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OASIS has indeed changed again and quite dramatically this time. While there are 28 M items that have been deleted from the data set and only 6 new ones added, don’t be fooled into believing that this will be a breeze. The 6 items that have been added are GG and J items from the Skilled Nursing Facility (SNF) assessments that are a result of the IMPACT Act requirements, moving home health more into compliance with this Act’s requirements. In addition to deletions and new items, there are 16 items that have been revised in terms of coding options, skip patterns, time point for completion changes, etc.
The OASIS items to be removed include:
M1011, M1017, M1018, M1025, M1034, M1036, M1210, M1220, M1230, M1240, M1300, M1302, M1313, M1320, M1350, M1410, M1501, M1511, M1615, M1750, M1880, M1890, M1900, M2040, M2110, M2250, M2430, M0903
The OASIS-D items to be added include:
GG0100, GG0110, GG0130, GG0170 (expanded), J1800, J1900
Some key things to note in the implementation of the new OASIS items:
- The reverse order of the numbering system from Independent to Dependent
- Understanding the meaning and Selecting the appropriate response for Not Attempted, Not Applicable or Patient Refused
- Safety is ALWAYS a consideration
- IF the full task is not completed then it was not attempted: example: Walk 50 feet with two turns: if the patient can ONLY walk 40 feet then when responding to GG0170: K – the response would be NOT ATTEMPTED, assuming that the patient was capable of performing this activity prior to the current illness/injury/exacerbation.
- Understand the term assistance and apply accurately
- Understand that several of the items within the GG items are duplicative of M items and clinicians should ensure they are appropriately scoring each.
Items considered to be Major Changes with OASIS-D:
- Pressure Ulcers:
- Pressure Ulcer/Injury Language from National Pressure Ulcer Advisory Panel (NPUAP) being incorporated into OASIS items and guidance
- Dash (-) added as a response option at Discharge ONLY for M1311
- More guidance re: “Present at the most recent SOC/ROC” for M1311
- The Term CODING being used through guidance/instruction – referring to selecting responses for OASIS Items and not just for diagnosis coding.
- Multiple Versions of and OASIS item at different time points:
- M1311, M2102, GG0130, GG0170
The changes to OASIS-D are not only going to impact the collection of the dataset but will impact the overall comprehensive assessment of the patient and has the potential to impact reimbursement in future years through its application in the reimbursement model and outcomes/value-based purchasing models.
The following link is a comprehensive listing of OASIS items and a summary version of how each will be impacted by OASIS-D.
WATCH OUR COMPLIMENTARY HPS WEBINAR addressing the OASIS-D changes and preparation for its implementation in January 2019!VIEW WEBINAR