Q: Which multi-factor tool should we use for fall risk assessment?
A: Home health agencies are not mandated on which fall risk assessment tool they should use. In fact, like all process elements on the OASIS-C assessment, use of a standardized tool is optional. For M1910, Fall risk assessment, if a standardized tool is used, it must be a multi-factor falls risk assessment that includes at least one standardized tool that has been validated as effective in identifying the risk of falls in community-dwelling seniors. In addition to scientific testing for validity, the tool must also include a standard response scale, which means the same questions and responses would be used each time the tool is administered.
At this point, there has not been identified a single multi-factor falls risk assessment tool that meets the standardized tool criteria. The Missouri Alliance Multi-factor Fall Risk Assessment is undergoing validation at this time, but has not yet met those requirements. This tool can be used with another validated standardized tool, such as the Timed Up and Go (TUG) or the Functional Reach Assessment. Those latter tools cannot be used alone, because they only measure one factor of falls. The agency must measure at least two factors of falls to be able to respond to M1910 that a multi-factor falls risk assessment was completed.
July 9th, 2010 at 2:41 pm
CMS in their April OASIS-C Q&A’s stated if the “validated tool” did not show a risk for a patient fall that despite the answers to the “multifactoral” portion of the complete fall risk assessment, the answer to the OASIS question would be No risk for falls.
Chapter 3 dictates that a multifactoral, validated tool be used. We know there is no tool to date. Why would Medicare want us to answer this question as a no risk for falls based only on one portion of their requirement. That being the validated portion. The validated tools are not multifactoral. We should not be judging patient safety on just one requirement and not the other.