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A Breakdown of the CMS OASIS-E Guidance Manual

On May 16, 2022, the Centers for Medicare & Medicaid Services (CMS) released the Draft OASIS-E Guidance Manual. In which CMS announced that the OASIS-E implementation has been delayed due to the public health emergency and is currently scheduled to be effective as of January 1, 2023.

Given this announcement, how will your agency prepare for the OASIS changes? What impact will these changes have on Value-Based Purchased (VBP)?

Read our breakdown of these changes below:

Section A changes were made, including adding a separate item for race and ethnicity. The goal of this change was to provide more data to address racial and ethnic disparities in healthcare outcomes. Additional new items for patient tracking include a new language item and transportation access, both to identify any barriers to healthcare services, as well as a new item for discharge and transfer OASIS time points where an agency must indicate if and how they provided a current reconciled medication list to subsequent providers.

Section B items include hearing, vision, and health literacy, with the intent to identify potential barriers to understanding and following treatment plans.

Section C includes the Brief Interview for Mental Status (BIMS) along with Signs and Symptoms of Delirium from CAM ©. The guidance manual states that most patients are able to attempt the BIMS.

Section D changes the PHQ-2 interview to the PHQ-9 patient mood interview, aligning with the skilled nursing facility MDS and creating more standardization across services.

Section J further expands on pain assessment. The frequency of pain interfering with activity (M1242) has been retired, and items assessing pain in three areas have been added. These areas include effect’s on sleep (J0510), pain interfering with therapy (J0520), and pain interfering with activity (J0530).

Section K replaces the previous M1030 therapies at Home and expands upon nutritional status, now including additional items such as a mechanically altered diet or a therapeutic diet as options, along with parenteral/IV feeding and feeding tube. The rationale indicates that nutritional approaches may influence an individual’s dignity, self-worth, and pleasure from eating.

Section N now includes an item on high-risk drug classes with side effects that could adversely impact health, safety, and quality of life.

Section O reviews all special treatments, procedures, and programs that may apply. These include treatments such as chemotherapy, suctioning, tracheostomy care, dialysis, IV medications, etc. These treatments may be performed in the patient’s home or other settings.

There are 27 new items in total on the OASIS-E, listed below for reference.

  • A1005: Ethnicity
  • A1010: Race
  • A1110: Language
  • A1250: Transportation
  • A2120: Provision of Current Reconciled Medication List to Subsequent Provider at Transfer
  • A2121: Provision of Current Reconciled Medication List to Subsequent Provider at Discharge
  • A2122: Route of Current Reconciled Medication List Transmission to Subsequent Provider
  • A2123: Provision of Current Reconciled Medication List to Patient at Discharge
  • A2124: Route of Current Reconciled Medication List Transmission to Patient
  • B0200: Hearing
  • B1000: Vision
  • B1300: Health Literacy
  • C0100: BIMS: Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
  • C0200: BIMS: Repetition of Three Words
  • C0300: BIMS: Temporal Orientation
  • C0400: BIMS: Recall
  • C0500: BIMS: Summary Score
  • C1310: Signs and Symptoms of Delirium (from CAM©)
  • D0150: Patient Mood Interview (PHQ-2 to 9)
  • D0160: Total Severity Score
  • D0700: Social Isolation
  • J0510: Pain Effect on Sleep
  • J0520: Pain Interference with Therapy Activities
  • J0530: Pain Interference with Day-to-Day Activities
  • K0520: Nutritional Approaches
  • N0415: High-Risk Drug Classes: Use and Indication
  • O0110: Special Treatments, Procedures, and Programs

Change can be overwhelming. Consider reaching out to HealthPRO Heritage at Home at homehealth@healthpro-heritage.com for additional support. We are here to answer questions you may have and provide support to ensure your success in 2023 and beyond.

Tags: Home Health