How to Complete the OASIS for SLPs, PTs and OTs – With Examples

In this article, we will demystify the OASIS by answering the following (in non-baffling language!):

What is the OASIS?
Who can complete the OASIS?
What does the OASIS measure?
How long does it take to complete the OASIS?
How do I answer an OASIS question?
Can you give me a few examples? (YES!)

Pro tip: Although the OASIS has a reputation for being difficult, it’s really more time-consuming than anything else.

What is the OASIS?

First, 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.

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.

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.

Who Can Complete the OASIS?

OASIS START OF CARE (the initial evaluation): Registered Nurses, Physical Therapists, and Speech Language Pathologists

– Only the very first home health care provider to visit a patient is required to complete the OASIS Start of Care.

– That same provider typically also completes the OASIS recertification (re-evaluation) and OASIS discharge.

– Per Medicare, if a patient has nursing and therapy orders, then an RN should complete the OASIS. 

– If a patient has only therapy orders, then the PT should do it. 

– BUT, if an RN or PT aren’t available to complete the OASIS within 24-72 hours after the patient is admitted into your agency, an SLP can complete the OASIS.

OASIS RECERTIFICATIONS AND DISCHARGES: Registered Nurses, Physical Therapists, Speech Language Pathologists & Occupational Therapists can complete these.


What Does the OASIS Measure?

As a general rule of thumb, when answering OASIS questions, assess the amount of support the patient needs in order to complete the task safely- not how the patient performs the task.

For example, let’s say your patient lives alone and doesn’t have any family or friends close by for support, so she does everything by herself. BUT, she looks unsteady on her feet, eats only one meal a day because she can’t make it to the grocery store consistently, and can barely get off the couch without falling over. Due to these safety concerns, even though she does all of these tasks independently, on the OASIS you 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: Lying to Sitting on Side of Bed.

Following that is an example of the task plus how to score it at Start of Care and 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 take 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 sit ups in bed. She reaches to hold him under the elbow as he swings his legs over the bed, but she let’s 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.

Recertification:
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 several OASIS specialists at your agency who’ll 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, answer them the best you can then shoot an email to your supervisor or OASIS specialists for clarification, ASAP.

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 (Link here). 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 clarified as you get used to the OASIS. Those details should be covered in your training and/or directed to your supervisor or the OASIS specialists at your agency.

Or, you could always crack open the 350 page Medicare Manual…

More Resources:

The Home Health SLP Handbook: Everything you need to provide speech therapy to adults in the home health setting. by [Chung Hwa Brewer, Miwa Aparo]
The Home Health SLP Handbook: Everything you need to provide speech therapy to adults in the home health setting.

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