Starting at the End

If you want to score well in OASIS-C, chances are that your care planning will have to be taken to the next level. In reviewing clinical records the most common problem with care plans are that they are too vague. Some agencies are reluctant to put parameters on their clinical records because they may trigger too many phone calls. Orders to weigh patients have fallen off as agencies were cited on state surveys for not weighing patients. Orders for every possible intervention relating to diabetes are found on some care plans even though it is not realistically possible to carry all out all the orders in the episode.

This haphazard approach to care planning will help your agency’s performance in OASIS-C like cheesecake helps you lose weight. If you want to achieve financial and clinical success in OASIS-C, a refined approach to care planning is essential.

Starting at the end might very well be the best place to start – the end of the OASIS-C dataset. Every time you transfer or discharge a patient you will be faced with the ominous M2400. This ‘single’ data item is actually six questions. Specifically, it asks ‘Since the previous OASIS assessment, were the following interventions both included in the physician plan of care and implemented?’ for the following six individually assessed conditions:

• Diabetic foot care
• Falls preventions interventions
• Depression
• Interventions to monitor and mitigate pain
• Interventions to prevent pressure ulcers
• Pressure ulcer tx based on moist wound healing principles

Note that you will be reporting directly to CMS when you don’t address one of these areas AND perform the interventions as ordered. Those care plans that are regarded as a piece of regulatory fluff and don’t truly the guide the care of the patient will result in unfavorable information being sent to CMS.

Furthermore, if the visit nurse provides diabetic foot care or teaches regarding depression and it isn’t ordered on the care plan, it will not be reflected on this question.

So, start at the end. As you are writing care plan, keep this question in mind so that appropriate interventions will be ordered and then FOLLOW THEM!

OASIS-C training is ongoing at our training center. Please call 225-216-1241 for dates. In additions, we are available to provide training onsite at your location. As always, we welcome questions and comments in the box below as well as by email.