OASIS-E Home Health Data Set

The draft version of OASIS-E is here. Lots of changes are coming!

It should be noted right away that this is the draft version and it is not finalized yet, so there are some changes that could happen before OASIS-E goes live on January 1st of 2021 January 1st of 2022. (The COVID pandemic has pushed this back at least 1 year.) Everything in this post is current to the best of my knowledge as of the time of posting this. You can find and download all the OASIS data sets using this link to the CMS website. When OASIS-E becomes final, it will be uploaded on that page.

What’s new with OASIS-E?

Very little was changed for OASIS D-1, but that is not the case for the E version. Before I dive into that part, I’ll say up front that I know lots and lots of people will be disappointed and frustrated with how much has been added, but I appreciate how the OASIS has improved in capturing the social determinants of health in this new version. My wish and hope is that, before this is finalized, CMS will receive quality constructive feedback and consider removing more items to help reduce the length of this tool.

A Items

• A1005 – Ethnicity – “Are you of Hispanic, Latino/a, or Spanish origin?” – 6 options to choose from.
• A1010 – Race – This is an expanded version of the previous M0140 item, now with 15 options to choose from. Many of these are expansions of the Asian and Pacific Islander categories.
• A1110 – Preferred language and need for an interpreter
• A1250 – Transportation – A proprietary question from NACHC to assess lack of transportation
• A2120, A2121, A2122, A2123, A2124 – Items for transfer or DC OASIS asking if the reconciled med list was passed on to the subsequent provider and patient and how it was transmitted for each.

B Items

• B0200 – Hearing – 4 options
• B1000 – Vision – Expanded version of the M1200 item, now with 5 options.
• B1300 – Health Literacy – 6 options for this literacy screening question

C Items

• C0100 – Determining if brief interview for the patient’s mental status should be completed (associated with C0200-C0500 items)
• C0200 – Repetition of three words
• C0300 – Temporal orientation
• C0400 – Recall
• C0500 – Score for total from C0200-C0400 items
• C1310 – Signs and symptoms of delirium – from the Confusion Assessment Method (CAM)

D Items

• D0150 – Patient mood interview – This is the previous PHQ-2 screening tool (as in M1730), but if they score above the threshold then it expands into the PHQ-9.
• D0160 – Total score from D0150 for symptom frequency
• D0700 – Social isolation – assesses for loneliness and social isolation – 6 response options

J Items

• J0510 – Pain effect on sleep – 6 options
• J0520 – Pain interfering with therapy – 6 options
• J0530 – Pain interfering with daily activities – 6 options

K Items

• K0520 – Nutritional approaches – Appears to partially be an expanded version of the previous M1030 item, which now includes texture modified and therapeutic diet options.

N Items

• N0415 – High-risk drug use and indication – identifies several categories of high-risk meds and if they are indicated for the patient.

O Items

• O0110 – Special treatments, procedures, etc. Includes cancer, respiratory, IV meds/access, and dialysis.

What hasn’t changed with OASIS-E?

Not very much, which surprised me. There are still all of the M1800s and GG items (GG0100-GG0170). The M1700s items remain the same, except where they are expanded with the C items. The basic intake M items are all still there and unchanged as far as I can tell (except where expanded for ethnicity and race), as well as the M1300s items, M1400, M1600s items, and M2000s items.

What we are left with is a much larger data collection set. I’ll be curious to learn how much time this will add to the average SOC and comprehensive assessment. The items that no longer exist (like M1200 and M1242) appear to have been replaced with new items. I don’t see any cases where an item has been completely removed without having been replaced or expanded upon.

In closing

What are your thoughts? Besides frustration, of course. The data nerd and SDoH parts of me really appreciate how OASIS-E will be a much more holistic, comprehensive tool. But the clinician part of me can’t help but focus on how much more time this will add. Also, if you see any errors in the above please let me know so I can correct it accordingly.