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With the first quarter of 2019 coming to a close, HPS would like to share some key insights to help ensure that your OASIS-D assessments are processed efficiently.
Home health agencies may find many of the changes to OASIS-D daunting, but there are several modifications that have helped make assessments easier than ever before. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) is the primary driving force behind the OASIS changes. The IMPACT Act requires the submission of standardized data by home health agencies (HHAs) to mirror the data of post-acute care entities.
The newly implemented changes ensure more accurate and efficient data collection by removing multiple assessment items and adding items that are reflected in the post-acute setting assessments. The objective of the OASIS changes is also to ensure more comprehensive patient assessments through improved planning and measuring the quality of patient care.
A significant part of efficiently implementing OASIS-D is awareness of best practices that can help your agency stay compliant as items change. Applying these updates in reimbursement and outcomes-based and value-based purchasing models has the potential to impact both reimbursement and quality outcomes in years to come.
As home health educators, we have compiled some industry best practices and tips to help you stay compliant with OASIS changes and get your agency up to speed.
Best Practices and Tips for Ensuring OASIS-D Compliance
- GG Items: Utilize GG Item Guides
You may have noticed that the majority of the new items added are GG items. These GG items have been added to align quality measurement across post-acute care assessment (PAC) instruments to meet the IMPACT Act of 2014 provisions.
The GG mobility items can prove to be confusing since they are based on the mobility items from the Skilled Nursing Facility (SNF) assessment and are now required to be performed in a home setting for HHAs.
The best resources to become familiar with the GG items are:
- The Home Health Guide to OASIS-D, which features an extensive section on instructions for completion of the new OASIS GG items, as well as all of the M and J items.
- The CMS OASIS-D Guidance Manual contains guidance on the GG items as well as answers to any concerns or confusion regarding OASIS compliance.
GG Item Tip: Licensed clinicians may assess the patient’s performance based on direct observation (preferred) as well as reports from the patient, clinicians, care staff, and/or family.
- J Items: Did the Patient Really Fall?
All falls that the patient has experienced should be included in response to these items, including intercepted falls:
- Intercepted falls occur when the patient would have fallen if he or she had not caught him/herself or had not been intercepted by another person—this is still considered a fall.
- Instances that include a therapist challenging a patient’s balance intentionally as a therapeutic intervention does not qualify as a fall.
- Pressure Ulcers: Record Ulcers During Patient Admission
M1311 was the biggest change to OASIS outside of the addition of the GG & J items.
- Pressure Ulcer/Injury Language from the National Pressure Ulcer Advisory Panel (NPUAP) is incorporated into OASIS items and guidance. Use the word INJURY if the wound is not technically an ulcer.
- Dash (-) was added as a response option at Discharge ONLY for M1311.
- Additional guidance is provided regarding pressure ulcers present at the patient’s most recent SOC/ROC.
- The Dash (-) Response: Make Usage Scarce
It is important to only enter N/A and Unknown when it is absolutely necessary. CMS allows the dash (-) response for certain items, indicating that no information is available. However, it is important that clinicians abide by the expectation that dash response usage is a rare occurrence.
- EMR: Does Yours Have an OASIS Scrubber?
OASIS scrubbing systems take your OASIS assessments through a quote scrubbing process to validate selected responses based on the rest of the data in the OASIS to identify errors and inconsistencies.
Scrubbing systems are sometimes built into agency EMRs, but they can also be purchased separately. Additionally, most EMR software for home health has edits built in that trigger notification if an answer is inconsistent regarding an OASIS-D item. Be sure to pay careful attention to notifications as you strive to accomplish a complete and correct OASIS assessment.
Utilizing an OASIS scrubbing platform has many benefits:
- Minimizes the depth of manual reviews
- Aids in documentation accuracy
- Helps to receive appropriate reimbursement
- Improves patient care quality
OASIS Scrubbing Tip: Our professional recommendation would be to explore the possibility of utilizing a scrubbing component for OASIS, such as Strategic Healthcare Programs’ (SHP) OASIS scrubbing platform. The software notifies users of any unresolved issues in a daily email to help with the management and tracking of assessment items.
- Quality Assurance Reviews: Utilize Assessment Evaluation Resources
HHAs can be proactive in ensuring compliance by using internal or third-party quality assurance reviews. This will help in evaluating if an agency’s assessment responses meet requirements and will help agencies to ensure appropriate Medicare reimbursement.
- Utilize the OASIS-D Change Guide and Home Health Guide to OASIS-D
- The OASIS-D Change Guide is a comprehensive list of all OASIS items with a description of the changes.
- The Home Health Guide to OASIS-D covers everything you need for a seamless transition when it comes to OASIS-D item changes and improving the quality of patient care outcomes.
Staying on top of the OASIS changes and making sure you are compliant can be a challenging task when juggling patient care and daily priorities. Keeping best practices top of mind can help relieve stress by ensuring compliance.
For a more extensive look at tips and best practices for OASIS-D compliance, please refer to the Home Health Guide to OASIS-D.
GET THE OASIS-D GUIDE TODAY