on each of the listed patient outcomes derived from OASIS data as well as other indicated patient outcomes from the claim. It also compares the agency with its own previous performance and with the performance of all other agencies in the nation. ● Risk adjustment : A statistical method that minimizes the influence of patient-related factors – such as age, diagnoses, and functional ability – that might adversely affect an agency’s outcomes; its purpose is to ensure that agencies are equitably compared with one another. ● Skilled intermittent services : Skilled services are those that require the “skills” of a registered nurse or rehabilitation therapist (physical therapist, occupational therapist, or speech-language pathologist). “Intermittent” services, as opposed to “continuous” or “one-time-
only” services, consist of skilled care provided during “visits” more than one time and only over a limited amount of time. ● Standards : Authoritative statements defined and promoted by the profession by which the quality of practice, service, or education can be evaluated. ● Therapeutic relationship : The alliance between a healthcare provider and a patient in which the provider and patient engage each other to effect a beneficial change for the patient. The therapeutic relationship assumes that the provider has certain ethical and professional responsibilities to the patient. ● Value-based purchasing : Payment for care based on quality of care as defined by specific clinical and financial measures. Publications ● Instant OASIS Answers 2019 – D/ICD-10 Edition OASIS Answers, Inc. P.O. Box 2768 Redmond, WA 98073 Tel: 425-868-2304 http://www.oasisanswers.com/products ● Medicare Home Health Benefit Regulations Medicare Benefit Policy Manual Chapter 7 – Home Health Services Centers for Medicare and Medicaid Services https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/ Downloads/bp102c07.pdf ● OASIS-D Guidance Manual https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/HomeHealthQualityInits/Downloads/OASIS- D-Guidance- Manual-final.pdf Websites ● Home Health Compare https://www.medicare.gov/homehealthcompare ● Medicare Learning Network (MLN) https://www.cms.gov/Outreach-and-Education/Medicare-Learning- Network-MLN/MLNGenInfo/Index.html ● Home Health Quality Improvement http://www.homehealthquality.org ● MLN Web-Based Training https://www.cms.gov/Outreach-and-Education/Medicare-Learning- Network-MLN/MLNProducts/WebBasedTraining.html Centers for Medicare and Medicaid Services. (2019). Outcome and assessment information set OASIS-D guidance manual . Effective January 1, 2019. Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives- Patient-Assessment- Instruments/HomeHealthQualityInits/Downloads/OASIS-D-Guidance-Manual-final.pdf Centers for Medicare and Medicaid Services. (2020). Quality measures . Retrieved from https://www.cms.gov/ Medicare/Quality-Initiatives- Patient-Assessment-Instruments/QualityMeasures Henderson, R. (2015, December). Industry employment and output projections to 2024. Bureau of Labor Statistics Monthly Labor Review, 1-28 . Retrieved from http://www.bls.gov/opub/mlr/2015/article/pdf/industry- employment-and-output-projections-to-2024.pdf Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, 42 U.S.C. §§ 1951-1970 (2014).
Resources Associations/Organizations ● American Occupational Therapy Association 4720 Montgomery Ln, Suite 500 Bethesda, MD 20814 301-657-1291 http://www.aota.org ● American Physical Therapy Association 1111 North Fairfax St Alexandria, VA 22314-1488 703-684-2782 http://www.apta.org ● American Speech-Language-Hearing Association 2200 Research Blvd Rockville, MD 20850-3289 800-638-8255 http://www.asha.org ● National Association for Home Care & Hospice 228 Seventh St, SE Washington, DC 20003 202-547-7424 http://www.nahc.org ● Wound, Ostomy and Continence Nurses Society
1120 Rte 73, Suite 200 Mount Laurel, NJ 08054 888-224-9626 http://www.wocn.org
References AMN Healthcare. (n.d.). Home healthcare: Fastest-growing industry faces workforce challenge s. Retrieved from http://www.amnhealthcare.com/home-health-industry-growth Centers for Medicare and Medicaid Services. (2020b). Hospice item set . Retrieved from https://www.cms.gov/ Medicare/Quality-Initiatives- Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set- HIS.html Centers for Medicare and Medicaid Services. (2020c). COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers . https://www.cms.gov/files/document/summary-covid-19-emergency-declaration- waivers.pdf
HOME HEALTH THERAPY: USING OASIS, UPDATED Final Examination Questions Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 148, or complete your test online at EliteLearning.com/Book
71. When first introduced by the Centers for Medicare and Medicaid Service (CMS), the initial purpose of the OASIS instrument was to: a. Measure the quality of care provided by home health agencies. b. Produce Potentially Avoidable Events Reports for use by Medicare surveyors. c. Determine the payment provided to an agency for caring for a patient. d. Determine an agency’s compliance with Medicare’s Conditions of Participation. 72. CMS primarily developed the Home Health Compare website to provide information to: a. Home health agencies. b. Consumers of home care services. c. Nursing home administrators. d. Medicare and accreditation surveyors.
73. What drives the CMS to make changes to the OASIS data set? a. Feedback from home health agencies and Medicare surveyors. b. CMS decisions about what measures should be added or dropped. c. Congressional mandates and advances in quality measurement science. d. Evidence-based practices that produce improved patient outcomes at less cost. 74. OASIS items that are considered “process measures” assess: a. How much the agency should be paid for providing care to the patient. b. If the therapist used “best practice” assessment and intervention strategies. c. If the patient improved, stayed the same, or deteriorated during the stay in home care. d. How much the patient’s risk should be adjusted compared with patients at other agencies.
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