Chapter 6 – What is OASIS E-1?

About the Author:
Mark Aquino is a registered nurse in California with a Bachelors of Science in Nursing and Masters of Health Administration from West Coast University. He has at least 5 years of experience in the front lines as a visiting nurse in home health and hospice in direct patient care. He is author of OASIS NINJA: A Home Health Nurse’s Guide to Visits, Documentation, and Positive Patient Outcomes. This guide provides nurses with the information they need to provide quality care to their patients in the comfort of their own homes. He also writes books about how to live a good life and how to improve yourself on a daily basis such as Self Help Transformation: An Evidence-Based Approach to Personal Transformation for Mental Health, Physical Fitness, Relationships, and Career. You can also find all his books here. Learn more at OasisNinja.com.

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OASIS E-1 is one of the new standards set by OASIS. This certification will be given to individuals with a range of physical disabilities. It has multiple items with multiple letters, including questions on ethnicity, language, transportation, hearing, vision, and pain in activity. The new version will also remove the M item regarding pain during activity and replace it with J items. This will require a lot of education and training.

OASIS-D1

OASIS-D1 and OASIS-E are two OASIS forms. The first one is based on the older version of the assessment tool, and the newer version is designed to measure the same things, but with updated guidance and 25 percent of the assessments’ items. The revision will also change the item numbers and sectional structure, and it will align with other data assessment systems used in post-acute care settings. This version will also retire several items, including M1200 Vision, M1242 Interfering Pain, and M2016 Drug Education.

As the new version of the assessment takes effect on Jan. 1, 2021, the OASIS data set will undergo dramatic changes. Though the implementation of OASIS-E has been delayed due to the COVID-19 Public Health emergency, it is expected to be finalized by 2023. However, organizations must be prepared for the transition and its implications. In addition to changes in data collection and reporting standards, OASIS-D1 and OASIS-E will require a new assessment structure.

The new OASIS assessment will have the same goals, but will be based on social determinants of health. These factors will affect care and payment. By identifying social determinants of health, organizations will be better equipped to address patient needs. In addition, these factors can bridge the gap between the quality of care and the quality of outcomes. Moreover, the new assessment is consistent with other CMS initiatives and focuses on holistic care.

OASIS-D1 is the best option for supervisors and QA staff that are preparing for the COS-C exam. OASIS-D1 and OASIS E-1 can be combined with a certification program to provide a complete course for healthcare professionals. This course consists of 16 lessons, each with a handout, video demonstration, and post-quizzes. The course is available in bulk for multiple users. McBee offers bulk licensing options for multiple users.

OASIS-D1 and OASIS-E have similar structure and function, but the OASIS-D1 has more detailed information on the new standardized OASIS. The new version also supports the IMPACT Act of 2014 and adds two SPADEs elements. Although the OASIS-D1 data set is similar, it differs from the OASIS-E in appearance and flow.

OASIS-D1 transitional component

Implementing the OASIS-D1 transitional component is a vital part of the agency quality process. This component will help your agency measure clinician insight, engagement, and satisfaction. However, it is important to note that it may seem counterintuitive to train clinicians on OASIS-D1 items too early. After all, they won’t be using them for months. That said, the benefits of this approach are significant.

As part of the OASIS-D1 transitional component, many current assessment items will be retained, but with a different character designation. They will be moved into a lettered section, based on the part of the body they represent. For example, Section M will represent the integumentary system. Items that pertain to wounds, such as M1720, “When Anxious,” will remain in Section C.

For the OASIS-D1 transitional component, CMS requires providers to document a change in a primary diagnosis and other diagnoses. A medical necessity documentation is needed. The documentation that accompanies an OASIS-D1 transitional component is essential to the reimbursement process. OASIS documentation must be accurate to support medical necessity and case mix weight. The OASIS-D1 transitional component is the perfect tool to get started on the right foot.

OASIS-D1’s main changes were made to make the standards more consistent with the IMPACT Act. The OASIS-D1 transitional component, also known as OASIS-D1, aims to create a standard for health information and the corresponding medical data. It has similarities with the MDS data set. It is important for organizations to understand the impact of this transition on OASIS data.

Future research on the OASIS-D1 transitional component should consider whether the measures are generalizable and how to make them more reliable. Current studies used nonrepresentative samples, and a multistage probability sampling design would increase confidence in validity and reliability inferences. More representative samples would also decrease sampling error, but they would not necessarily lead to better point estimates. But it is important to note that the OASIS-D1 transitional component will become effective after January 1, 2020.

The OASIS-D1 transitional component is important because it serves both resumption and recert functions. It should be completed accurately and fully to contribute to an integrated discharge plan. By doing so, the OASIS assessment will contribute to coordinating an integrated discharge plan. And as long as it meets these two critical criteria, OASIS-D1 will continue to be an important part of the CMS’s integrated care system.

OASIS-E implementation date

CMS recently bumped up the OASIS-E implementation date from Jan. 1, 2021, to January 1, 2023, due to the COVID-19 public health emergency. The new rule will require HHAs to use OASIS-E beginning with discharges on or after January 1, 2023. CMS also published an interim final rule in the Federal Register on May 8, 2020, which will cut short the PHE reprieve and set the OASIS-E implementation date for January 1, 2023.

CMS has continued to fine-tune OASIS-E, including the separation of race and ethnicity questions. It has also removed Item M2016 and added the “Patient declines to respond” option. While the Office of Management and Budget has not yet approved the new version of OASIS-E, SimiTree consultants caution against making additional changes. In the meantime, home health providers should take advantage of OASIS-E accuracy training sessions to become compliant.

The Centers for Medicare & Medicaid Services released the latest OASIS Q&As, providing guidance to OASIS questions submitted through their help desk. OASIS Q&As cover topics ranging from updates to coding M and GG items to guidelines for confusing scenarios. Here are the highlights of the 14 Q&As. If you are planning to use OASIS-E, make sure you know the deadline and how to prepare. The OASIS-E implementation date has a huge impact on the home health industry.

In the end, the OASIS-E implementation date is just around the corner, and your actions today will be crucial to the future success of your organization. With so many changes brewing in health care, ensuring that your team is ready is key. In fact, almost 40% of agencies don’t have an OASIS-E education plan. You can find out more about the deadline and the OASIS-E education requirements by browsing our blog.

OASIS-E is aligned with CMS’ other initiatives. It focuses on the holistic nature of health care delivery. By collecting data elements related to social determinants of health, an organization can address the needs of each patient. As a result, they can help reduce healthcare disparities. The OASIS-E implementation date is set for January 1, 2023. The proposed changes are significant revisions to the OASIS-D1 items, and a new response option.

OASIS-E education

Implementation of the OASIS-E is expected to begin by the end of this year. As of this writing, only 15% of agencies plan to implement the OASIS-E. This means that the majority of agencies will still train their staffs using the previous manual. Regardless of the implementation date, agencies should focus on transitional aspects of OASIS-E education and training. In addition to this, the transitional items of the OASIS-E are likely to increase clinician insight, engagement, and satisfaction.

Although there are many new OASIS-E items in the final version, many current assessment items will retain their character designation of “M.” These items will still be included in the corresponding lettered section of the OASIS-E. Section M represents the integumentary system. As a result, only “M” items related to wounds will be included in this section. Thus, the item M1720, “When Anxious,” will remain in Section C.

The OASIS-E manual has detailed information on items, including tips on answering specific questions. Chapter 3 is devoted to the transitional process for data elements and will help clinicians assess their patients. For more detailed descriptions of the changes made from OASIS D1 to OASIS-E, refer to Appendix D. This section contains a chart with a summary of the changes and new items since the D1 version.

OASIS-E is an important step toward achieving the broader CMS objectives for quality care. It requires organizations to collect information about the social determinants of health, and the results of this process will help them identify and address the needs of individual patients. By doing so, organizations will be better equipped to treat patients and reduce the disparities in care. So, as home health agencies prepare for the OASIS-E, they should focus on this important task.

The OASIS-E will be implemented nationwide on January 1, 2023. Home health agencies will transition to the new system by 2023, though the onset of the implementation was delayed due to a COVID-19 public health emergency. OASIS-E data will directly impact patient outcomes and payment, so it’s vital for providers to understand how to use this new system. This update represents one of the most important changes to the industry in years.

About the Author:
Mark Aquino is a registered nurse in California with a Bachelors of Science in Nursing and Masters of Health Administration from West Coast University. He has at least 5 years of experience in the front lines as a visiting nurse in home health and hospice in direct patient care. He is author of OASIS NINJA: A Home Health Nurse’s Guide to Visits, Documentation, and Positive Patient Outcomes. This guide provides nurses with the information they need to provide quality care to their patients in the comfort of their own homes. He also writes books about how to live a good life and how to improve yourself on a daily basis such as Self Help Transformation: An Evidence-Based Approach to Personal Transformation for Mental Health, Physical Fitness, Relationships, and Career. You can also find all his books here. Learn more at OasisNinja.com.

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