OASIS-Central

When one thinks of emergent care it is almost synonymous with the hospital emergency room. This common assumption was the cause of much confusion in OASIS-B1, M0830, emergent care. Response 3, doctor’s office emergency visit/house call, is the source of the problems and also possible inequities in outcome results.

With the new OASIS-C set to launch on January 1, 2010, this will change.

The Centers for Medicare and Medicaid Services (CMS) have in the past considered any visit scheduled less than 24 hours in advance, no matter what reason, emergent care.

Examples of emergent care in OASIS-B1 could have been:

• A clinic does not schedule appointments in advance. The receptionist calls and tells the patient when to come in. If this call occurs less than 24 hours in advance of the visit.
• The patient is due to see the physician for a blood pressure check and a prescription renewal in two weeks. When they calls to make an appointment, the receptionist informs the patient that the physician will be on vacation at that time, but there is an opening the next day, less than 24 hours later, resulting in it being considered emergent care.

The examples above aren’t usually considered examples of emergent care. True examples would be considered examples like improper medication administration, dehydration, wound infection and GI bleeding. But even though they aren’t true examples, the agency would still incur an adverse event outcome and see less favorable results in the utilization outcome.

When creating the new OASIS-C, CMS made a change. The data element in OASIS-C on emergent care (M2300) asks only about visits to a hospital emergency department and has deleted the 24 hour condition. With OASIS-C the results for emergency care will solely reflect emergency situations and more accurately reflect what steps were actually taken.

This post was adapted from the article “Bid Farewell to Troublesome Data Elements,” which was featured in the February 2009 issue of  Homecare Direction, a Beacon Health monthly newsletter.