Welcome to this video series for Home Health agencies.
We will be discussing OASIS
which is the Outcome and Assessment Information Set for CMS submissions.
As always if you need more information than this short video can provide
please go to the OASIS Manual in the current edition on www.cms.gov.
Today we'll be talking about signing off an OASIS assessment.
As far as OASIS goes
there are two ways to think about "signing off".
One way is with your electronic health system software
which often includes a date and time stamp
and draws from your password to authorize your signature.
The OASIS way is to use M0080: Discipline of Person Completing the Assessment
which does not require a signature and date.
So these are two different mechanisms.
Your software is different than the OASIS sign off.
The correct answer for comprehensive assessments for M0080 is always 1: RN
if there are any orders for nursing care in place
by the time of the assessment completion.
But to answer it in this way
an RN must have made a home visit and participated in the assessing activities
on or before the M0090: Date Assessment Completed.
The name of this RN and assessment notes should be documented elsewhere
in your electronic health records or in retained nursing notes.
If the care plan physician does not complete orders
for skilled nursing care by the M0090 date
but only has orders for therapy
the appropriate therapist of the listed discipline
is now the signer of this OASIS assessment.
The therapist's license is responsible
for the accuracy of the entire OASIS assessment.
This therapist must have made a home visit
with results included in this assessment.
Remember, the only therapists authorized to complete an OASIS assessment in M0080
are PT and speech path.
In some cases an OT can sign off on M0080
in an assessment if it is not a start of care.
If this is a discharge assessment the last person in the home that was qualified under M0080
is responsible for the assessment.
If the discharge is emergent
it might mean that this is the therapist listed in M0080
even though there are orders for skilled nursing
because they were the last person in the home.
If both nursing and therapy discharged the patient on the same day
the last discipline in the home is listed under M0080.
If multiple disciplines contribute opinions to the assessment
there is still only one discipline assigned in M0080
who must take all of the available advice
and condense it according to their clinical judgment.
Other members of the assessment team might include other job functions
like a Masters in Social Work, a pharmacist,
the nurses aides that are helping or a physician's assistant.
This is easy to tell because M0080 has no place to indicate these individuals.
Only one eligible discipline condenses all the information
and signs off on M0080.
If this is a discharge assessment
and the last agency employee into the house was a CNA
that person cannot be listed in M0080.
Instead the records should be searched
for the last discipline listed into the home.
That person should interview the CNA
to determine answers to items that might need the most recent information.
It is always the clinical judgement of the discipline in M0080 which decides
what is actually on the submitted assessment.
After the M0090 date that assessment should be in queue for submission
to the ASAP database with the information locked as signed off.
If after submission a revision is necessary
there are correction procedures referred to in the OASIS Manual Appendix B-4.
Thank you for your interest in OASIS
and for watching this video.
As always you can get more information on OASIS
by going to the www.cms.gov website
for the most recent OASIS Manual.
There's also a list of the OASIS Coordinators on that website.
which is a great reference for further information.
Thank you so much for your time.