Last Minute Questions
Over the last few days, I have been getting a lot of last minute OASIS questions as we are about to dive headfirst into the new dataset. Real quickly, let me address a couple of them in case you are also wondering.
First of all, the use of dataset begins January 1. That means if the response to M0090 (date assessment completed) includes ‘2009’, you will use the old dataset even if the episode begins in 2010. Many of my clients point out that this make no sense. Never mind all that right now. Just do it.
Secondly, when an OASIS-C begins with, “Since the previous OASIS assessment…..” the time period includes the actual prior assessment visit. For instance, if you found your patient to have pain on admission and you called for orders for therapy and the patient has been pain free ever since, you would include the interventions performed during the admission visit.
Finally, the ‘physician ordered plan of care’ discussed at length in M2250 means that the physician plan of care has been communicated to and ‘authorized’ by the physician. If the orders have been requested but not received then the plan of care is not considered to physician authorized.
This means that a one way fax to the doctor does not count. A cursory ‘okay’ by the office nurse will not suffice unless you are confident that she has relayed the message to the MD and she is communicating the MD’s message to you.
Again, sometimes, the answer will be, ‘No’.
The date that you receive the last piece of information that you require for the care planning is the date that should be reflected in M0090. Therefore if you do the admission on Monday and it isn’t until Wednesday that you hear back from the MD, M0090 will be whatever date Wednesday falls on. A lot of the timeliness will be at the mercy of physician cooperation. However, the MD’s will never sign off on anything timely if we get it to them late. Our processes will also be reflected in these questions.
And please don’t shoot the messenger.