Occupational Therapy

[KateRN1]

Interesting discussion at work the other day, and I'm still trying to find the answer to the question. As far as I've been taught, OT cannot be the primary discipline in the home and must be ordered in conjunction with PT or skilled nursing. As such, an OT has no business completing OASIS data sets, because the OT should never make the final visit. The OT in our office has been asked by higher-ups on at least 2 occasions to complete OASIS discharge data because she made the final home visit. I have been searching the CMS website to see if I can find this in black and white and am not having any luck so far. Can anyone shed some light on this for me? Am I completely nuts? Having a senior moment?

[annaedRN, RN]

Haven't researched it. Our OTs have been doing the discharge OASIS if they are the last discipline in the home. My agency is really by the book too. Let me know what you find out

[jnette, ASN, EMT-I]

At our agency the SN RN does all the OASIS SOCs and Discharges, regardless of any therapy invoved. The only exception I can think of is if a patient is PT only... but then the SN still does the SOC OASIS, and if I'm thinking correctly, the PT discharges out. But I'll get the info you need and get back with you on this Monday. :)

Or NrsKaren would probably have your answer for you in a heartbeat... she's our Queen of HH rules and regs around here !

[berube]

the only oasis the OT can not do the initial SOC, they can be in the only ones in on recert and they can do the discharge if they are the last discipline out.

[luvmy2angels]

To the best of my knowledge SN, PT or OT can do the OASIS d/c for my place of employment. Only stipulation is that SN cannot have an LPN do it, must be an RN.

[HmarieD]

Your agency should have a manual of Medicare Conditions of Participation. Look up 484.55, Comprehensive Assessment of Patients. It discusses who can complete which OASIS and when.

I'm sure you can find this online as well.

[NRSKarenRN, BSN, RN]

ot permitted to perform and document oasis assessment ...they do in our agency.. we have over 3,000 oasis per month: ~1,500 new with remainder resumptions care, recerts and discharges.

oasis-c guidance manual september 2009 for 2010 implementation chapter 1-8 centers for medicare & medicaid services chapter 1:

who completes oasis-c

as identified in (m0080) discipline of person completing assessment, the comprehensive assessment and oasis data collection should be conducted by a registered nurse (rn) or any of the therapies (pt, slp/st, ot). an lpn/lvn, pta, ota, msw, or aide may not complete oasis assessments,

in cases involving nursing, the rn completes the comprehensive assessment at soc. any discipline qualified to perform assessments - rn, pt, slp, ot - may complete subsequent assessments. for a therapy-only case, the therapist usually conducts the comprehensive

assessment. it is acceptable for a pt or slp to conduct and complete the comprehensive assessment at soc. an ot may conduct and complete the assessment when the need for occupational therapy establishes program eligibility. note: occupational therapy alone does not establish eligibility for the medicare home health benefit at the start of care; however, occupational therapy may establish eligibility under other programs, such as medicaid. the medicare home health patient who is receiving services from multiple disciplines (i.e., skilled nursing, physical therapy, and occupational therapy) during the episode of care, can retain eligibility if, over time, occupational therapy is the only remaining skilled discipline providing care. at that time, an ot can conduct oasis assessments.

multidisciplinary cases may have multiple points of discipline-specific discharge, though only one is the agency discharge, which must include oasis data collection and completion of the oasis discharge comprehensive assessment. other non-oasis required documentation for recertification and discharge are specified in the home health services conditions for coverage (cfcs) & conditions of participations (cops).6 oasis items were designed to be discipline-neutral and have been tested and validated with clinicians from various disciplines

downloads

oasis-c guidance manual [zip 4 mb]

education is key here.. along with change in "not my job" attitude....and adequate ot reimburesement for perfoming work expectations.

we had to overcome:

a. knowledge deficit

b. learning education

c. my time equals money, oasis is fluff

d. "no other agency makes me do this paperwork"

to empowering them to take total responsibility for this aspect of patient care ---- if we can get $$$ for care provided then you can expect compensation in return. our funcational scores wnet through the roof after educating pt, ot and st to independently perform and take ownership in oasis....so far have been higher than our competitors.