Functional Assessment Standardized Items (FASI): Round 1

Functional Assessment
Standardized Items (FASI)
FASI Assessor Training

FASI Project Team
• Barbara Gage

GW

• Pat Rivard

Truven

• Trudy Mallinson

GW

For questions about anything in this training
or conduct of the study, please contact:
[email protected] 202-994-6833
For other question, please contact
[email protected] 603-893-0668
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Overview
• Testing standardized items for home and communitybased waiver recipients
• Builds on the national efforts to create exchangeable
data across the caregiving team, including those in the
Medicare and Medicaid programs.
• Items will be tested on five population groups:
• Aged
• Disabled
• ID/DD
• Brain Injury
• Seriously Mentally Ill

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Training Objectives
• Define Functional Assessment
Standardized Items (FASI)
• Explain the intent of the items and the
rating scale
• Discuss coding instructions and data
gathering strategies
• Provide opportunities to accurately
code case examples
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Who is Assessed?
• Current recipients in each of the HCBS
programs:
– I/DD

– Aging
– Disability

– Seriously Mentally Ill
– Brain Injury

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Time Frames
Assessment Reference Period
• The time frame is 3 days and past month.
– For the 3 day period, this means the 3 consecutive
calendar days prior to the day the assessment is being
conducted. For the 3 day period, code the usual
performance
• Example: The assessment is being conducted on Tuesday
• The assessment reference period is Saturday, Sunday, Monday

– For the past month period, this looks at approximately the
past 30 days. For this period, code the most dependent
performance.
• Example: The assessment is being conducted on August 24th.
• The assessment reference period is July 24th – August 24th.
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Modes of Data Collection
• The FASI Items are collected using
multiple sources of information.
• The preferred modes of are:
– Direct observation
– Recipient self-report
– Primary caregiver report
– Other care giver report
– Case notes
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Steps in the Assessment Process
1. Assess the person’s functional status
Based on direct observation, their own self-report, family
reports, and/or caregiver reports, including reports
documented in the person care plan record during the 3-day
assessment period.

2. Allow individuals to perform activities as independently
as possible, as long as they are safe.
3. If helper assistance is required because the person’s
performance is unsafe or of poor quality, score
according to amount of assistance usually provided.

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Steps in the Assessment Process (continued)
4.

Activities may be completed with or without assistive device(s).
Use of assistive device(s) to complete an activity should not
affect your coding of the activity.

5.

Code the person’s usual functional performance in the past 3
days in Column A.
If the person’s functional performance changed during the
past 30 days, code their most dependent performance in
Column B.

6. Refer to agency, Federal, and State policies and procedures to
determine who may complete an assessment. Assessments are
to be done in compliance with facility, Federal, and State and
regulatory requirements.

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Unknown & Not Applicable
• There should always be a coding
option for you to use in response
• Score “09” if the item is not applicable

• If scoring “other” please specify what
that refers to

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Section A

IDENTIFICATION
INFORMATION
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Identification Information
TM01

0115
35
01
03
TM
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Identification Information
• Complete each of the 5 items in
Section A by writing in the appropriate
numbers or letters

• Make sure you fill in each box
provided
• Please use a dark permanent pen (not
a pencil)
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The Rating Scale and How to Use It

CODING FASI ITEMS

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Rating Scale
definitions are right
on the page

The FASI Forms

Put your identifier
on every page

TM01

If boxed is checked, only fill out Column A,
otherwise also complete Column B
Full item definitions
right on the page

06

05

04

04

04

04

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The Rating Scale
Code the person’s usual performance for the past 3
days (Column A), and most dependent performance in
the past month (Column B) using the 6-point scale:
• Code “06” for Independent.
• Code “05” for Setup or clean-up assistance.

• Code “04” for Supervision or touching assistance.
• Code “03” for Partial/moderate assistance.
• Code “02” for Substantial/maximal assistance.
• Code “01” for Dependent.

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The Rating Scale

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Key Coding Questions
• Does the person need assistance (physical,
verbal/ non-verbal cueing, setup/clean-up) to
complete the activity
✔ If no, Code 06-Independent
✔ If yes …

• Does the person need only set-up or clean-up
assistance?
✔ If yes, Code 05-Set-up or clean-up
✔ If no ...

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Key Coding Questions (cont’d)
• Does the person need only verbal/non-verbal
cueing, or steadying/touching assistance?
✔ If yes, Code 04-Supervision or touching assistance
✔ If no ...

• Does the person need lifting assistance or
trunk support with the helper providing less
than half of the effort?
✔ If yes, Code 03-Partial/moderate assistance
✔ If no ...
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Key Coding Questions (cont’d)
• Does the person need lifting assistance or
trunk support with the helper providing more
than half of the effort?
✔ If yes, Code 02-Substantial/maximal assistance
✔ If no ...

• Does the helper provide all of the effort, or
are two helpers needed, to complete the
activity?
✔ If yes, Code 01-Dependent
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Complete Coding Definitions
• 06. Independent – Person completes the activity
by him/herself with no assistance from a helper.
• 05. Setup or clean-up assistance – Helper SETS
UP or CLEANS UP; person completes activity.
Helper assists only prior to or following the
activity.
• 04. Supervision or touching assistance – Helper
provides VERBAL CUES or TOUCHING/STEADYING
assistance as person completes activity.
Assistance may be provided throughout the
activity or intermittently.
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Complete Coding Definitions
• 03. Partial/moderate assistance – Helper does
LESS THAN HALF the effort. Helper lifts, holds or
supports trunk or limbs, but provides less than
half the effort.
• 02. Substantial/maximal assistance – Helper
does MORE THAN HALF the effort. Helper lifts or
holds trunk or limbs and provides more than half
the effort.

• 01. Dependent – Helper does ALL of the effort.
Person does none of the effort to complete the
activity. Or, the assistance of 2 or more helpers is
required for the person to complete the activity.
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Additional Coding Questions
Why was the activity not attempted? Code the
reason:
• Code 07, Person refused, if the person refused
to complete the activity during the 3 day
assessment period.
• Code 09, Not Applicable, if the person does not
usually perform this activity.
• Code 88, Not attempted due to short-term
medical condition or safety concerns, if the
person did not attempt the activity during the
assessment period due to short-term medical
condition or safety concerns.
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Coding Tips
• Whenever possible, observe the person as he/she performs each
activity.
• Talk with participant, usual caregivers and family members.
• Use probing questions.
• When possible, review documentation for the 3-day and 30-day
assessment periods.
• Code based on the person’s actual usual/most dependent
(Column A/Column B) performance of each activity.
• Code to reflect the usual/most dependent (Column A/Column B)
amount of assistance/effort provided.
• Activities may be completed with or without assistive devices.
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SECTION B1

SELF CARE
Functional Assessment Standardized Items (FASI)

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Self Care Items
TM01

X

04

04
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8 Self Care Items
• 6a. Eating
• 6b. Oral hygiene
• 6c. Toileting hygiene
• 6d. Wash upper body
• 6e. Shower/bathe self
• 6f. Upper body dressing
• 6g. Lower body dressing
• 6h. Putting on/taking off footwear
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Self Care Item Definitions
6a. Eating: The ability to use suitable utensils
to bring food to the mouth and swallow food
once the meal is presented on a table or tray.
Includes modified food consistency.

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Self Care Definitions (cont’d)
6b. Oral hygiene: The ability to use suitable items
to clean teeth. [Dentures (if applicable): The ability
to remove and replace dentures from and to the
mouth, and manage equipment for soaking and
rinsing them.]
6c. Toileting hygiene: The ability to maintain
perineal/feminine hygiene, adjust clothes before
and after using the toilet, commode, bedpan or
urinal. If managing an ostomy, include wiping the
opening but not managing equipment.
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Self Care Definitions (cont’d)
6d. Wash upper body: The ability to wash, rinse,
and dry the face, hands, chest, and arms while
sitting in a chair or bed.

6e. Shower/bathe self: The ability to bathe self
in shower or tub, including washing, rinsing, and
drying self. Does not include transferring in/out
of tub/shower.

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Self Care Definitions (cont’d)
6f. Upper body dressing: The ability to put on and
remove shirt or pajama top; includes buttoning, if

applicable.
6g. Lower body dressing: The ability to dress and

undress below the waist, including fasteners; does not
include footwear.

6h. Putting on/taking off footwear: The ability to
put on and take off socks and shoes or other footwear
that is appropriate for safe mobility.
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Self Care Scoring Example 1
• Ms. F brushes her teeth while sitting on
the side of the bed. Her care attendant
gathers her toothbrush, toothpaste,
water, and an empty cup and puts them
on the bedside table for her before
leaving the room. Once Ms. F is finished
brushing her teeth, which she does
without any help, her care attendant
returns to gather her items and dispose
of the waste.
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Self Care Scoring Example 1
• What item is this?

• How would you code this?

• What is your rationale?
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Self Care Scoring Example 2
Assessor: “Describe how Mr. C usually washes his upper body.
Specifically, does he wash, rinse, and dry his face, hands, chest, and arms
while sitting in a chair or bed?”
Caregiver: “He has to sit in his bed because he’s too weak in the morning
to get to the sink, and I have to help him do most of it.”
Assessor: “What can Mr. C complete for himself when washing, rinsing,
and drying his upper body? Does he need instructions, safety reminders,
setup, or physical help?”
Caregiver: “I have to give him a basin of water, washcloth, and open his
soap container, lather his wash rag and place it in his hand. I encourage
him to wash his arms, but he always gets tired after washing one of his
arms. I then do all the remaining washing, rinsing, and drying of his
upper body. I’ve tried giving him a little rest break before asking him to
continue washing himself, but he then complains of feeling cold and
wants me to finish washing him. After washing his upper body, I have to
clean up the wash basin, washcloth, and soap for him.”
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Self Care Scoring Example 2
• What item is this?

• How would you code this?

• What is your rationale?
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Section B2

MOBILITY
Functional Assessment Standardized Items (FASI)

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Mobility Items

TM01

X

06
06
05
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Mobility: 7 Moving & Transfer Items
7a. Rolls left and right
7b. Sits to lying
7c. Lying to sitting on side of bed
7d. Sits to stand
7e. Chair/bed-to-chair transfer

7f. Toilet transfer
7g. Car transfer
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Mobility: Moving & Transfer Item Definitions
7a. Roll left and right: The ability to roll from lying on back to left and right side,
and return to lying on back.
7b. Sit to lying: The ability to move from sitting on side of bed to lying flat on the
bed.
7c. Lying to sitting on side of bed: The ability to safely move from lying on the
back to sitting on the side of the bed with feet flat on the floor, and with no back
support.
7d. Sit to stand: The ability to safely come to a standing position from sitting in a
chair or on the side of the bed.
7e. Chair/bed-to-chair transfer: The ability to safely transfer to and from a bed to a
chair (or wheelchair).
7f. Toilet transfer: The ability to safely get on and off a toilet or commode.
7g. Car transfer: The ability to transfer safely in and out of a car or van on the
passenger side. Does not include the ability to open/close door or fasten seat belt.
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Mobility Item Skip Pattern 1
8. Does the person walk?

0. Yes – Continue to question 8a.
1. No, but walking is indicated in the
future – skip to question 9.
2. No, and walking is not indicated –
skip to question 9.
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Mobility: 12 Walking Items
8.

Does the person walk?

8e. 1 step (curb)

8a. Walks 10 feet

8f. 4 steps

8b. Walks 50 feet with two
turns

8g. 12 steps

8c. Walks 150 feet

8d. Walks 10 feet on
uneven surfaces

8h. Walks indoors
8i. Carries something in
both hands
8j. Picking up objects
8k. Walks for 15 minutes
8l. Walks across a street

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Mobility Item Skip Pattern II
9. Does the person use a manual
wheelchair?
0. No – Skip to question 10.
1. Yes – Continue to question 9a.
10. Does the person use a motorized
wheelchair/scooter?
0. No – Skip to question 11a.
1. Yes – Continue to question 10a.
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Mobility: Manual Wheelchair
9.

Does the person use a manual
wheelchair?

9a. Wheels 50 feet with two turns

9b. Wheels 150 feet
9c. Wheels for 15 minutes
9d. Wheels across street

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Mobility: Motorized Wheelchair/Scooter
10. Does the person use a motorized
wheelchair/scooter?
10a. Wheels 50 feet with two turns

10b. Wheels 150 feet
10c. Wheels for 15 minutes
10d. Wheels across street

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Mobility: Walking Item Definitions
8a. Walks 10 feet: Once standing, the ability to
walk at least 10 feet in a room, corridor or
similar space.
8b. Walks 50 feet with two turns: Once standing,
the ability to walk at least 50 feet and make
two turns.
8c. Walks 150 feet: Once standing, the ability to
walk at least 150 feet in a corridor or similar
space.
8d. Walks 10 feet on uneven surfaces: The ability
to walk 10 feet on uneven or sloping surfaces,
such as grass or gravel.
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Mobility: Walking Item Definitions
8e. 1 step (curb): The ability to step over a curb or up and down one
step.
8f. 4 steps: The ability to go up and down four steps with or without a
rail.
8g. 12 steps: The ability to go up and down 12 steps with or without a
rail.
8h. Walks indoors: from room to room, around furniture and other
obstacles.
8i. Carries something in both hands: While walking indoors e.g.
several dishes, light laundry basket, tray with food.

8j. Picking up objects: The ability to bend/stoop from a standing
position to pick up a small object, such as a spoon, from the floor.
8k. Walks for 15 minutes: without stopping or resting (e.g.
department store, supermarket.)

8l. Walks across a street: crosses street before light turns red.
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Mobility: Wheeling Item Definitions
9a & 10a. Wheels 50 feet with two turns:
Once seated in wheelchair/scooter, the ability
to wheel at least 50 feet and make two turns.
9b & 10b. Wheels 150 feet: Once seated in
wheelchair/scooter, the ability to wheel at least
150 feet in a corridor or similar space.
9c & 10c. Wheels for 15 minutes: without
stopping or resting (e.g. department store,
supermarket.)
9d & 10d. Wheels across a street: crosses
street before light turns red.
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Mobility Scoring Example 1
• Mr. M has has motor control problems
following a severe traumatic brain
injury 10 years ago. When
transitioning from a sitting to a
standing position, Mr. M’s mother
assists by touching his trunk slightly
to steady him.

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Mobility Scoring Example 1
• What item is this?

• How would you code this?

• What is your rationale?
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Mobility Scoring Example 2
• Assessor: “Please describe how Ms. L usually
moves from sitting on the side of the bed to
sitting in a chair. Once she is sitting, how does
she get to the chair?”
• Caregiver: “She needs help to get to sitting up
and then to the chair.”
• Assessor: “I’d like to know how much help she
needs for getting from sitting on the bed to get
to sitting in a chair.”
• Caregiver: “She needs two people to help her to
stand up from sitting on the side of the bed and
to swivel and to sit down in a chair.”
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Mobility Scoring Example 2
• What item is this?

• How would you code this?

• What is your rationale?
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Section B3

INSTRUMENTAL ACTIVITIES
OF DAILY LIVING

Functional Assessment Standardized Items (FASI)
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IADL Items
TM01

X
04
03
03
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12 IADL Items
11a. Make light cold meal

11g. Telephone-placing call

11b. Make light hot meal

11h. Medication managementoral

11c. Light daily housework
11d. Heavier periodic housework
11e. Light shopping

11f. Telephone-answering call

11i. Medication managementinhalant/mist
11j. Medication managementinjectables
11k. Simple financial
management

11l. Complex financial
management

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IADL Item Definitions
11a. Make light cold meal: The ability to plan and prepare all aspects of a
light cold meal such as a bowl of cereal and sandwich and cold drink.
11b. Make light hot meal: The ability to plan and prepare all aspects of a
light hot meal such as heating a bowl of soup and reheating a
prepared meal.
11c. Light daily housework: The ability to complete light daily housework
to maintain a safe home environment such that the person is not at
risk for harm within their home. Examples include wiping counter tops
or doing dishes.
11d. Heavier periodic housework: The ability to complete heavier periodic
housework to maintain a safe home environment such that person is
not risk for harm within their home. Examples include doing laundry,
vacuuming, cleaning bathroom.
11e. Light shopping: Once at store, can locate and select up to five needed
goods, take to check out, and complete purchasing transaction.

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IADL Item Definitions
11f.

Telephone-answering call: The ability to answer call in
person’s customary manner and maintain for 1 minute or
longer. Does not include getting to the phone.

11g.

Telephone-placing call: The ability to place call in person’s
customary manner and maintain for 1 minute or longer. Does
not include getting to the phone.

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IADL Item Definitions
11h. Medication management-oral medications: The ability to prepare and take all
prescribed oral medications reliably and safely, including administration of the
correct dosage at the appropriate times/ intervals.

11i.

Medication management-inhalant/mist medications: The ability to prepare
and take all prescribed inhalant/mist medications reliably and safely, including
administration of the correct dosage at the appropriate times/intervals.

11j.

Medication management-injectable medications: The ability to prepare and
take all prescribed injectable medications reliably and safely, including
administration of the correct dosage at the appropriate times/intervals.

11k. Simple financial management: The ability to complete financial transactions
such as counting coins, verifying change for a single item transaction or writing
a check.
11l.

Complex financial management: The ability to complete financial decisionmaking such as budgeting, remembering to pay bills, and investment decisionmaking.
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IADL Scoring Example 1
• Mr. W’s caregiver places the phone in
front of him and then leaves. Mr. W
makes a call to his friend using on his
phone and they talk for 10 minutes.

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IADL Scoring Example 1
• What item is this?

• How would you code this?

• What is your rationale?
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IADL Scoring Example 2
• Assessor: “Please describe how Ms. B
usually takes her oral medication?”
• Caregiver: “She can take them by
herself.”

• Assessor: “Does she need assistance to
take the right amount or at the right
time?”
• Caregiver: “I set the pills up in a pill box
at the start of each week and she
remembers to take them each morning.”
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IADL Scoring Example 2
• What item is this?

• How would you code this?

• What is your rationale?
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Functional Assessment Standardized Items

PERSONAL PRIORITIES

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Personal Priorities
• At the end of each set of functional/caregiver
items, record the individual’s top two priorities
in this area for the next six months.
– Self-care, Mobility, IADLs, and Living arrangements,
Caregiver Assistance and Availability

• To the extent possible, have the person say how
much (or how little) assistance they are hoping
to need in 6 months
• Probe to ensure these are the person’s most
important goals

• Write the goals using the person’s own words
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Examples of Personal Priorities
Be independent in cleaning my teeth
Go to the toilet by myself
Walk to the store by myself
Run a 5k race with my sister
Go out to dinner with my friends
Find someone to do my laundry
Strong enough to watch TV without a caregiver present

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SECTION C

ASSISTIVE DEVICES

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Assistive Devices
TM01

02
09
02
00
02
02
02
09
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Scoring Assistive Devices
Indicate which assistive devices the person needs to complete
self-care, mobility, and IADL activities
02. Assistive device needed and available – Person needs this
device to complete daily activities and has the device in the
home.
01. Assistive device needed but current device unsuitable –
Device is in home but no longer meets person’s needs.
00. Assistive device needed but not available – Person needs
the device but it is not available in the home.

If device is not used, code reason:
07. Person refused – Person chooses not to use needed device.
09. Not applicable – Person does not need this device.

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Assistive Devices Scoring Tip
• Remember, to score the person’s need
for and availability of each assistive
device for the past month.

• Do not score what you think the
person could do if they had an
assistive device.

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Assistive Device Items
Mobility-related Devices

ADLs/IADLs

12a.

Manual wheelchair

12o.

Shower/commode chair

12b.

Motorized wheelchair or scooter

12p.

Walk/wheel-in shower

12c.

Specialized seating pad (e.g. air-filled, gel, shaped
foam)

12q.

Glasses or contact lenses

12r.

Hearing aid

12s.

Communication device

12d.

Mechanical lift

12e.

Walker

12f.

Walker with seat

12g.

Cane

12h.

Crutch(es)

12i.

Prosthetics

12j.

Orthotics/Brace

Moving around safely
12k.

Bed rail

12l.

Electronic bed

Environment adaptations
12t.

Stair rails

12u.

Lift chair

12v.

Ramps

Other: _________
Not Applicable – No assistive device needed in past
month (Check box)

12m. Grab bars

12n.

Transfer board

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SECTION D

SUPPORT NEEDS AND
CAREGIVER ASSISTANCE
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Living Arrangements and Availability of Assistance
TM01

04

04

1

04

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04

71

Living Arrangements and Availability of Assistance

• Indicate the person’s usual living
arrangements and the availability of
assistance.

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Availability of Paid and Unpaid Assistance
TM01

04

04

05

05

03

03

09

09

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Availability of Paid and Unpaid Assistance
Code safety and quality of caregiver assistance and their willingness to
provide assistance with each of the following activities.
05. Assistance not needed – No assistance needed.

04. Caregiver(s) currently provide assistance – Person’s usual caregiver(s)
willing and able to provided needed assistance.
03. Caregiver(s) need training/supportive services to provide assistance
– Caregiver(s) available and need assistance to provide support.
02. Unclear if caregiver(s) will provide assistance– Caregiver(s) available
in the home but it is not clear if caregiver(s) will provide needed
assistance.

01. Assistance needed but no caregiver(s) available – Person needs
assistance but no caregiver(s) available in the home.
00. Assistance needed but person declines assistance – Person needs
caregiving but declines this assistance.

09. Not applicable – Person does not do this activity.
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Availability of Paid and Unpaid Assistance
15a. Self-care assistance (for example, bathing, dressing, toileting, or
eating/feeding).
15b. Mobility assistance (for example, bed mobility, transfers, ambulating, or
wheeling).

15c. IADL assistance (for example, making meals, housekeeping, telephone,
shopping, or finances).
15d. Medication administration (for example, oral, inhaled, or injectable
medications).
15e. Medical procedures/treatments (for example, changing wound dressing, or
home exercise program).
15f. Management of equipment (for example, oxygen, IV/infusion equipment,
enteral/parenteral nutrition, or ventilator therapy equipment and supplies).
15g. Supervision (for example, due to safety concerns).
15h. Advocacy or facilitation of person’s participation in appropriate medical care
(for example, transportation to or from appointments).
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Availability of Paid and Unpaid Assistance

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