OASIS Alert
Put Your M1830 Skills to the Test
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Does preference impact bathing ability? How well do you know your way around M1830 --
Scenario 1:
Your patient is able to safely bathe herself without assistance but cannot shampoo her hair. How would you score M1830?Scenario 2:
Your patient has demonstrated that she is able to bathe in the shower without assistance, but she chooses to sponge bathe independently at the sink. How should you score M1830?Scenario 3:
Your patient's shower is not safe for use. How would you answer M1830?Scenario 4:
Your patient is on physician-ordered bed rest. How would you answer M1830?Scenario 5:
Your patient fell getting out of the shower on two previous occasions and is now afraid and unwilling to try again. How would you answer M1830?Scenario 6:
Your patient chooses not to navigate the stairs to his bathtub. How would you answer M1830?Put Your M1830 Skills to the Test -- Answers
Answer 1:
Shampooing is specifically excluded from the bathing tasks for M1830, say the Centers for Medicare & Medicaid Services in the January 2011 OASIS Questions and Answers. Because the specific task of shampooing hair is not included in the scoring of M1830, and because your patient can otherwise bathe safely, you can select "0" -- Able to bathe self in shower or tub independently, including getting in and out of tub/shower for this patient.Answer 2:
OASIS item M1830 addresses your patient's ability to bathe in the shower or tub, not her actual performance, regardless of where or how she currently bathes, CMS says in the January 2011 OASIS Q&As. Willingness and compliance are not the focus of this item.If your patient can bathe safely without assistance, you would select response "0" in this scenario. If she requires assistance to bathe in the shower or tub, then you should choose from responses "1," "2," or "3" depending on the level of assistance she needs.
Answer 3:
Your patient's environment can impact his ability to complete specific activities of daily living tasks, CMS says in the January 2011 OASIS Q&As. When your patient's tub or shower is nonfunctioning or not safe, he is currently unable to use the facilities. Choose from responses "4" -- Unable to use the shower or tub, but able to bathe self independently with or without the use of devices at the sink, in chair, or on commode, "5" -- Unable to use the shower or tub, but able to participate in bathing self in bed, at the sink, in bedside chair, or on commode, with the assistance or supervision of another person throughout the bath or "6" -- Unable to effectively participate in bathing and is bathed totally by another person, depending on his ability to participate in bathing activities outside the tub or shower, CMS says.Answer 4:
Your patient's medical restrictions mean that she is unable to bathe in the tub or shower at this time, CMS says in the January 2011 OASIS Q&As. Select response "4," "5," or "6," whichever most closely describes the patient's ability at the time of the assessment.Answer 5:
If your patient's fear is a realistic barrier to her ability to get in and out of the shower safely, then her ability to bathe in the tub or shower may be affected, CMS says in the January 2011 OASIS Q&As.If her fear causes her to refuse to enter the shower even with the assistance of another person; choose from responses "4," "5," or "6" depending on her ability at the time of the assessment. If she is able to bathe in the shower when another person is present to provide required supervision or assistance, then response 3 -- Able to participate in bathing self in shower or tub, but requires presence or another person throughout the bath for assistance or supervision
would best describe her ability.Answer 6:
You must consider your patient's environment when responding to the OASIS items, CMS says in the January 2011 OASIS Q&As. If she chooses not to navigate the stairs, but is able to do so with supervision, then her ability to bathe in the tub or shower is dependent on that supervision which allows her to get to the tub or shower, CMS says."While this may appear to penalize the patient whose tub or shower is on another floor, it is within this same environment that improvement or decline in the specific ability will subsequently be measured," CMS says.
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