CNS-10238-Change Table. Crosswalk of Changes between 60 ad 30-day comment period

CMS Response to Public Comments on the Testing of a Revised OASIS Instrument

Revised
OASIS-C
page #
2
3

Item #

M0150

Changes from OASIS-C Published in Federal Register, July 2007
Revision based on Public Comment/Internal Review

Added the words "Advantage plan" to response 2

Items to be Used at SOC & ROC: M1100 changed to M1102;
Specific Time
Follow-up: M1030 changed to M1031; M0447, M0448, M0469, M0489,
Points
M1070, M1073 added;
Transfer: M1030 changed to M1031; M1070, M1073 added;
Discharge: M1030 changed to M1031; M0200, M0210, M0220, M0384,
M0550, M0715, M0717, M0775, and M0805 deleted; M0822, M0823,
M0824, M0896, M0900, M1070, M1073, M1120, M1130, and M1140 added

3

M0102

4

M0104

5

M0230/240/246

7

M0275

7

M0285

7

M1020

OASIS-C Change Table

Wording has been changed to: ”Indicate the date this referral for home
health services was made.”
Wording has been changed to read: “If the physician indicated a specific
start of care date when the patient was referred for home health services,
record the date specified.”
Letters have been placed in front of ICD-9 items in column 2 to improve the
usability of the grid; e.g.: a. ( __ __ __ . __ __ )
Wording has been changed as follows:
- Underlined wording added to the item stem: "Which of the following signs
or symptoms characterize this patient as at risk for major decline or
hospitalization?";
- Underlined wording has been added to response 6: "History of falls (2 or
more falls - or any fall with an injury - in the past year)"
- Response option added: "7 - Other"
Replaced proposed item with new (CARE-based) item with same number.

Wording has been changed as follows:
- Underlined wording changed in the item stem: "Has the patient received
an influenza vaccination during this year's recommended time period?";
- Underlined wording changed in response 3: “NA - Does not apply.
SOC/ROC date is not within time period."

10/19/2007

Reason for Change

Response to public comment requesting this option be
included in response
Revised to reflect items added, deleted or changed in
response to public comments and internal review.

Response to public comment requesting clarification of
wording
Response to public comment requesting clarification of
wording
Internal review indicated need to improve clarity of grid.
Response to public comments requesting a change in
the wording of the title, clarification of time frame for
history of falls, and inclusion of additional risk
indicators.

Response to public comment and internal review to use
a format and language common to the CARE
instrument.
Response to public comments and internal review
suggesting that the time period identified for
administration of vaccines should be modified to reflect
the fact that recommended times for influenza
vaccination may vary from year to year and to
document whether flu vaccine to document whether flu
vaccine was received, regardless of who provided
vaccine.

Page 1

Revised
OASIS-C
page #
7

Item #

Revision based on Public Comment/Internal Review

Reason for Change

M1021

Wording has been changed as follows:
- Underlined wording changed in the item stem: "Did the patient receive an
influenza vaccination from your agency during this year's recommended
time period?";
- Underlined wording changed in response 3: “NA - Does not apply.
SOC/ROC date is outside this year's recommended time period."

Response to public comments and internal review
suggesting that the time period identified for
administration of vaccines should be modified to reflect
the fact that recommended times for influenza
vaccination may vary from year to year.

8

M1025

Added the words "Not Indicated" to response 2

8

M1030

Item is now collected at SOC/ROC only. Skip patterns were removed from
options "0" and "1"

Response to public comment requesting this option be
included in response
Response to public comments requesting clarification of
timepoints when vaccine items are collected.

8

M1031

Item added to Follow-up, Transfer and Discharge in place of M1030.

8

M1035

Added the words "Not Indicated" to response 2

8

8

9

9

9
9

Response to public comments requesting clarification of
timepoints when vaccine items are collected.

Response to public comment requesting this option be
included in response.
M0382
Deleted and replaced with M0822/M0823, a CARE-based item. This new Response to public comment and internal review to
item is moved to new section entitled "Support Need" located just prior to
improve coordination with the CARE instrument and
"Therapy Need" on page 20 of the revised OASIS-C.
allow documentation of care provided by a family
member, caregiver needs and care gaps.
M0384
Deleted and replaced with M0824. This new item is moved to new section Response to public comment and internal review to
entitled "Support Need" located just prior to "Therapy Need" on page 20 of improve coordination with the CARE instrument and
the revised OASIS-C.
allow documentation of care provided by a family
member, caregiver needs and care gaps.
M0420
Wording has been changed to divide first response category into:
Response to public comment to allow clinicians to skip
"0 - Patient has no pain (Go to M1070)"; and
pain assessment questions for patients who do not
"1 - Patient has pain that does not interfere with activity or movement"
have pain.
M1050
Wording change to item stem - deleted "administered within the timeframe Wording change in item stem based on internal review
specified by the tool".
indicating phrase was unnecessary. Skip pattern
Skip patterns removed from options "0" and "1".
deletion based on internal review to allow
doccumentation of pain assessment for all patients with
pain.
M1065
Direction changed to "Complete M1065 if M1050 = "1"or if M0420 is greater Response to public comments seeking clarification of
Change Direction than "1".
timepoints/conditions for collecting this item.
M1070
M1070 previously documented pressure ulcer prevention plans. It now
Based on public comments about confusion on time
collects data on whether the patient was assessed for the risk of developing points for collection and difficulty answering "combined"
pressure ulcers.
questions. M0446 has been split into a "process" item
(M1070) and an "assessment" item (M0446).

OASIS-C Change Table

10/19/2007

Page 2

Revised
OASIS-C
page #
9

M0446

M0466 previously collected data on whether the patient was assessed for
the risk of developing pressure ulcers. It now documents whether the
patient was assessed to be at high risk of developing pressure ulcers.

9
10

M1072
M1073

10

M0448

New item replaces M1070. To be collected at SOC/ROC only.
New item replaces M1070. To be collected at Follow-up, Transfer and
Discharge.
Wording change to item stem - added "(non-epithelialized) "

10

M0452

10

Item #

Revision based on Public Comment/Internal Review

Wording change to item stem - added "(non-epithelialized)"
Rows b.i, b.ii, c.i, and c.ii referencing eschar removed

M0454 & M0456 Wording change to item stem - added "(non-epithelialized)" and changed
Change direction measurement from millimeters to centimeters.

Reason for Change

Previously M0446 tried to measure both assessment
and process simultaneously, which may have
contributed to the confusion about this section.This
change also allows clinicians to skip M1072 (at SOC)
and M1073 at other time points if the patient is
assessed to be not at risk of developing pressure
ulcers.
Response to public comments seeking clarification of
the term "unhealed".
Response to public comments seeking clarification of
the term "unhealed" and consistency in the use of the
terms "unhealed" and "non-epithelialized". Response to
public comments and internal review indicating that
language separating ulcers with and without eschar
should be removed.
Response to public comments seeking clarification of
the term "unhealed" and consistency in the use of the
terms "unhealed" and "non-epithelialized". Response to
public comments indicating wound length and width are
typically measured in centimeters.

10

M0454

| ___ | ___ | . | ___ | (cm)

Response to public comments indicating wound length
and width are typically measured in centimeters.

10

M0456

| ___ | ___ | . | ___ | (cm)

Response to public comments indicating wound length
and width are typically measured in centimeters.

10

M0461

Wording change to response 0 - added words "or healed"

10

11

Response to public comments seeking clarification and
consistency in the use of the terms "healed" and "reepithelialized".
M0465
Wording changes to skip pattern direction in item stem - [If patient has no Response to public comments skip patterns to allow
pressure ulcers (M0447 = "0" and M0448 = "0", skip to M0469]
this item to be skipped if there is no pressure ulcer.
Wording changes to responses 3 and 4 - references to "without eschar" and Response to public comments and internal review
"with eschar" removed
indicating that language separating ulcers with and
Sequence of responses renumbered to accomodate changes.
without eschar should be removed.
M1080
Directions changed to indicate item should be completed only if patient has Internal review indicated need to clarify that moisture
Change direction an open Stage II or higher pressure ulcer or a pressure ulcer that is
retentive dressings are only appropriate if ulcer is open.
designated as "not stageable", regardless of whether eschar is present.

OASIS-C Change Table

10/19/2007

Page 3

Revised
OASIS-C
page #
11

M1080

Wording change to item stem - added "open"

Internal review indicated need to clarify that moisture
retentive dressings are only appropriate if ulcer is open.

11

M1085

Wording change to item stem - added "open"

Internal review indicated need to clarify that moisture
retentive dressings are only appropriate if ulcer is open.

11

M0478

Wording change to item stem - clarified to direct skip to M0483.
Wording change to response 0 - added words "or healed"

11

M0487

Wording change to item stem - clarified to direct skip to M0489.
Wording change to response 0 - added words "or healed"

11

M0489

Wording change to item stem - added words "excluding bowel ostomy"

12

M0490

Wording change to response 0 - Deleted word "never".

Response to internal review recommending clarification
of skip patterns and public comments seeking
consistency in the use of the terms "healed" and "reepithelialized".
Response to internal review recommending clarification
of skip patterns and public comments seeking
consistency in the use of the terms "healed" and "reepithelialized".
Response to public comment questioning whether
ostomies are included in this item.
Response to public comment requesting deletion of the
word "never".

12
12

Item #

Revision based on Public Comment/Internal Review

M1102/1105/1110 Wording change as indicated by underline: Complete M1102 (or M1105) &
Change direction M1110 if patient has a diagnosis of heart failure .
M1102
Numbering of M1100 changed to M1102

14

M0590/M1120
Order revision

14

M0590

OASIS-C Change Table

Order revised--M1120 placed after M0590

Skip directions added to response 7 - "(Go to M0610)"

10/19/2007

Reason for Change

Rewording needed to accommodate renumbering of
item M1100.
Response to public comment requesting renumbering
of item to avoid confusion between the visually similar
M1100 and M1110.
Response to public comment allowing depression
screening and intervention items to be skipped if no
signs or symptoms of depression are observed or
reported.
Response to public comment allowing depression
screening and intervention items to be skipped if no
signs or symptoms of depression are observed or
reported.

Page 4

Revised
OASIS-C
page #
15

Item #

Revision based on Public Comment/Internal Review

M0672

Response option wording change as indicated by underline:
"3 - Able to participate in bathing self in shower or tub, but requires
presence of another person throughout the bath for assistance or
supervision.
Response option 4 split into responses 4 and 5:
4 - Able to bath self independently or with the use of devices in chair or on
commode, but unable to use the shower or tub.;
5 - Able to participate in bathing self in bed, bedside chair, or on commode,
but requires presence of another person throughout the bath for assistance
or supervision and is unable to use the shower or tub.

Reason for Change

Response to public comment requesting ability to
document progress when patient achieves ability to
bathe self in chair or commode. A response category
was added to document a patient’s ability to bath self
independently or with the use of devices in a chair or on
the commode.

Response sequence renumbered.
16

M0715

Wording change to item stem as indicated by underline: Is the patient’s
Response to public comment requesting clarification of
ability to transferring and/or ambulate better or worse than it was before the the term “prior to the current illness or injury".
onset of the illness or injury that initiated this episode of care?;
Wording change to responses as indicated by underline:
0 - Patient at least as able to transfer and ambulate now as s/he was before
the onset of the illness or injury that initiated this episode of care.; 1 Patient is less able to transfer and ambulate now than before the onset of
the illness or injury that initiated this episode of care.

16

M0717

Wording change to item stem as indicated by underline: Is the patient's ability to
Response to public comment requesting clarification of
perform self-care activities (grooming, dressing, and bathing) better or worse than it the term “prior to the current illness or injury".
was before the onset of the illness or injury that initiated this episode of care?;
Wording change to responses as indicated by underline:
0 - Patient is at least as able to perform self-care activities now as s/he was before
the onset of the illness or injury that initiated this episode of care.;
1 - Patient is less able to perform self-care activities now than before the onset of
the illness or injury that initiated this episode of care.

17

M0732

Item eliminated

OASIS-C Change Table

Response to public comment requesting elimination of
items to minimize burden.

10/19/2007

Page 5

Revised
OASIS-C
page #
17

Item #

M0775

Wording change to item stem as indicated by underline: Is the patient’s ability to
Response to public comment requesting clarification of
perform routine household tasks (light housekeeping, light meal preparation,
the term “prior to the current illness or injury".
laundry) better or worse now than it was before the onset of the illness or injury that
initiated this episode of care?;
Wording change to responses as indicated by underline:
0 - Patient is at least as able to perform routine household tasks now as s/he was
before the onset of the illness or injury that initiated this episode of care.; 1 - Patient
is less able to perform routine household tasks now than before the onset of the
illness or injury that initiated this episode of care.

18

M1140

18

M1160

Wording change to item stem as indicated by underline: Has this patient
had a multi-factor Fall Risk Assessment (such as falls history, use of
multiple medications, mental impairment, toileting frequency, general
mobility/transferring impairment, environmental hazards)?
Wording change to item stem - added "omissions" and "dosage errors"

18

M1170

Item title changed from "Medication Reconciliation" to "Medication Follow-up":
Wording change to item stem as indicated by underline: Was the patient’s
physician (or other primary care practitioner) contacted within one calendar day to
resolve clinically significant medication issues?

19

M0792

Wording change to item stem as indicated by underline: Patient's current
ability to prepare and take all prescribed inhalant/mist medications
(nebulizers, metered dose devices, oxygen) reliably and safely, including
administration of the correct dosage at the appropriate times/intervals.

19

M0805

Wording change to item stem as indicated by underline: Is the patient's ability to
Response to public comment requesting clarification of
prepare and take all prescribed medications (oral and, if applicable, inhalant or
the term “prior to the current illness or injury".
injectable medications) reliably and safely (including administration of the correct
dosage at the appropriate times/intervals.) better or worse than before the onset of
the illness or injury that initiated this episode of care?
Wording change to responses as indicated by underline:
0 - Patient is at least as able to prepare and take all prescribed medications now
than before the onset of the illness or injury that initiated this episode of care;
1 - Patient is less able to prepare and take all prescribed medications now than
before the onset of the illness or injury that initiated this episode of care.

OASIS-C Change Table

Revision based on Public Comment/Internal Review

10/19/2007

Reason for Change

Response to internal review indicating clarification of
wording was needed and and public comment
requesting choice of assessment tools should be the
agency choice
Internal review indicated need to include these relevant
terms.
Response to public comments and internal review
indicating that the title was confusing because it is
inconsistent with JCAHO definition of Medication
Reconciliation. Response to public comment requesting
ability to deal with non-urgent medication issues.
Response to public comment requesting that oxygen be
explicitly stated in question to avoid confusion.

Page 6

Revised
OASIS-C
page #
19

Item #

M0810

Delete direction for response option "NA" [ If NA, go to M0826 ]

19
20

M0820
M0822

20

M0823

20
21

M0824
M0845

21

M0870

22

M0896

Deleted; information incorporated into new item M0822
Revised version of M0382 based on CARE item added to new "Support
Need" section
Revised version of M0382 based on CARE item added to new "Support
Need" section
Renumbered M0384 moved to "Support Need" section
Wording added to response as indicated by underline: 15 - Wound
Response to public comments and internal review
infection or deterioration; Options 19 and 20 eliminated and list renumbered indicating chemotherapy and scheduled surgical
procedures were inappropriate options for this item. .
Response to public comment requesting addition of
wound deterioration.
Skip pattern simplified - skip directions for responses 2, 3 and 4 eliminated Response to internal review indicating need for
and a single skip direction added to item
clarification.
Wording added to response as indicated by underline: 15 - Wound
Response to public comments and internal review
infection or deterioration; Options 19 and 20 combined as "Scheduled
indicating that other procedures beyond chemotherapy
treatment or procedure" and list renumbered
and scheduled surgical procedures should be
documented. Response to public comment requesting
addition of wound deterioration.

OASIS-C Change Table

Revision based on Public Comment/Internal Review

10/19/2007

Reason for Change

Response to public comments indicating confusion over
timepoints for data collection.
Response to public comment and internal review to
improve coordination with the CARE instrument and
allow documentation of care provided by a family
member, caregiver needs and care gaps.

Page 7