OASIS – Think Home Care Blog

OASIS-D1 Guidance from Qualidigm

Changes to the OASIS data set will be incorporated into OASIS-D1 effective January 1, 2020. To help home health agencies understand these changes, Qualidigm has itemized the list of data set changes in a one-page document and four 90-second videos.

A number of changes to the OASIS data set have been made and will be incorporated into OASIS-D1 effective January 1, 2020 (click here for data submission specifications). These changes align with the new Patient-Driven Groupings Model (PDGM). Under this new model, OASIS accuracy will continue to be important with Functional Impairment Level derived directly from OASIS items.

To help home health agencies understand these changes, Qualidigm has itemized the list of data set changes outlined in this one-page document. Additionally, Qualidigm recently released its Quality Quick Minute video series focused on the OASIS-D1 changes. The videos series is comprised of four brief, 90-second information videos outlining these changes to assist with preparation in anticipation of the January 1 effective date.

The OASIS-D1 Quality Quick Minute video series includes the following:

All four videos can also be accessed from the home health section of the Qualidigm website at www.qualidigm.org/our-services/home-healthcare-consulting/.

Marissa Moncata
Senior Business Analyst, Consulting Services
Qualidigm
MMoncata@qualidigm.org

Blueprint for OASIS Accuracy Returns This November

Staying on top of OASIS coding is never easy, and PDGM will bring additional challenges in 2020. Join us November 4-5, 2019 in Devens for an intensive, two-day, workshop & exam from OASIS Answers. Though open to all, Alliance members can attend at a significant discount.

Staying on top of OASIS coding is never easy but – with the new PDGM standards arriving in a few months – 2020 is going to be a real challenge.

That’s why we’re pleased to offer Blueprint for OASIS Accuracy, a two-day, data-collection workshop in Devens, Massachusetts on November 4-5, 2019.

This workshop — designed by OASIS Answers — provides a comprehensive look at the OASIS items including the OASIS-D1 revisions and OASIS-related PDGM information effective January 1, 2020. The course awards 13 CEUs. Attendees can also take an optional exam at the same location the following day (registration and payment for the exam is entirely separate from the workshop).

Though the program is available to all, members may attend for just $429.00 per registrant, a discount of $150 off the non-member rate. If you’ve been thinking about having the Alliance join, this will give you immediate return on your investment.

Return to www.thinkhomecare.org.

A New Version of OASIS is Coming!

Is your staff just getting used to completing OASIS-D? Surprise, CMS recently announced there will be a new version for 2020!

It was a surprise to many when CMS declared during the April 3^rd, Open Door Forum, that effective January 1, 2020 there would be a new version of OASIS. I know I was thinking at first that the presenter misread the effective date, but apparently this update is needed to support the Patient Driven Grouping Model (PDGM). One more thing for HHA to deal with. But, HCA of MA will be here for you. (See link at end to out Fall 2019 OASIS training.)

Thankfully though, after reviewing the CMS Memorandum, I realize that there are only a few minor changes.

Quick synopsis: Two items will be added to the Follow-Up assessment: M1033-Risk for Hospitalization and M1800-Grooming. These items should pose no problem since staff is familiar with answering these items at SOC/ROC. Surprisingly, the other change involves the “option” to no longer answer 23 items! Rather than leaving the items blank, the clinician will be required, however, to respond by using the equal sign (=).

Here are the “optional” items for your convenience.

Start of Care/Resumption of Care (SOC/ROC)

• M1910 Fall risk Assessment

Transfer (TRN) and Discharge (DC)

• M2401a Intervention Synopsis: Diabetic Foot Care

• M1051 Pneumococcal Vaccine

• M1056 Reason Pneumococcal Vaccine not received

Follow-Up (FU)

• M1021 Primary Diagnosis

• M1023 Other Diagnoses

• M1030 Therapies

• M1200 Vision

• M1242 Frequency of Pain Interfering with Activity

• M1311 Current Number of Unhealed Pressure Ulcers at Each Stage

• M1322 Current Number of Stage 1 Pressure Injuries

• M1324 Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable

• M1330 Does this patient have a Stasis Ulcer

• M1332 Current Number of Stasis Ulcers that are Observable

• M1334 Status of Most Problematic Stasis Ulcer that is Observable

• M1340 Does this patient have a Surgical Wound

• M1342 Status of the Most Problematic Surgical Wound that is Observable

• M1400 Short of Breath

• M1610 Urinary Incontinence or Urinary Catheter Presence

• M1620 Bowel Incontinence Frequency

• M1630 Ostomy for Bowel Elimination

• M2030 Management of Injectable Medications

• M2200 Therapy Need

HCA of MA next Blueprint for OASIS Accuracy will be held on November 4th and 5th. Option to take the certification exam will be on the 6th.

You can register for the course here.

Blog post by: Colleen Bayard.

OASIS D-Day: Assess Once, Score Twice

In less than three weeks, home health agencies will be transitioning from OASIS-C-2 to the new OASIS D assessment. Given all the regulatory changes this year and with the holiday season upon us, it has really been a sprint to get staff trained.

HCA of MA recently held three training sessions for members and not surprisingly there is concern with staff being ready, especially around the nuanced degrees of functional assessments and specifically related to the new items related to mobility and self-care. While OASIS-D comes advertised as “dropping 28 previous M-Items” from OASIS-C-2, the additional assessments will require lots of creative patient engagement on the part of the admitting nurse or therapist, according to HCA Director of Regulatory and Clinical Affairs Colleen Bayard.

“OASIS-D is intended to begin to standardize patient assessment and quality measures across all post-acute providers,” said Bayard. “But for us in home care some of the new items ask for very nuanced responses. For example, the mobility item (GG0170) has 17 mobility activities that the clinician must ‘code’ with a 6-point scale from independent to dependent or ‘code’ with 4 possible responses related to ‘activity not attempted.’ he admitting clinician is responsible for assessing a patient’s ability to stair climb, pick up an object from the floor and even make a car transfer.

During the Alliance’s trainings, Bayard warned agencies to expect some productivity issues related to the learning curve, but stressed that the training message across the industry should be: “assess once, score twice.” In other words, be aware of OASIS M assessment questions which track to newly added GG assessments and use the same assessment to respond to multiple OASIS items in the same category. Bayard also recommends close auditing or self-monitoring in the initial months, especially related to the responses “patient refused” or “dash” (not attempted). (Ask: could the clinician interview a family member as a way to get a response?)

Bayard recommends using the “Expansion of the one Clinician Rule” to your advantage because CMS is encouraging an interdisciplinary team approach with OASIS-D. Bayard’s final advice: “As you focus on your training be aware that your nurses are going to need to have a strong intersection of observational skills with interview skills.”

HCA has several places members can come to share and learn as they move past Jan 1. Our Clinical Directors and Quality Improvement list serves and networking groups will be highly focused on OASIS-D as winter turns to spring. The Clinical Directors next meet Thursday, January 10 and the QI Managers will next meet on January 9^th. Meeting information is here. Our email groups are here.

If you haven’t already studied it – here is a list of more than 100 answers to OASIS questions received by CMS from the industry during recent CMS in-person trainings and webinars.

Return to www.thinkhomecare.org.

Educational Calendar Updates

As you probably know, the Home Care Alliance of MA is constantly adding new programs in our calendar, especially with all that is changes in our industry. Please see below some new (and old) programs that we have to offer over the next few weeks:

Thursday, November 17^th: “Coping with Chaos: Compliance Climate 2016”

Home Health and Hospice agencies must continue to navigate a chaotic environment with no end in sight. Get clarity on what the government enforcement agencies and contractors are focusing on in 2016-2017. Learn how to formalize processes and systems to capture key payment and clinical documentation concerns to avoid overpayment requirements and disclosures, including use of PEPPER data. Understand how to approach communications and requests from the MACs, ZPICS, the OIG and the DOJ. Finally, take control of your agency’s health and survival by committing to a sound ethics and compliance program framework and evolving ethics and compliance activities.

*NEW*Tuesday, November 29^th: “Medicare B Home Nurse Practitioner Program”

Certain outpatient therapy and other Medicare services may be furnished by a home health agency (HHA) to individuals who are not homebound or otherwise are not receiving services under a home health plan of care (POC) using Medicare Part B billing. As of January 1, 2016, Medicare expanded this list to include advance care planning as a billable service provided by either a physician or a nurse practitioners. Hear how one agency has developed and successfully used Part B Billing to expand the scope of their community services.

*NEW*Wednesday, November 30^th,, and Wednesday, December 7^th: “Riding the Wave: OASIS C-2 Changes”
Oasis-C-2 is just over a month away; are your clinicians aware of all the changes? Come join the HCA for training on the structure and content changes in the OASIS-C2 data set that are effective January 1, 2017. These new items can impact your quality scores and re-imbursement; so be sure your clinicians are familiar with the changes.

*Western MA date and location TBD*

*DATE CHANGE*Monday, December 5^th: “The Gold Standard: Understanding the Background and Importance of Compression for Wound Care Patients”

Compression plays a vital role in both wound healing and reduction of wound recurrence. Participants will increase their understanding of lower extremity ulcer presentation, compression types, options, dosage and how each can ultimately impact success and outcomes. In the home health arena, it is vital to clearly understand current options available to maximize clinical effectiveness and cost-efficiency.

Tuesday, December 6^th: “Financial Management Conference” *NOTE AGENDA ADDITION: Medicare PPS Changes for 2017*

Agency CFOs and CEOs will be well served by joining HCA on December 6 in Norwood for the Annual Financial Managers Conference. This year’s event features a stellar line-up of expert panels including speakers on Value-Based Purchasing, Revenue Cycle Management, Bundled Payments, and HIPAA/ Cyber Security

Thursday, December 8^th: “The Aide’s Role in Understanding Mental Health Disorders”

This presentation will explore some mental health disorders that may create challenges for the Nurse Aide in the home setting. According to the National Alliance on Mental Illness approximately 43.8 million adults or 1 in 5 adults in the U.S experiences mental illness annually. Chances are that some of the patients we care for in the home may be experiencing some sort of mental illness. Learn strategies that can help you when caring for these patients.

*NEW*Tuesday, December 13^th: “A Team Approach to Medication Management”

It takes the entire home health team working together to ad- dress this vital aspect of health care to make a difference and improve the quality of care for those we serve every day. This 90-minute webinar is devoted to promoting a Team Approach to Medication Management in home health.

To learn more about any of our programs go to our calendar: http://www.thinkhomecare.org/events

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