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The comment deadline is scheduled for May 11th, 2018 with The OASIS-D Draft Guidance Manual release date in July 2018.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.
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
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.
|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 firstname.lastname@example.org