OASIS Alert

Train and Train Again to Get Case Mix Right

Try this expert technique to improve OASIS accuracy.

Once you've studied your agency's case mix trends, you'll likely find reason for further OASIS training. But don't train on case mix only once and then allow everyone to slip back into their bad habits.

Save the dates: Schedule training sessions on a regular basis, such as every 90 days or six months, says Pat Jump, MA, BSN, RN, COS-C, with Rice Lake, Wis.-based Acorn's End Training & Consulting. That way everyone remains certain of how to properly complete the OASIS document and accurately assess Medicare patients. Follow up by evaluating the resulting case mix weight.

Home health agencies put a lot of time into training nurses on the OASIS and its new-development updates, says Beth Carpenter, a Lake Barrington, Ill.-based consultant with Beth Carpenter & Associates. But it's important to continue to train on the basics like how to complete the OASIS correctly and what the questions mean. Don't put OASIS training on the back burner, she says. Remember, the OASIS is both an in depth assessment and a means for reimbursement -- make it a priority.

Try this: Consider sending a supervisor out to do a second OASIS for comparison as a professional growth exercise, Carpenter suggests. "We audit charts on a regular basis, but the OASIS is the source of that information. Using a second OASIS as a basis for discussion on a regular basis is a good thing." There will likely still be situations with a divergence of opinion, but this technique will help open up discussion and improve consistency.

In the vast majority of situations, intensive training for all clinicians (nurses as well as therapists) helps to improve case mix accuracy, Jump says. Thorough clinician training should concentrate on three areas, she says:

  • OASIS training;
  • Coding training; and
  • Patient assessment training.
  • Patient assessment training should include how to deal with situations specific to home health, such as how to "coax" the reluctant client into undressing for assessment and dealing with family and other potential distractions or barriers when completing the assessment, Jump says.

    Additionally, clinicians should receive frequent, repeated OASIS training in order to accurately answer data items, Jump advises. Annual OASIS training is the bare minimum frequency due to the complexity of the assessment form. Failure to provide training from a well-experienced OASIS trainer often results in poor outcomes and low reimbursement, she says.