Home Health & Hospice Week

CMS significantly revamped OASIS-C in response to field testing. A whole new OASIS world is coming in 2010 -- and you'll need to start preparing sooner than you think. This month, the Centers for Medicare & Medicaid Services plans to issue a new version of the OASIS-C tool that it has significantly revised based on industry comment and field testing, said CMS's Debora Terkay at the National Association for Home Care & Hospice's annual meeting Oct. 14. Implementation of the new assessment tool is slated for January 2010, said Angela Richard with OASIS contractor University of Colorado Health Sciences Center. CMS field tested the new OASIS-C in 11 home health agencies in Colorado, Massachusetts, and Ohio, noted Elizabeth Madigan with OASIS contractor Case Western Reserve University. Three to five clinicians at each agency tested the tool at various time points. CMS was careful to choose a mix of provider types such as hospital-based, freestanding, and non-profits and a mix of locations ranging from frontier to urban, Madigan explained in a packed session at the conference in Ft. Lauderdale, Fla. The agency also made sure that physical therapists completed assessments. One major purpose of the field testing was to determine which items needed revisions. "If you ask home care folks what they think, they'll tell ya," Madigan joked. CMS significantly revised the tool based on testers' feedback, noted Deborah Deitz with Abt Associates, another OASIS contractor. Example: CMS and its contractors revised the new item on drug education (M1180 on the originally proposed OASIS-C form). The item will now indicate that clinicians don't have to teach every drug on the first visit. Instead, they can prioritize the high-risk drugs, Deitz said. They also revamped the item on the Pneum-ococcal Vaccine (M1031), Deitz revealed. Instead of asking if the vaccination is "up to date," the new tool will just ask if the patient has ever received the PPV, she explained. That's because determining whether the status is up to date can be complicated. The tool will also ask about vaccinations at discharge instead of admission, Deitz added. Ambulation Change Gets A Cheer A number of changes CMS proposed last year will remain in the tool. For example, the new item on ambulation (M0702) will differentiate between walking with a cane and walking with crutches or a walker, Deitz noted. Attendees cheered this long-desired revision. Other changes Deitz noted include: • Activities of daily living (ADLs) will now specify that they must be performed "safely;" • Medication questions will now ask about 100 percent of a patient's time instead of 50 percent; • The "prior status" column for ADLs is gone; and • The prognosis question about death within six months has been [...]