OASIS Alert

Published on Sun Nov 01, 2009 PDF

Find out what your time frame is for assessing fall risk.

Don't stop with the question and responses. Read further for the item intent and response specific instructions.

Scenario: During your comprehensive assessment of Mr. Jones, you address each of the items listed in M1910. M1910 asks, "Has this patient had a multi-factor Fall Risk Assessment (such as falls history, use of multiple medications, mental impairment, toileting frequency, general mobility/transferring impairment, environmental hazards)?" The patient's multiple medications and mild confusion lead you to conclude that he is at a higher risk of falls. Which of the following answers should you choose?

0 - No multi-factor risk assessment conducted

1- Yes, and it does not indicate a risk for falls

2- Yes, and it indicates a risk for falls.

Solution: 0 -- No multi-factor risk assessment conducted.

According to the Centers for Medicare & Medicaid Services' item intent discussion under M1910, a multi-factor risk assessment "must include at least one standardized tool that has been validated as effective in identifying falls risk in community-dwelling elders, and which includes a standard response scale."

Response-specific instructions explain that you can use a comprehensive multi-factor tool that meets these criteria (see Eli's OASIS Alert, Vol. 10, No. 11, p. 106). Or you can use several tools as long as one of them meets the criteria described under the item intent section.

Example: You can use a Timed Up and Go (TUG) standardized test and also consider other items in your assessment, such as medications, cognitive status, ambulation, transferring and incontinence, CMS says.

You need a minimum of two factors in the standardized assessment or one factor in that and one additional factor to meet the requirement of multi-factor, CMS advises in question 30 of the Oct. 21 OCCB OASIS C Q&As.

Heads up: To answer "yes" to M1910, the clinician doing the OASIS C assessment also must do the falls risk assessment. It can't be done by anyone else, CMS says. Also, you must complete the assessment within the time frame for completing the comprehensive assessment it is part of (such as 5 days for a start of care OASIS).