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OASIS D Data Set – New for Home Health Agencies January 2019

OASIS continues to change as a data set used for the purposes of quality assessment, as well as payment for Medicare certified home health agencies.  The anticipated 2019 home health payment changes associated with the introduction of a Home Health Grouper Model (HHGM) is one of two reasons that agencies will use new OASIS items as of January 2019, the OASIS-D.

The second reason for OASIS changes is the ongoing inclusion of measures related to the IMPACT Act of 2014.  The ACT provides for both quality measurement and potential changes in post-acute payment if CMS can use the new data to create a ‘bundled’ post hospital stay payment that considers each patient’s characteristics and select the right setting (IRF (inpatient rehab facility), SNF (skilled nursing facility) or HHA (home health), the right duration and related cost to achieve the best outcome.

OASIS-D is effective January 1, 2019.

New Standardized OASIS items-

  • Patients Experiencing One (1) or More Fall with Major Injury (J1800): lookback questions at discharge if a patient experienced one or more falls; and (J1900) if the fall involved no injury, injury but not major (e.g. skin tear) or major injury (e.g. broken bone).
  • Functional Abilities and Goals (GG0100): at SOC, ROC, FU and discharge use a new rating of patient independence in 1) self-care; 2) indoor mobility; 3) stairs; and 4) functional cognition prior to the current illness.
  • Prior Device Use (GG0110): at SOC, ROC, FU and discharge asses prior use of specific devices and aids.
  • Using a new 6-point scale, the patients functional level is assessed for:
    • Self- care (G0130) 7 specific activities (Items A-H);
    • Mobility (G0170) 12 very specific activities (e.g. walk 50 feet and make two (2) turns, ability to go and down 12 stairs with or without a rail, etc.) (Items A-S); and,
  • Pressure Ulcer/Injury Stage to include unstageable deep tissue injury.

Other items and wording changes are made to align the OASIS measures with the same measures in IRF-PAI (IRF data set), the Long-Term Hospital data set, and the SNF MDS data set.

As veterans of home health know, changes to OASIS mean changes the software companies must incorporate before January 2019, as well as agency education of staff in the new OASIS items and wording.  CMS provides the following estimated costs only for the time associated with collecting and submitting the new items in each OASIS data set – all estimates anticipate paying a clinician $72.40/hour, and related administrative time paid at $39.86/hour:

OASIS

Additional Clinician Time
In Minutes

Additional Admin Time in Minutes

Total Additional Minutes/OASIS

Additional Cost

SOC

47.7

5

52.7

$60.88

ROC

47.7

5

52.7

$60.88

FU

23.7

5

28.7

$31.92

TOC

7.8

5

12.8

$12.73

DAH

2.7

5

7.7

$6.58

For more information on OASIS D, visit the CMS.gov website.

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