Discharge oasis vs Admission oasis discrepancies

I would go with having a copy of the admit oasis so that you have the info available to you. But agree with you that you should call it as you see it. If the patient declined, then they declined. As far as your agency doing shady practices, that may not be the case everywhere, but you can expect to find some deviance along the way. One of the biggest discrepancies I have found is a lack of taking corrective action when nurses report things. This puts the reporting nurse in a bad position. How many nurses want to report their employer to authorities for fraud, waste, and abuse when they know that it will mean they lose their job? Not many. That is why so much goes on that is not lawful, moral, or good patient care practice.

My question to the staff is if the OASIS reflects that the patient status has declined and that decline was not anticipated, why are we discharging them. If the scoring was wrong on admission, then there needs to be education with the entire staff so that everyone is looking at the questions the same way. This scenario is also why it is preferable to have the admitting clinician discharge the patient.

This is a common problem, and sometimes not easy to solve. It shows the importance of a very acurate initial assessment. Whenever possible we try to have the case manager (who is likely the admitting nurse) do the discharge visit.