OASIS Background

As described by CMS, the Outcome and Assessment Information Set, or home health OASIS, “is a group of standard data elements….designed to enable systematic comparative measurement of home health care patient outcomes at two points in time. OASIS-based quality measures can be used for quality improvement efforts that home health agencies (HHAs) can employ to assess and improve the quality of care they provide to patients.”

In other words, CMS aims to increase standardization across the post-acute environment with the latest revision of the OASIS home health data set. As a result, this will enable the calculation of cross-setting quality measurements, pursuant to the requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.

OASIS-D

Home health agencies will utilize OASIS-D as the latest data set (new and modified items), effective on January 1, 2019. The focus of this latest revision is on quality and comparison of those quality indicators. As a result, the new set includes more functional items that the home health clinicians will have to assess, as well as a modification of the pressure ulcer and fall history questions.

Upcoming Changes

  • Comparison of quality indicators
  • Additional OASIS functional assessments
  • Modification of pressure ulcer questions
  • Additional fall history questions
  • Removal of select M items

One important thing to note is that the updates to the OASIS home health data set do not affect the case-mix calculation. Instead, the updates place a heavy emphasis on the quality and standardization across all post-acute providers.

Potential Challenges

Above all, the functional assessment requirements at the OASIS-D start of care could foreseeably pose an obstacle to agencies. Why? The new data set will include an assessment of functional areas that do not typically include a comprehensive OASIS assessment unless therapy was ordered. For example, walking on uneven ground, a curb, or transferring into the car.

Benefits of OASIS-D

On the other hand, CMS will be more equipped to accurately track the comparison of quality outcomes between post-acute providers. Subsequently, this change is significant in monitoring the achievement of more quality patient outcomes in the home health environment.

How to Prepare for OASIS-D

As with all new regulations, success with the new OASIS-D data set depends on essential tools: OASIS-D training and preparation.

  • Before January 2019:
    • Update to the latest electronic medical record (EMR) platform
    • Train and educate your staff on the latest revisions, including OASIS documentation accuracy
  • After January 2019:
    • Have a quality assurance program in place to ensure the quality and accuracy of staff