Although the January 1, 2019 implementation date has come and gone, agencies should not lessen their focus on accurate OASIS-D data set collection. Just like any new process, agencies need to provide support through OASIS-D education. In addition to developing new assessment practices, clinicians are learning guidance that often conflict between items that assess the same functional activity. This is not a quick feat amid the ever-expanding expectations of the home health field clinician. Agencies who provide resources and coding services to support their staff are encouraging a successful learning process. How can your agency achieve this? Check out our carefully curated list below.
Key points to consider when educating your staff on OASIS-D:
- QUICK GUIDES: Create and distribute quick guides as an easy reference. Examples are crosswalks, cheat sheets and pocket references. Chapter Three of the OASIS guidance manual is great, however, it may not be the most feasible reference in the field.
- HANDS-ON: Engage in hands-on learning opportunities. Use scenarios/skits during staff meetings and email snippets that focus on key areas of assessment and guidance.
- GET REAL: Encourage staff to share real-life cases to talk through during meetings and as they are happening. Holding a discussion of real-life cases or challenges one clinician encounters may assist others in understanding the application of OASIS-D guidance.
- REVIEW, REVIEW, REVIEW: Monitor documentation to ensure accuracy and consistency. Quick turnaround of feedback reduces and prevents continued errors and the formation of habits.
- ONE-ON-ONE: Provide one-on-one education. Documentation oversight allows education to be specific and tailored to each staff member’s deficit.
- COLLABORATIVE POLICIES: Develop collaborative policies. “It takes a village!” should be our home health mantra. Whether it is a discussion between nurses or an interdisciplinary team review, the clinician completing OASIS-D should have input from all staff that has contact with the patient during the assessment time-frame.
- AGENCY-WIDE CONSISTENCY: Ensure consistency across the agency for ambiguous scenarios. There are still questions that relate to OASIS-D collection that require clinical judgement. “How is GG0170F Toilet Transfer coded for a foley and ostomy patient?” and “Can hands be considered utensils for GG0130A Eating?” are two examples. In the absence of guidance, agencies are instructed to use clinical judgment. Be sure all clinicians are assessing these types of situations consistently. Create a running log of these scenarios and how your agency answers them.
- KEEP INFORMED: Staying up to date with Q&A releases from CMS will ensure judgment is not wrongly applied to questions that CMS has specifically addressed.
Ensuring your staff has the resources and full support to correctly assess and code OASIS items will be critical to ensuring a smooth transition to the new data set. If your agency is overwhelmed or does not have the capacity to provide the vital resources during this transitory OASIS-D learning curve, partnering with a health care consulting firm is an excellent way to keep your agency on track.
OASIS-D directly impacts reimbursement, outcomes and STAR ratings and will have the potential to affect future payment methodology and outcome/value-based purchasing models. Moreover, an increase in standardized questions will give CMS the information needed to compare home health with other post-acute providers. Though challenging, this is our opportunity to supply CMS with accurate information that will determine the inevitable changes in healthcare reform.
OASIS-D Resources for Agencies
CMS OASIS-D Guidance Manual
McBee’s Complete Guide to OASIS-D resource page to access helpful webinars and handouts