CMS-R-245.Crosswalk of Nonmaterial Changes

Attachment A - OASIS-C version 12.2 (3-4-2009 - previously submitted) Compared to OASIS-C version 12.3 (6-19-2009a - current version with corrections)

Page 1

OASIS-C Version 12.2 (3-4-2009)
OASIS-C
Item Text
Item #
M0100 This Assessment is Currently Being
Completed for the Following Reason:

M0102

M0104

M1000

OASIS-C Version 12.3 (6-15-2009a)
Explanation for Correction
Impact on Burden
CORRECTIONS
This Assessment is Currently Being Completed for SKIP PATTERN FIX
NONE
the Following Reason:
Corrected invalid “Go To” directions in
response 8.and 9
8 – Death at home [ Go to M0906 ]
8 – Death at home [ Go to M0903 ]
9 – Discharge from agency [ Go to M1032 ] 9 – Discharge from agency [ Go to M1040 ]
Date of Physician-ordered Start of Care
Date of Physician-ordered Start of Care
CLARIFICATION
NONE
(Resumption of Care): If the physician (or
(Resumption of Care): If the physician indicated a Deleted phrase “or physician designee”
physician designee) indicated a specific start specific start of care (resumption of care) date when as this phrase was confusing since it
of care (resumption of care) date when the
the patient was referred for home health services, implied home care orders can come
patient was referred for home health services, record the date specified.
from non-physician
record the date specified.
__ __ /__ __ /__ __ __ __
__ __ /__ __ /__ __ __ __
month / day / year
month / day / year
(Go to M0110, if date entered)
(Go to M0110, if date entered)
NA –No specific SOC date ordered by physician
NA –No specific SOC date ordered by
physician (or physician designee)
Date of Referral: Indicate the date that the
Date of Referral: Indicate the date that the written CLARIFICATION
NONE
written or documented orders from the
or verbal referral for initiation or resumption of care Added clarification that verbal orders
physician or physician designee for initiation was received by the HHA.
are acceptable and deleted phrase “or
or resumption of care were received by the
physician designee” to improve
HHA.
clarity/provide correct guidance
From which of the following Inpatient Facilities From which of the following Inpatient Facilities was TYPO FIX
NONE
was the patient discharged during the past 14 the patient discharged during the past 14 days?
Added abbreviation (NF) to response 1.
days? (Mark all that apply.)
(Mark all that apply.)
Deleted response 3 -“Hospital
1 - Long-term nursing facility
1 - Long-term nursing facility (NF)
emergency department”, (this item asks
2 - Skilled nursing facility (SNF / TCU)
2 - Skilled nursing facility (SNF / TCU)
about inpatient facilities). Renumbered
3 - Hospital emergency department
3 - Short-stay acute hospital (IPPS)
responses.
4 - Short-stay acute hospital (IPPS)
4 - Long-term care hospital (LTCH)
5 - Long-term care hospital (LTCH)
5 - Inpatient rehabilitation hospital or unit (IRF)
6 - Inpatient rehabilitation hospital or unit
6 - Psychiatric hospital or unit
(IRF)
7 - Other (specify)
7 - Psychiatric hospital or unit
NA - Patient was not discharged from an inpatient
8 - Other (specify)
facility [Go to M1016 ]
NA - Patient was not discharged from an
inpatient facility [Go to M1016 ]

Form# CMS–R–245 (OMB# 0938–0760) – OASIS-C

June 15, 2009

Attachment A - OASIS-C version 12.2 (3-4-2009 - previously submitted) Compared to OASIS-C version 12.3 (6-19-2009a - current version with corrections)

OASIS-C Version 12.2 (3-4-2009)
OASIS-C Version 12.3 (6-15-2009a)
OASIS-C
Item Text
CORRECTIONS
Item #
M1032 Risk for Hospitalization: Which of the
No longer collected at Discharge, No change at
following signs or symptoms characterize this other collection timepoints.
patient as at risk for hospitalization? (Mark all
that apply.)
M1034

M1036

M1050

M1100

M1306

Page 2

Explanation for Correction

Impact on Burden

DELETION
Data from Discharge timepoint not
needed for calculation of payment,
quality or risk adjustment

DECREASE
Decreases number
of items reported at
DC by 1.

Overall Status: Which description best fits the No longer collected at Discharge, No change at
patient’s overall status? (Check one)
other collection timepoints.

DELETION
Data from Discharge timepoint not
needed for calculation of payment,
quality or risk adjustment
Risk Factors, either present or past, likely to No longer collected at Discharge. No change at
DELETION
affect current health status and/or outcome:
other collection timepoints.
Data from Discharge timepoint not
(Mark all that apply.)
needed for calculation of payment,
quality or risk adjustment
Pneumococcal Vaccine: Did the patient
Pneumococcal Vaccine: Did the patient receive
SKIP PATTERN FIX
receive pneumococcal polysaccharide vaccine pneumococcal polysaccharide vaccine (PPV) from Corrected invalid “Go To” directions for
(PPV) from your agency during this episode of your agency during this episode of care (SOC/ROC response 1.
care (SOC/ROC to Transfer/Discharge)?
to Transfer/Discharge)?
0 - No
0 - No
1 - Yes [Go to M1304 at TRN; Go to M1100 at 1 - Yes [Go to M1500 at TRN; Go to M1230 at DC]
DC]
Patient Living Situation: Which of the following No longer collected at Discharge. No change at
DELETION
best describes the patient's residential
other data collection timepoints.
Data from Discharge timepoint not
circumstance and availability of assistance?
needed for calculation of payment,
(Check one box only).
quality or risk adjustment

DECREASE
Decreases number
of items reported at
DC by 1.
DECREASE
Decreases number
of items reported at
DC by 1.
NONE

Does this patient have at least one unhealed Does this patient have at least one unhealed
CLARIFICATION
(non-epithelialized) Pressure Ulcer at Stage II Pressure Ulcer at Stage II or higher or designated Replaced “non-stageable” with
or higher or designated as "not stageable"?
as "unstageable"?
”unstageable” per WOCN guidance.
Clarified definition of healed – deleted
term “non-epithelialized” so that newly
epithelialized ulcers are not excluded,
as this item acts as a gateway to further
items that include newly-epithelialized
ulcers.

NONE

Form# CMS–R–245 (OMB# 0938–0760) – OASIS-C

DECREASE
Decreases number
of items reported at
DC by 1.

June 15, 2009

Attachment A - OASIS-C version 12.2 (3-4-2009 - previously submitted) Compared to OASIS-C version 12.3 (6-19-2009a - current version with corrections)

OASIS-C Version 12.2 (3-4-2009)
OASIS-C
Item Text
Item #
M1307 Date of Onset of Oldest Unhealed Stage II
Pressure Ulcer identified since most recent
SOC/ROC assessment:
__ __ /__ __ /__ __ __ __
month / day / year
UK - Present at most recent SOC/ROC
assessment
NA - No new Stage II pressure ulcer identified
since most recent SOC/ROC assessment

OASIS-C Version 12.3 (6-15-2009a)
CORRECTIONS
(M1307) The Oldest Non-epithelialized Stage II
Pressure Ulcer that is present at discharge
1-Was present at the most recent SOC/ROC
assessment
2-Developed since the most recent SOC/ROC
assessment: record date pressure ulcer first
identified:
__ __ /__ __ /__ __ __ __
month / day / year
NA - No non-epithelialized Stage II pressure
ulcers are present at discharge

Page 3

Explanation for Correction

Impact on Burden

CLARIFICATION
Responded to comments that
instructions for completing item were
unclear by rewording /re-ordering
responses.

NONE

M1308

Current Number of Unhealed (nonCurrent Number of Unhealed Pressure Ulcers at
epithelialized) Pressure Ulcers at Each Stage Each Stage:
(2 – 4
(Enter “0” if none; excludes Stage I pressure
(Enter “0” if none; enter “4” if “4 or more”;
ulcers and Stage II, III or IV pressure ulcers that
enter “UK” for rows d.1 – d.3 if “Unknown”)
have been newly-epithelialized for more than 30
days)
COLUMN 1:Number Present
COLUMN 1: Complete at SOC/ROC/FU & DC,
COLUMN 2: Number of these that were
Number Currently Present
present on admission (most recent SOC /
ROC)
COLUMN 2: Complete at FU and DC – Number
of those listed in column 1 that were present on
admission (most recent SOC/ROC)

CLARIFICATION/ DELETION
DECREASE
Clarified definition of healed – deleted Eliminates reporting
term “non-epithelialized” so that newly
of Column 2 at
epithelialized ulcers are not excluded,
SOC/ROC.
and changed instruction so that ulcers
epithelialized for more than 30 days) do
not have to be reported. Changed
instructions so that Column 2 does not
have to be reported at SOC/ ROC. If
recording number of pressure ulcers
greater than 4 at any stage, actual
number of ulcers is reported rather than
4,

M1310

Directions for M1310 and M1312: If the
patient has one or more unhealed (nonepithelialized) Stage III or IV pressure ulcers,
identify the pressure ulcer with the largest
surface dimension (length x width) and record
in centimeters:

CLARIFICATION
Clarified definition of healed– deleted
term “non-epithelialized” so that newly
epithelialized ulcers are not
unintentionally excluded. Corrected
directions to include M1314.

NONE

M1324

Stage of Most Problematic (Observable)
Stage of Most Problematic (Observable) Pressure
Pressure Ulcer:
Ulcer:
• 1 - Stage I [Go to M1330 at SOC/ROC/FU ] • 1 - Stage I

SKIP PATTERN FIX
Deleted invalid “Go To” directions for
response 1

NONE

Form# CMS–R–245 (OMB# 0938–0760) – OASIS-C

Directions for M1310, M1312 and M1314: If the
patient has one or more unhealed Stage III or IV
pressure ulcers, identify the pressure ulcer with
the largest surface dimension (length x width) and
record in centimeters:

June 15, 2009

Attachment A - OASIS-C version 12.2 (3-4-2009 - previously submitted) Compared to OASIS-C version 12.3 (6-19-2009a - current version with corrections)

OASIS-C Version 12.2 (3-4-2009)
OASIS-C
Item Text
Item #
M1334 Status of Most Problematic (Observable)
Stasis Ulcer:
• 1 - Fully granulating
• 2 - Early/partial granulation
• 3 - Not healing
M1342

Status of Most Problematic (Observable)
Surgical Wound:
0 - Re-epithelialized

OASIS-C Version 12.3 (6-15-2009a)
CORRECTIONS
Status of Most Problematic (Observable) Stasis
Ulcer:
• 0 –Newly epithelialized
• 1 - Fully granulating
• 2 - Early/partial granulation
• 3 - Not healing
Status of Most Problematic (Observable) Surgical
Wound:
0 -Newly-epithelialized

M1500

Symptoms in Heart Failure Patients:

Symptoms in Heart Failure Patients:

M1510

M1600

Page 4

Explanation for Correction

Impact on Burden

CLARIFICATION
Added ”newly epithelialized” in
response to request for clarification and
consistency in Integumentary items.

NONE.

CLARIFICATION
Replaced re-epithelialized with newly
epithelialized due to request for
clarification and consistency.
SKIP PATTERN FIX
Corrected “Go To” directions for
response NA

NONE

NA - Patient does not have diagnosis of heart NA - Patient does not have diagnosis of heart
failure [Go to M1732 at TRN; Go to M1600 at failure [Go to M2004 at TRN; Go to M1600 at DC ]
DC ]
Heart Failure Follow-up:
Heart Failure Follow-up:
TYPO FIX
Corrected grammatical error in
3 - Implemented physician-ordered patient-specific 3 - Implemented physician-ordered patient-specific
response 3.
established parameters for treatment

established parameters for treatment

Has this patient been treated for a Urinary
Tract Infection in the past 14 days?

Has this patient been treated for a Urinary Tract
Infection in the past 14 days?

UK - Unknown

NONE

NONE

TYPO FIX
Modified directions to omit UK
response at time of discharge, since
this item would be known at this time.

NONE

TYPO FIX
Modified directions to omit UK
response at time of follow up and
discharge, since this item would be
known at this time.
DELETION
Data from Discharge timepoint not
needed for calculation of payment,
quality or risk adjustment

NONE

UK – Unknown [Omit UK option at DC]
M1620

Bowel Incontinence Frequency:
UK - Unknown

M1750

Is this patient receiving Psychiatric Nursing
Services at home provided by a qualified
psychiatric nurse?

Form# CMS–R–245 (OMB# 0938–0760) – OASIS-C

Bowel Incontinence Frequency:
UK – Unknown [Omit UK option at FU and DC]

No longer collected at Discharge. No change at
other collection timepoints.

DECREASE
Decreases number
of items reported at
DC by 1.

June 15, 2009

Attachment A - OASIS-C version 12.2 (3-4-2009 - previously submitted) Compared to OASIS-C version 12.3 (6-19-2009a - current version with corrections)

Page 5

OASIS-C Version 12.2 (3-4-2009)
OASIS-C Version 12.3 (6-15-2009a)
OASIS-C
Explanation for Correction
Impact on Burden
Item Text
CORRECTIONS
Item #
M1830 Bathing: Current ability to wash entire body Bathing: Current ability to wash entire body safely. CLARIFICATION
NONE
safely. Excludes grooming (washing face and Excludes grooming (washing face, washing hands Clarified guidance to include
hands only)
and shampooing hair)
shampooing in definition of grooming,
to be consistent with M1800 Grooming.
M2100 Types and Sources of Assistance:
Types and Sources of Assistance:
CLARIFICATION / TYPO FIX
NONE
Clarified guidance by deleting the
ROWS - Needing assistance = patient needs ROWS - Type of Assistance
confusing language from Row
assistance on any item on the “e.g.” list:
Instructions, “Needing assistance =
Column 3 - Caregiver(s) currently provide
patient needs assistance on any item
Column 3 - Caregiver(s) currently provides
assistance
on the e.g. list:” and replacing with
assistance
“Type of Assistance”.

M2410

To which Inpatient Facility has the patient
been admitted?
NA - No inpatient facility admission

Form# CMS–R–245 (OMB# 0938–0760) – OASIS-C

Corrected grammatical error in Column
3 Heading
To which Inpatient Facility has the patient been
TYPO FIX
admitted?
Modified directions to omit response
NA - No inpatient facility admission [OMIT NA AT NA at the Transfer timepoint. NA is not
an appropriate response at the Transfer
TRANSFER]
time point.

NONE

June 15, 2009