Recent changes to OASIS C2 – the Outcome and Assessment Information Set – are not making things easier for home health providers, and despite repeated assurances that the market is ripe, more guidance is needed if the home health industry is going to master this new compliance requirement. OASIS C2 was totally rewritten for 2017, and the new version, effective January 1, 2017, includes changes required for standardization with other post-acute care data sets, along with three new and five revised items and guidance.
Confusion Over New Standards
Clinicians need to understand the intent and guidance from the OASIS Manual in order to assess their homecare patients accurately, consistently, completely, and appropriately. At the core of the homecare industry, OASIS leads to reimbursement, outcomes for star ratings and value based purchasing (VBP). But many clinicians aren’t familiar with the intent or the impact of OASIS responses, or how to assess the patient and determine which of the standardized OASIS responses apply to their patients.
Answering “M items” correctly is of special importance. Understanding The Centers for Medicare & Medicaid Services’ (CMS) intent behind every M item will help clinicians to assign the correct scores for patients. To expertly respond to OASIS items will be even more important in the next few years as CMS attempts to develop a tool that will accurately present and follow the patient across all care providers.
A proficiency test earlier this year concluded that less than two-thirds of managers were proficient in OASIS. Scores were not much better for other uses of the system – only 55 percent of registered nurses, 45 percent of speech therapists and 58 percent of physical therapists were proficient with the system. The numbers from this year are about on par with what was reported last year, which seems to indicate stagnation and a need for help.
OASIS is the critical link for many home health care agencies, and the new M and GG items are crucial. CMS offers a run-down of this year’s changes, but experts say you need additional help. “OASIS C2 does present some changes and challenges for home health,” one consultant stated.
Business Opportunities – and Challenges
The lack of OASIS competency is bad news for health care providers trying to enter the market. Failures of home care agencies, most recently one in Chicago and one in California, continue despite what has been called a nationwide shortage of home care providers.
“We are facing a caregiver shortage nationwide,” Right at Home owner Michael Juceam told a Florida newspaper. “We have a silver tsunami coming.” Angela Polletta-Penny, director of an adult day health program in Massachusetts, said that without home care options the so-called “Sandwich Generation” –middle aged adults now caring for both children and parents – is feeling the pinch. “We’re talking about 40-year-old people, having kids and making it all work,” she said.
The market is still trying to meet the demand: One of the most successful homecare outfits to jump into the market is Senior Helpers, a Maryland-based franchise setup. “The market for senior care businesses will continue to expand,” the company boasts.
Getting OASIS Right
Home care consultant Sharon Litwin provides a rundown of the overhauled rules in her audio conference for ProfEdOnDemand, “OASIS C2 – New and Challenging Items.” Aimed at RNs, PTs, OTs, STs and clinical managers, Litwin’s talk will help you understand the concept and flow of OASIS CS and the comprehensive assessment as well as the concept behind OASIS, an overview of the recent changes, and an in-depth look at the new M and GG items. “This is a must attend session for clinicians and managers who perform, audit and/or are responsible for integrity of OASIS in a home health agency,” Litwin says. “Beginners to OASIS, those who are struggling with OASIS, or those who need a refresher will all benefit from this seminar.”
