Q: Our current OASIS-C M1910 Fall Risk Assessment utilizes the Missouri Alliance Multifactor Fall Risk Assessment and the Timed Up & Go Test (TUG). We are finding that patients who are not ambulatory can not be rated with the TUG and need to use a different standardized and validated test. Do you have any recommendations?
A: CMS has clarified that for an assessment tool to meet the criteria for a “yes” response on M1910, the assessment would need to have been validated as a tool that specifically measures risk for falls. If the patient is not able to participate in tasks required to allow the completion and scoring of the assessment(s), as would be the case in a non-ambulatory patient, a response of “0 – No multi-factor fall risk assessment conducted” should be reported.
September 20th, 2010 at 3:03 pm
Because the pt is nonambulatory and a TUG assessment can’t be performed, can we use the Morse Fall Risk Assessment? It is validated tool and can be used on pt’s who are unable to get up out of bed.
September 21st, 2010 at 8:25 am
CMS has stated that each agency is responsible for determining whether the risk assessments used meet reliability and validity requirements. It would be important for the agency to have sufficient evidence to support that the Morse Fall Risk Assessment was “scientifically tested on a population of community dwelling elders and shown to be effective in identifying people at risk for falls.” Most of the literature supports validity in the acute care and long-term care settings. A bedbound patient in the hospital managed around-the-clock by clinicians would have a different fall risk than one at home, in which an unskilled caregiver is assisting and transferring the patient. Both patients would score a “O” on the Morse Fall Risk Assessment related to Ambulatory Aid and Gait, which may not accurately reflect the patient’s risk in the home setting. In addition, the Morse tool does not take into account environment, medications and injury risk.
At this point, because there is no CMS endorsement of specific tools, and because compliance with this item affects patient outcomes, agencies would need to feel comfortable the tool they use accurately reflects fall risk in the home setting.
November 1st, 2010 at 10:58 am
M1910 – is there an evidenced based practice tool to assess fall risk in the non-ambulatory patient in the home setting?
November 2nd, 2010 at 3:59 pm
Currently, there is no validated assessment that evaluates fall risk for the non-ambulatory patient.