to use the telephone
  • M1900 Prior functioning ADL/IADL
  • M2040 Prior medication management
  • M2102a-e SOC Assistance available for ADLs, IADLs, medications, medical procedures and equipment
  • M2102b&e D/C assistance available for IADLS and equipment
  • M2430 Reason for hospitalization
  • M0903 Date of last home visit

Note that OASIS items M1311 will be modified to support a new pressure ulcer measure to replace the current pressure ulcer measure.

Improving Efficiency of Data Collection

New updates to the data collection tool will make the collection of HHA data more efficient for providers (with the exception of death at home, in which case it will take an additional 0.9 minutes for providers to complete).

Below is a table summarizing how the proposed update will impact the timeliness of data collection.

Item Time Savings
Transfer of Care 11.4 less minutes
Resumption of Care 11.4 less minutes
Follow-Up 0.6 less minutes
Discharge 2.7 less minutes

 
Click to review CMS’ Change Table for OASIS 2019

Preparing Your Clinical Staff

Accurate data collection is vital to the success of any home health agency. This is especially the case since financial and clinical outcomes are calculated from the OASIS Assessment. Keeping up with OASIS changes can be overwhelming. Make sure your clinicians are prepared and proficient in current OASIS clinical practices, followed by additional training for OASIS-D in November. 

How LW Consulting, Inc. Can Help

LW Consulting Inc. specializes in OASIS-C2 and OASIS-D training and education. Our management consulting team offers ongoing OASIS webinars and OASIS-D workshops. Additionally, LW Consulting, Inc. provides chart audits and competency assessments for providers. 

 

Is your facility implementing OASIS clinical best practices? Now is the time to prepare.

Contact Patty Klinefelter, Senior Home Health Consultant for LW Consulting, Inc. by calling 540-660-9152 or email pklinefelter@lw-consult.com 

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