OASIS D-Day: Assess Once, Score Twice

December 11, 2018

In less than three weeks, home health agencies will be transitioning from OASIS-C-2 to the new OASIS D assessment. Given all the regulatory changes this year and with the holiday season upon us, it has really been a sprint to get staff trained.

HCA of MA recently held three training sessions for members and not surprisingly there is concern with staff being ready, especially around the nuanced degrees of functional assessments and specifically related to the new items related to mobility and self-care.  While OASIS-D comes advertised as “dropping 28 previous M-Items” from OASIS-C-2, the additional assessments will require lots of creative patient engagement on the part of the admitting nurse or therapist, according to HCA Director of Regulatory and Clinical Affairs Colleen Bayard.

“OASIS-D is intended to begin to standardize patient assessment and quality measures across all post-acute providers,” said Bayard. “But for us in home care some of the new items ask for very nuanced responses. For example, the mobility item (GG0170) has 17 mobility activities that  the clinician must  ‘code’ with a  6-point scale from independent to dependent or  ‘code’ with 4 possible responses related to ‘activity not attempted.’ he admitting clinician is responsible for assessing a patient’s ability to stair climb, pick up an object from the floor and even make a car transfer.

During the Alliance’s trainings, Bayard warned agencies to expect some productivity issues related to the learning curve,  but stressed that the training message across the industry should be: “assess once, score twice.” In other words, be aware of OASIS M assessment questions which track to newly added  GG assessments and use the same assessment to respond to multiple OASIS items in the same category.  Bayard also recommends close auditing or self-monitoring in the initial months, especially related to the responses “patient refused” or “dash” (not attempted). (Ask:  could the clinician interview a family member as a way to get a response?)

Bayard recommends using the “Expansion of the one Clinician Rule” to your advantage because CMS is encouraging an interdisciplinary team approach with OASIS-D. Bayard’s final advice: “As you focus on your training be aware that your nurses are going to need to have a strong intersection of observational skills with interview skills.”

HCA has several places members can come to share and learn as they move past Jan 1. Our Clinical Directors and Quality Improvement list serves and networking groups will be highly focused on OASIS-D as winter turns to spring.  The Clinical Directors next meet Thursday, January 10 and the QI Managers will next meet on January 9th. Meeting information is here. Our email groups are here.

If you haven’t already studied it – here is a list of more than 100 answers to OASIS questions received by CMS from the industry during recent CMS in-person trainings and webinars.

Return to www.thinkhomecare.org.


Educational Calendar Updates

November 15, 2016

As you probably know, the Home Care Alliance of MA is constantly adding new programs in our calendar, especially with all that is changes in our industry. Please see below some new (and old) programs that we have to offer over the next few weeks:

Thursday, November 17th: “Coping with Chaos: Compliance Climate 2016”

Home Health and Hospice agencies must continue to navigate a chaotic environment with no end in sight.  Get clarity on what the government enforcement agencies and contractors are focusing on in 2016-2017.  Learn how to formalize processes and systems to capture key payment and clinical documentation concerns to avoid overpayment requirements and disclosures, including use of PEPPER data.  Understand how to approach communications and requests from the MACs, ZPICS, the OIG and the DOJ. Finally, take control of your agency’s health and survival by committing to a sound ethics and compliance program framework and evolving ethics and compliance activities.

 *NEW*Tuesday, November 29th: “Medicare B Home Nurse Practitioner Program”

Certain outpatient therapy and other Medicare services may be furnished by a home health agency (HHA) to individuals who are not homebound or otherwise are not receiving services under a home health plan of care (POC) using Medicare Part B billing. As of January 1, 2016, Medicare expanded this list to include advance care planning as a billable service provided by either a physician or a nurse practitioners.  Hear how one agency has developed and successfully used Part B Billing to expand the scope of their community services.

 *NEW*Wednesday, November 30th,, and Wednesday, December 7th: “Riding the Wave: OASIS C-2 Changes”
Oasis-C-2 is just over a month away; are your clinicians aware of all the changes? Come join the HCA for training on the structure and content changes in the OASIS-C2 data set that are effective January 1, 2017. These new items can impact your quality scores and re-imbursement; so be sure your clinicians are familiar with the changes.

*Western MA date and location TBD*

 *DATE CHANGE*Monday, December 5th: “The Gold Standard: Understanding the Background and Importance of Compression for Wound Care Patients”

Compression plays a vital role in both wound healing and reduction of wound recurrence.  Participants will increase their understanding of lower extremity ulcer presentation, compression types, options, dosage and how each can ultimately impact success and outcomes. In the home health arena, it is vital to clearly understand current options available to maximize clinical effectiveness and cost-efficiency.

 Tuesday, December 6th: “Financial Management Conference” *NOTE AGENDA ADDITION: Medicare PPS Changes for 2017*

Agency CFOs and CEOs will be well served by joining HCA on December 6 in Norwood for the Annual Financial Managers Conference. This year’s event features a stellar line-up of expert panels including speakers on Value-Based Purchasing, Revenue Cycle Management, Bundled Payments, and HIPAA/ Cyber Security

 Thursday, December 8th: “The Aide’s Role in Understanding Mental Health Disorders”

This presentation will explore some mental health disorders that may create challenges for the Nurse Aide in the home setting. According to the National Alliance on Mental Illness approximately 43.8 million adults or 1 in 5 adults in the U.S experiences mental illness annually.  Chances are that some of the patients we care for in the home may be experiencing some sort of mental illness.  Learn strategies that can help you when caring for these patients.

 *NEW*Tuesday, December 13th: “A Team Approach to Medication Management”

It takes the entire home health team working together to ad- dress this vital aspect of health care to make a difference and improve the quality of care for those we serve every day. This 90-minute webinar is devoted to promoting a Team Approach to Medication Management in home health.

 

To learn more about any of our programs go to our calendar:  http://www.thinkhomecare.org/events


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