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January 25, 2018


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Medical Coding News Archives

MAJOR CHANGES FOR OASIS-C IN FISCAL 2010

 
December 22, 2009:

On January 1, 2010, the Centers for Medicare and Medicaid Services (CMS) will roll out one of the most comprehensive revisions to OASIS since its original release in 1999.

OASIS was initially designed for measuring home health care patient outcomes. CMS anticipates that creating the new data set for OASIS-C will promote best practices to prevent serious chronic conditions, improve the quality of care for patients, and provide guidance to the home health industry. Many of the changes for the OASIS-C data set reflect public comment and field testing. Major revisions include the addition of new items to make measuring home health care delivery more clear and consistent; replacement, consolidation, or elimination of specific OASIS-B1 items; and improvement of the data collection requirements that measure processes of care by home health agencies.

Processes measured in OASIS-C are categorized into seven domains: timely care, prevention, care coordination, assessment, education, care planning, and implementation of care plan.

A total of 25 process of care measures will be reported to agencies via CMS’s CASPER reporting system. Of these, the following 13 process measures that have been endorsed by the National Quality Forum (NQF) will be reported publicly on Home Health Compare reports.

  • Timely initiation of care
  • Influenza immunization received for current flu season
  • Pneumococcal polysaccharide vaccine ever received
  • Heart failure symptoms addressed during short-term episodes
  • Diabetic foot care and patient education implemented during short-term episodes of care
  • Pain assessment conducted
  • Pain interventions implemented during short-term episodes
  • Depression assessment conducted
  • Drug education on all medications provided to patient/caregiver during short-term episodes
  • Multifactor falls risk assessment for patients 65 or older
  • Pressure ulcer prevention plans implemented
  • Pressure ulcer risk assessment conducted
  • Pressure ulcer prevention included in the plan of care

Additional process of care measures are undergoing consumer testing and may be added to Home Health Compare reports based upon pending results. Those additional process measures include:

  • Drug education on high-risk medications provided to patient/caregiver at start of episode
  • Potential medication issues identified and timely physician contact made at start of episode
  • Potential medication issues identified and timely physician contact made during episode

Home health agencies should be aware that OASIS-C process items have potential for use in pay-for-performance, a quality-based purchasing system for home health care, if CMS decides to move forward. In addition, CMS has revised the outcome and utilization measures to now include 37 outcome and utilization items. The following 10 outcome measures will be publicly reported.

  • Acute care hospitalization
  • Emergency department care without hospitalization
  • Improvement in ambulation/locomotion
  • Improvement in bathing
  • Improvement in bed transferring
  • Improvement in management of oral medications
  • Improvement in dyspnea
  • Improvement in status of surgical wounds
  • Improvement in pain interfering with activity
  • Increase in number of unhealed pressure ulcers

CMS has released the OASIS-C Guidance Manual as well as other documents to prepare the home health community for the implementation of OASIS-C on January 1, 2010.

 

 
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