Crosswalk

Revisions to Initial Proposed Draft OASIS-C1 in Response to Public Comments & CMS Review

September 24, 2013

Change	OASIS Item	Type of change	Description of Change	Reason for change
1	M0032	Capitalization change	Capitalization removed - text reverts to OASIS-C format. Response now reads: (month/day/year)	Internal review indicates this was an unintended change
2	M1011	Wording change to item stem	Added descriptive text to item stem. Item stem now reads: List each Inpatient Diagnosis and ICD-10-C M code at the level of highest specificity for only those conditions actively treated during an inpatient stay having a discharge date within the last 14 days (no V, W, X, Y, or Z codes or surgical codes):	Public comment/request
3	M1025	Change to instruction wording	Modified Instructions related to M1025 – removed reference to Appendix D (which has been eliminated) and removed reference to risk adjustment of quality measures as it is not relevant to instructions for item completion and potentially confusing.	Internal review - Appendix D is being eliminated from the Guidance Manual
4	M1033	Wording change made to response 7 and 9	Added /revised wording to conform to best practice standards and increase clarity. Response 7 now reads: Currently taking 5 or more medications Response 9 now reads: Other risk(s) not listed in 1 - 8	Public comment/request
5	M1046	Wording change made to response 1 and 2	Added explanatory language from Guidance Manual. Response 1 now reads: Yes; received from your agency during this episode of care (SOC/ROC to Transfer/Discharge ) Response 2 now reads: Yes; received from your agency during a prior episode of care (SOC/ROC to Transfer/Discharge )	Public comment/request
6	M1100	Title moved inside box	Reverted to OASIS-C item format . Words “Availability of Assistance” moved back inside box.	Internal review indicates this was an unintended change
7	M1306	Wording change to item stem	Revised word order for clarity. Item stem now reads: Does this patient have at least one Unhealed Pressure Ulcer at Stage II or Higher or designated as "unstageable"? (Excludes Stage I pressure ulcers and healed Stage II pressure ulcers )	Public comment/request
8	M1307	Wording change to item stem and NA response	Clarified wording based on wound expert input. Item stem now reads: The Oldest Stage II Pressure Ulcer that is present at discharge: (Excludes healed Stage II Pressure Ulcers) NA response now reads: NA - No Stage II pressure ulcers are present at discharge	Public comment/request
9	M1308	Wording change to item stem	Improved word order. Item stem now reads: Current Number of Unhealed Pressure Ulcers at Each Stage or Unstageable: (Enter “0” if none; excludes Stage I pressure ulcers and healed Stage II pressure ulcers )	Public comment/request
10	M1309	Addition of response option	Instructions for completing item revised to accommodate pressure ulcers that are unstageable due to slough/eschar Response option added: d. Unstageable due to coverage of wound bed by slough or eschar	Public comment/request
11	M1320	Wording change to item stem	Improved word order and added explanatory text from Guidance Manual. Stem now reads: Status of Most Problematic Pressure Ulcer that is Observable: (Excludes pressure ulcer that cannot be staged due to a non-removable dressing/device).	Public comment/request
12	M1324	Wording change to item stem and NA response	Improved word order and added explanatory text from Guidance Manual; clarified NA response. Stem now reads: Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable: (Excludes pressure ulcer that cannot be staged due to a non-removable dressing/device, coverage of wound bed by slough and/or eschar, or suspected deep tissue injury) . NA response now reads: Patient has no pressure ulcers or no stageable pressure ulcers	Public comment/request
13	M1330	Wording change to response option 3	Added the word “device” to make consistent with guidance. Response 3 now reads: Yes, patient has unobservable stasis ulcers ONLY (known but not observable due to non-removable dressing/device	Internal review – improved consistency with other items
14	M1332	Wording change to item stem	Revised word order. Stem now reads: Current Number of Stasis Ulcer(s) that are Observable	Internal review – improved consistency with other items
15	M1334	Wording change to item stem	Improved word order. Stem now reads: Status of Most Problematic Stasis Ulcer that is Observable	Public comment/request
16	M1340	Punctuation change to response 1; wording change to response 3.	Improved punctuation. Added the word “device” to make response 3 consistent with guidance. Response 1 now reads: Yes, patient has at least one observable surgical wound Response 3 now reads: Surgical wound known but not observable due to non-removable dressing/device	Internal review
17	M1342	Wording change to item stem	Improved word order. Stem now reads: Status of Most Problematic Surgical Wound that is Observable	Public comment/request
18	M1510	Punctuation change made to response 1	Added apostrophe. Response 1 now reads: Patient’s physician (or other primary care practitioner) contacted the same day	Internal review identified punctuation error.
19	M1630	Punctuation change to item stem	Added semi-colon. Stem now reads: Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay; or b) necessitated a change in medical or treatment regimen?	Internal review identified punctuation error.
20	M1730	Instructions moved	Instructions moved inside box	Internal review indicated need for consistency.
21	M1900	Wording change in stem to make consistent with M2040	Stem now reads: Prior Functioning ADL/IADL: Indicate the patient’s usual ability with everyday activities prior to his /her most recent illness, exacerbation, or injury. Check only one box in each row.	Internal review indicated need for consistency.
22	M1910	Wording change made to response 1 and 2	Reverted to wording similar to OASIS-C for response 1 and 2. Response 1 now reads: Yes, and it does not indicate a risk for falls. Response 2 now reads: Yes, and it does indicates a risk for falls.	Public comment/request
23	M2102	Wording change made to response “d” based on public comments	Added example of “home exercise program”. Response d now reads: Medical procedures/ treatments (for example: changing wound dressing , home exercise program)	Public comment/request
24	M2110	Wording change made to response “UK”	Deleted “Omit “UK” option on DC” from response UK, since this item is no longer collected at discharge. Response UK now reads: UK – Unknown	Internal review/consistency
25	M2250	Wording change made to response “c” and “d”	Revised wording for Response c NA option to be consistent with M1730 Response c now reads: Falls risk assessment indicates patient has no risk for falls. Revised wording for Response d; option for notification of physician on depression assessment. Response d now reads: Depression intervention(s) such as medication, referral for other treatment, or a monitoring plan for current treatment and/or physician notified that patient screened positive for depression.	Internal review/NQF guidance for quality measure harmonization.
26	M2400	Wording change made to response “b”	Revised wording for Response b NA option to be consistent with M1730 Response b now reads: Every standardized, validated multi-factor fall risk assessment conducted at or since the last OASIS assessment indicates the patient has no risk for falls.	Internal review/item harmonization
27	M2430	Wording change made to response 1	Added “adverse drug reactions” to response 1 for consistency with M2310. Response 1 now reads: Improper medication administration, adverse drug reactions, medication side effects, toxicity, anaphylaxis	Internal review/consistency

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