Since its inception in 1999, home health’s Outcome and Assessment Information Set (OASIS) has been through many revisions targeted at enhancing validity and reducing collection time. Many of these changes have been directly related to the Impact Act of 2014. IMPACT Act is an acronym for Improving Medicare Post-Acute Care Transformation Act. The purpose of the Impact Act is to implement common standards and definitions when transitioning a patient from one care setting to another across the various post-acute care settings, and ultimately improve patient care. Currently, OASIS D-1 is serving this purpose. An ongoing multitude of studies, tons of research, and the endless quest to standardize the way data is collected is how OASIS E has come to be.
OASIS E has been on the radar of those in the post acute field since March 2020 when CMS announced that this most comprehensive overhaul to the OASIS data set was on its way. Due to the COVID-19 Public Health Emergency (PHE), the original January 1, 2021 start date was suspended. It wasn’t until December 15, 2021, that CMS released the finalized 2022 rule and confirmed that the new OASIS E effective date was reset to January 1, 2023. So here we are!
OASIS accuracy is, and will continue to be, vital to home health operations going forward with OASIS E. Home health agency’s quality measures, data collection, and reimbursement are all linked to the OASIS standardized instrument. In addition, the OASIS E data will account for one-third of performance scores and payment for agencies under another newbie in 2023, Home Health Value-Based Purchasing (HHVBP). So being ready for the OASIS E changes is a big deal!
What is new on the OASIS E form for Home Health?
As stated previously, this is the most extensive revision of the OASIS data set ever, so when it comes to OASIS E changes, there are a lot! To be exact, there are 159 OASIS E data elements changing with the new OASIS E assessment forms. This will include 39 new assessment items that are being added to the OASIS E charting including:
As if that isn’t enough, the entire landscape of the OASIS is changing so that it more closely mimics assessments utilized in other post-acute care settings. Aside from the M and GG prefixes that we have all become accustomed to, there will now be additional prefixes on items to coincide with the 16 new sections ranging from A to K (There is not a Section L or P). Visit the CMS OASIS E Guidance Manual 2022 for more detailed descriptions.
The OASIS E home health documentation changes will definitely take some getting used to, but the way the items are grouped is likely reminiscent of how most clinicians were taught to perform a head-to-toe assessment, and with repetition should get easier with time.
How to Succeed by taking these Critical Steps Now
Step 1 is to Breathe!
If you are already feeling overwhelmed by clinical documentation, OASIS E may have you feeling on edge. It is important to remember that you are not alone and there are resources available to help you author the best clinical documentation for the patients you are caring for. OASIS E skilled nursing documentation, as well as therapy documentation and collaboration take time to perfect. Being prepared will bring confidence in working through any unforeseen documentation challenges and diminish the number of errors.
Step 2 is to pause, review, and update your policies and procedures related to OASIS E.
Take the time to decide, before OASIS E goes into effect, who will do things such as be responsible for sending and confirming communication of reconciled medications at the Transfer and Discharge time points.
Step 3 is to START NOW educating Clinicians on changes to OASIS E
When the clock strikes midnight on December 31, 2022, OASIS D-1 is gone. Clinicians will need to be able to knock on the door ready to perform an OASIS E assessment. The CMS OASIS E manual is helpful, but it may also be helpful for clinicians to participate in OASIS E trainings that are directed specifically at their roles. Time may be needed to digest all the new OASIS E information and wrap their minds around how this will impact their personal assessment style so they can make modifications and feel well informed.
Finally, Step 4 is to Revisit your clinical documentation improvement program
Most agencies already have a clinical documentation improvement process, but with OASIS E it may be necessary to insert additional steps into the existing process once OASIS E goes into effect. One idea may be to incorporate OASIS E pulse checks into each of your weekly case conferences. This would be an ideal time to gauge how everyone is feeling, what impact the new OASIS E documentation is having on clinicians and discuss areas where they feel deficient so that an OASIS E education plan can be designed or sought out to meet their needs.
Home health OASIS E trainings available through HealthRev Partners
OASIS E Crosswalk
The OASIS D-1 to E Crosswalk acts as a quick glance cheat sheet to detail:
- What items are being deleted from the OASIS data set completely
- What new items are being added with OASIS E
- The different sections of the new OASIS E, including what items compose those sections
- Which OASIS E items are BIMS and SDOH items.
OASIS-E CROSSWALK
In addition to the crosswalk, we offer a free 3 part presentation that provides a general overview of specific changes to each of the following OASIS E assessment forms (Timepoints):
- OASIS E Start of Care and Resumption of Care assessments
- OASIS E Recert/Follow Up and Transfer to Inpatient Facilities assessments
- OASIS E Discharge and Death at Home assessments
Training on specific OASIS E guidelines
HealthRev Partners also provides more in-depth guidance related education that can be purchased and downloaded which includes a 3 part presentation to cover the following as well as notable changes to a few existing OASIS D-1 items.
At HealthRev Partners we can assist with the time-consuming task of identifying an agency’s needs regarding OASIS E education and training. HealthRev Partner’s Velocity uses advanced technology to take agencies to the next level. By combining clinical documentation intelligence with unmatched transparency, we can provide real time analytics related to the OASIS E health of your agency to help avoid penalties, promote maximum reimbursement, and improve publicly reported outcomes.
Want to learn more about our services? Schedule a conversation.
