Although the OASIS has a reputation for being difficult, it’s really more time-consuming than anything else. Let’s dive in!
What We’ll Cover
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What is the OASIS?
OASIS (Outcome and Assessment Information Set) is a comprehensive evaluation that Medicare requires home health agencies to complete in order to collect patient info and monitor progress and outcomes.
Home health agencies must complete the OASIS for Medicare patients at initial evaluation, re-evaluation, and discharge. These assessments are known as Start of Care, Recertification, and Discharge.
And when we say it’s comprehensive, we’re not exaggerating. The patient is reviewed from head to toe. Levels of independence with activities of daily living are assessed, as are the patient’s physical, emotional, and mental health.
What the OASIS is not: The OASIS evaluation does NOT replace a clinical evaluation.
If, for example, you are an SLP assessing a newly admitted patient, the OASIS is separate from your speech therapy evaluation. If you tried to do both in one visit, it would take over 3 hours! We wouldn’t recommend it if you have the choice.
Who Can Complete the OASIS?
OASIS Start of Care
The Start of Care is the initial evaluation. Only the first home health care provider to visit a patient must complete the OASIS Start of Care.
Registered Nurses, Physical Therapists, and Speech-Language Pathologists can complete this beginning portion of the OASIS. At the time of this writing, Occupational Therapists cannot complete a Start of Care.
The same provider typically also completes the OASIS recertification (re-evaluation) and OASIS discharge.
Start of Care: Registered Nurses
Per Medicare: If a patient has nursing and therapy orders, then an RN should complete the OASIS.
Start of Care: Physical Therapists
If a patient only has therapy orders, then the PT should do it.
Start of Care: Speech-Language Pathologists
If an RN or PT isn’t available to complete the OASIS in the 24-72 hours after the patient is admitted into your agency, an SLP can complete the OASIS.
OASIS Recertifications & Discharges
Registered Nurses, Physical Therapists, Speech-Language Pathologists & Occupational Therapists can complete these.
What Does the OASIS Measure?
When answering OASIS questions, you are usually assessing how much support the patient needs to do the task safely—not necessarily how the patient performs the task.
For example, let’s say your patient lives alone and does everything by herself. But when you assess her, you observe that she looks unsteady on her feet, eats only one meal per day because it’s hard to get to the grocery store, and can barely get off the couch without falling over.
She does all of these tasks independently. But due to these safety concerns, on the OASIS you will report that she needs at least a moderate amount of support.
How Long Does It Take to Complete the OASIS?
- Start of Cares: At least 2 hours in the home. Plus 1-2 hours of paperwork and contacting providers.
- Recertifications: 1-2 hours total
- Discharges: 1-2 hours total
Of course, every therapist/RN works at her own pace, so timing may vary!
How to Answer an OASIS Question (with Examples!)
Below is a task from the OASIS task, Lying to Sitting on Side of Bed.
Following that is an example of assessing this task with a patient, followed by how to score it at the Start of Care and at the Recertification.
Start of Care:
Mr. Dennis is a 75-year old male who was recently discharged from a qualifying inpatient stay (for sepsis). He received PT, OT, and ST services as an inpatient. When you arrive at the Dennis household, Mrs. Dennis answers the door and takes you to her husband’s bedroom. Mrs. Dennis easily arouses Mr. Dennis, who is taking an afternoon nap. You observe Mrs. Dennis stand over Mr. Dennis as he sits up in bed. She reaches to hold him under the elbow as he swings his legs over the bed, but she lets go once he’s standing.
Based on these observations, what is the patient’s performance for Lying to Sitting on the Side of the Bed at the start of care?
Answer: 04 Supervision or touching assistance.
It’s now two months later and you again arrive in the afternoon while Mr. Dennis is taking a nap. Mrs. Dennis asks you to wake up Mr. Dennis as she is taking food out of the oven. Dr. Dennis easily awakens when you call his name, and he sits up and gets out of bed quickly and easily without help.
Based on these observations, what is the patient’s performance for Lying to Sitting on the Side of the Bed at recertification?
Answer: 06 Independent
OASIS Training & Additional Info
Thankfully, home health agencies take the OASIS very seriously and typically provide tons of training for how to answer the questions.
There will likely be OASIS specialists at your agency whose job is to double-check your answers to make sure there aren’t conflicts or errors. If you aren’t sure how to answer some of the questions, do the best you can then shoot an email to your supervisor or OASIS specialists for clarification.
Centers for Medicare & Medicaid Services provides a free PDF User Manual on their website if you want extra info.
It is a mere 335 pages long.
Our advice? Pay close attention to the OASIS portion of your onboarding training!
In summary, the OASIS is time-consuming, can only be completed by specific disciplines depending on the situation, and is focused on the amount of support the patient needs to complete tasks safely.
There are plenty of nuances to learn and questions you’ll need to have clarified as you get used to the OASIS. Those details should be covered in your training and/or directed to your supervisor or OASIS specialists at your agency.
Or, you could always crack open the 350 page Medicare Manual…
Complete Digital Workbook
Handouts, Worksheets, & therapist treatment guides
The Adult Speech Therapy Workbook
Worksheets and Handouts
6 Speech Therapy Evaluation Templates
Medical SLP Clipboard
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