The Outcome Assessment Information Set (OASIS) is a set of data elements required of home health agencies to measure adult patient outcomes and as a means of payment. The reimbursement rate for the home health services rendered to each Medicare patient is based on the answers to specific OASIS questions and is determined under the Prospective Payment System.
OASIS is required of all non-maternity patients who are 18 years of age or older and receive skilled services from a Medicare-certified home health agency. This means home care agencies must collect OASIS data on Medicare, Medicaid, private insurance, and private pay HMO patients receiving skilled care. Clients receiving only personal care, homemaker, or chore services exclusively are excluded since these are not skilled services.
The federal government mandated the collection of OASIS data and incorporated it into the Code of Federal Regulations in 1999. The collection of OASIS data at certain time points and the measurement of changes between two or more points in time allow home care agencies and other entities, such as state surveyors, to gauge whether appropriate progress towards desired outcomes is being accomplished. The data elements of OASIS form the basis for measuring patient outcomes and are to be considered as only part of a complete assessment.
Oasis items should be answered during the clinician's assessment process. It takes both observation and interview to conduct an assessment, and often one may validate the other. Direct observation is preferable when assessing the patient's ADL and IADL status. The patient should be assessed based on their ability to perform certain functions rather than willingness of compliance. Some questions can best be answered by interview with the patient and caregiver. When completing the OASIS assessments, the answer should reflect the patient status at the time of assessment. 'Time of assessment' has been defined as the 24 hours prior to the assessment visit. In some cases, you will also be asked to indicate the patient's status 14 days prior to the assessment date; this knowledge will be gained by interview. It is important that you assess the patient accurately based on the knowledge gained from the assessment visit.
In most cases, an actual visit is required to perform the OASIS. In some cases, for example, transfer to an inpatient facility or unplanned discharge, it may not be possible to perform a visit. In these cases the information should be obtained by contact with the patient or caregiver such as via a telephone call, or, at the very least, the OASIS is completed based on the knowledge gained at the last patient contact.
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