OASIS-Central

Clinicians are getting up to speed on OASIS-C. While conducting in-­service education, it might be good to update their knowledge on data elements that did not undergo major change. M0100, reason for assessment (RFA), is one such data element. The following are a few FAQs:

When is the proper time to complete the transfer assessment? Does the patient need to be admitted to the inpatient ­facility?

The instructions for OASIS-B1 did not provide clear guidance. A clinician was to complete the assessment when “the patient’s transfer to an inpatient facility was for 24 hours or longer.” Because there was no mention of admission to the facility, some agencies completed the assessment once the patient was gone from home for 24 hours, others completed it when the patient was admitted, and a third group waited until the patient was admitted for 24 hours or longer.

The OASIS-C Guidance Manual should put everyone on the same page. The instructions direct completion of the transfer assessment when “a patient is admitted to an inpatient facility for 24 hours or ­longer.”

Which assessment should we complete when the patient dies in the emergency room?

To answer this question, it’s necessary look at the guidance for another data element, M0906, discharge/transfer/death date. The guidance manual says to “exclude death occurring in an inpatient facility or in an emergency room, as both situations would result in transfer OASIS collection and would report the date of transfer.” Based on that instruction, RFA 7, transfer to an inpatient facility—discharged from agency, would be the response, even though the patient was not admitted to the hospital, let alone for 24 hours.

Which assessment do we complete if the patient is held in the hospital observation room for 24–48 hours or longer? He is gone from home for the appropriate time for a transfer assessment, but he was not admitted.

The OASIS-C Guidance Manual rules out a transfer assessment. The instructions for RFA 6 say, “Short-stay observation periods in a hospital, regardless of duration, do not meet the definition for transfer to an inpatient facility.” It appears that there is no assessment defined for short-stay observations. Homecare DIRECTION recommends: Upon the patient’s return, determine whether he or she has experienced a major change in status. If so, complete RFA 5, other follow up.

This is an excerpt from the article “Refresher Course on M0100” by Diane Omdahl, which originally appeared in the February 2010 edition of Homecare Direction. Learn more about Homecare Direction here!