History of OASIS

2202.2 - History of OASIS (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) The OASIS is a group of data items developed, tested, and refined over the past decade for the purpose of enabling the systematic measurement of HHA patient care outcomes. Initially, the OASIS was a 79-item data set first published in 1994 by the Center for Health Services and Policy Research at the University of Colorado. Over the years, it has been modified as a result of input from a variety of home care experts, including representatives of all home health care disciplines. Future modifications to the OASIS are expected as we learn more about outcome measurement as well as determine what information would best serve the continued maintenance of a case-mix adjusted home health PPS. Relative to OASIS, the definition of outcomes is very specific: outcomes measure changes in a patient’s health status between two or more time points. The data are collected at specific time points following a patient’s admission to an HHA to determine whether appropriate progress toward desired outcomes is being achieved. These data items must be incorporated into the agency’s overall patient assessment process as OASIS was not developed to be a complete comprehensive assessment instrument. HHAs will find it necessary to integrate the OASIS items into their own process in order to comprehensively assess the health status and care needs of their own patient population. Effective, January 1, 2010, the OASIS data set was significantly modified to include process measures. Some points to remember about the uses of OASIS data items into an HHA’s assessment process can be found in Appendix C of the OASIS-C Guidance Manual. 2202.2A - Current Version of OASIS (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) The current version of OASIS and the Guidance manual is found on the CMS Web site at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html. 2202.2B - OASIS as Part of the HHA’s Comprehensive Assessment (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) OASIS data items are not meant to be the only items included in an agency’s assessment process for Medicare and Medicaid patients. They are standardized assessment items that must be incorporated into an agency’s own existing assessment policies process. An example of a comprehensive assessment showing an integration of the OASIS data items with other agency assessment items can be found in Appendix C: Sample Clinical Records Incorporating OASIS Data Set, in the OASIS User’s Manual. For a therapy-only case, the comprehensive assessment should include OASIS data items as well as other assessment data items the agency currently collects for therapy-only cases. 2202.2C - Incorporation of OASIS Data Items Into the Comprehensive Assessment (Refer to §484.55(e)) (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) In accordance with the regulations, agencies MUST incorporate the language of OASIS data items exactly as they are written into their own assessment process. Agencies are expected to replace similar items/questions on their current assessment as opposed to simply adding the OASIS items at the end of their existing assessment tool. For agencies electronically collecting assessment data using software that does not accommodate bolding or underlining for emphasis of words in the same manner as the current OASIS data set, capitalizing these words is acceptable. It is also recommended that HHAs include the data set numbers (M numbers) when incorporating the OASIS. In this way, the clinician will know that the M labeled items are items that MUST be assessed, completed, and reported. This will minimize delays in encoding due to incomplete OASIS data items. Agencies may wish to incorporate the assessment categories (e.g., Activities of Daily Living (ADLs)/Instrumental Activities of Daily Living (IADLs), Medications, etc.) into their own assessment process in a different order than presented on the OASIS form. While HHAs are encouraged to integrate the OASIS data items into their own assessment instrument in the sequence presented on the OASIS form for efficiency in data entry, they are not precluded from doing so in a sequence other than that presented on the OASIS form. However, this is not recommended because of the skip patterns built into the OASIS form.