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OASIS-E Changes and its Impact on Home Health Agencies
May 2023
Overview
Since introducing OASIS in 1999, OASIS-E constituted the most significant changes to meet the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) requirements by refining interoperability among the post-acute providers using Standardized Patient Assessment Data Elements (SPADEs).
Below are the critical areas of OASIS-E changes :
1. Restructuring of OASISOASIS sections have been reorganized and named from A to Q. Moreover, new elements have been added and grouped together with the previous OASIS-D1 elements under these OASIS sections.
- A - Administrative Section
- B - Hearing, Speech, and Vision
- C - Cognitive Patterns
- D - Mood
- E - Behavior
- F - Preferences for Customary Routine Activities
- G - Functional Status
- GG - Functional Abilities
- H - Bladder and Bowel
- I - Active Diagnoses
- J - Health Conditions
- K - Swallowing/nutritional status
- M - Skin Conditions
- N - Medications
- O - Special treatment, Procedures, Programs
- Q - Participation in Assessment and Goal Setting
OASIS-E now includes new and modified elements, while certain previous elements have been eliminated. Some of the OASIS guidance for existing elements have also been changed in lieu of these changes. Furthermore, the OASIS guidance for existing elements has been adjusted to accommodate these changes. Moreover, the newly added elements adhere to the naming convention and structure used in other post-acute care (PAC) assessment instruments. This facilitates the collection of patient assessment elements across various post-acute settings, enabling data comparison, outcome evaluation, data exchange, and quality assessment within and across PAC settings.
| Type | Elements in OASIS-D1 | Elements Added in OASIS-E | Elements Removed in OASIS-E | Change | Elements in OASIS-E |
|---|---|---|---|---|---|
| Start of Care | 158 | 59 | 14 | 45 | 203 |
| Resumption of Care | 131 | 49 | 8 | 41 | 172 |
| Recertification | 36 | 8 | 0 | 8 | 44 |
| Transfer | 22 | 1 | 1 | 0 | 22 |
| Death at Home | 9 | 0 | 0 | 0 | 9 |
| Discharge | 97 | 51 | 2 | 49 | 146 |
OASIS-E has implemented additional assessments to assess the mental status, mood, behavior, and related factors of patients, in accordance with the requirements of the IMPACT Act. These new assessments include:
1. Reconciled Medication List and Transfer (Section A): This assessment focuses on reconciling the patient's medication list during the transfer process.
2. Cognitive Patterns (Section C): This assessment aims to evaluate the patient's cognitive patterns, including their memory, attention, and decision-making abilities.
3. Signs and Symptoms of Delirium from CAM (Section C):This assessment focuses on identifying any signs and symptoms of delirium using the Confusion Assessment Method (CAM), which is a validated tool for diagnosing delirium.
4. Mood - Expansion of PHQ-2 to PHQ-9: The Patient Health Questionnaire (PHQ) is expanded from a 2-item questionnaire (PHQ-2) to a 9-item questionnaire
(PHQ-9) to comprehensively assess the patient's mood and screen for depression.
These additional assessments have been introduced to fulfill the requirements of the IMPACT Act and enhance the evaluation of mental health-related aspects in patient care.
What is the impact of OASIS-E changes on Home Health agencies?
Home Health Agency operations, quality of care, and patient outcomes were directly impacted by the OASIS-E changes. Although it improves interoperability and the transfer of health information within and across PAC settings, the estimated additional 2.5 minutes to complete the OASIS became an undeniable concern for clinicians for the past months since the introduction of OASIS-E.
What can Home Health agencies do?
Ensure Continuous Education and Training: Continuous education and training initiatives are crucial for Home Health Agencies to enhance their service quality in light of the OASIS-E changes. By providing ongoing education and training to clinicians and staff, agencies can equip them with the necessary knowledge and skills to navigate the updated requirements effectively.
Develop and Update Policies and Procedures: It is essential to review and update existing policies and procedures to align with the changes introduced by OASIS-E. Developing a streamlined process that meets the OASIS-E requirements will enable agencies to better adapt to the Home Health Value-Based Purchasing Model (HHVBP) and ensure compliance.
Establish a Reliable Coding and Quality Assurance (QA) Partnership: Collaborating with a dependable coding and QA partner will play a critical role in helping Home Health Agencies address the challenges associated with the OASIS-E changes. This partnership can assist in effectively addressing clinician pain points, such as OASIS-E documentation and other clinical aspects, allowing agencies to concentrate on delivering high-quality patient care.
By implementing these strategies, Home Health Agencies can proactively respond to the OASIS-E changes, enhance their operational efficiency, and maintain a focus on providing excellent patient care.
About Cliniqon
Cliniqon is committed to delivering Guaranteed Quality, Ensured Compliance, and Unparalleled Outcomes in Home Health agencies.
Cliniqon is a rising outsourcing business process management company with an outstanding reputation for delivering unparalleled outcomes to its clients. Cliniqon’s focus is for our partners to have peace of mind knowing that they are assured of guaranteed quality and ensured compliance throughout their journey with us.
Our thorough review process will further improve the quality of your clinical documentation, leading to accurate claims, and ensuring you receive the reimbursement you earn.
Cliniqon offers a complete and systematic approach, focused on improving the agency's quality measures and patient outcomes as we code and review OASIS. (SOC, ROC, Recertification, Transfer, and Discharge), Plan of Care, and Concurrent Documents for Star Rating Management and Survey Preparation so the agency can focus on providing high-quality care.
For more information, please visit Cliniqon or call us at 1800-826-2477 .
