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OASIS C

OASIS-C All Time Points

The all item OASIS-C instrument posted on 8/12/09 has been corrected (M1330) and replaced as of 9/11/09. Please replace any copies of the all item instrument that you may have made. Each individual time point instrument includes the correction to M1330 in the zip file in the Data Set Link on the left. See Downloads below for the All Time Point version which highlights new items in OASIS-C.

The Centers for Medicare & Medicaid Services (CMS) received OMB approval of the OASIS-C data set on 7/27/2009. OASIS-C is a modification to the Outcome and Assessment Information Set (OASIS) that Home Health Agencies (HHAs) must collect in order to participate in the Medicare program. Implementation of OASIS-C, OMB #0938-0760, is required effective January1, 2010.

Development of the modifications to the OASIS-B1 instrument began in 2005 following recommendations from a variety of stakeholders: industry feedback, NQF recommendations, a Home Health Technical Expert Panel who identified Best Practice process measures that were deemed to be within the control of the Home Health Agency and MedPAC Report: adding quality measures in home health (Chapter 5, June 2006 report)

OASIS C testing was completed in 2008 and an instrument revision posted 11/2008. The comment period ended January 13, 2009. CMS completed its review and response to comments resulting in a revised final version 12.4 of OASIS C. CMS would like to thank the commentors. CMS conducted a thorough and thoughtful review of all comments and our responses are posted below under downloads, as well as the Federal Register Notice and the final OASIS-C version. Additional documents may be reviewed at the Paperwork Reduction Act link.

Existing data elements have been refined to more accurately capture improvement and new process measures have been streamlined. (see NQF link in Related Links outside of CMS below)

OASIS C - A balanced set of measures

Home Health Agencies have adapted well to outcomes, which is important. There are 3 types of measures most commonly used in quality work.

  • Structure - Physical equipment and facilities such as using EHR.
  • Process - How the system works - performing what is known to be clinically relevant and evidence based.
  • Outcome - The final product, results - stabilization, decline or improvement.

Measures are posted to NQF website (link below)

Measure Priorities

Developing priorities such as Global Harmonization of Measures across settings is a National Quality Forum priority which began with Flu and Pneumonia Immunizations. Currently Care Coordination Practices, Health Information Technology Expert Panel II (HITEP) and a Pressure Ulcer Framework is underway

  • Standardizing assessment/quality measurement across (post-acute) health care settings. The PAC demo has begun in 2008 and will result in a report to Congress in 2011 on the potential to use a single instrument to measure patient care and costs longitudinally. In the interim, OASIS, MDS and CARE will be determining like elements that can be described and measured the same way across settings of care.
  • Electronic Health Record (EHR) - ASPE will begin to work with AHIMA and Reigenstreif to LOINC enable the OASIS C version as a first step toward interoperability standards. The Office of the National Coordinator (ONC) is to develop a plan for interoperability.