Riley lives alone in their own apartment. Since their discharge from the hospital, their two daughters alternate staying with them during the day and night so that one of them is always there, except for the times when one goes out to run an errand or pick up a child at day care.
The best response option for M1100 Patient Living Situation would be:
- 01 – Patient lives alone / Around the clock
- 02 – Patient lives alone / Regular daytime
- 06 – Patient lives with other person(s) in the home/ Around the clock
- 07 – Patient lives with other person(s) in the home/ Regular daytime
Correct Response = a. 01 – Patient lives alone / Around the clock
Rationale = Per OASIS Item Guidance: Patient still considered to be living alone, since daughters are only staying there temporarily. Daughters are providing round-the-clock care, even if one occasionally needs to be out of the house for brief periods.
August underwent a total knee replacement one week prior to her admission to home health and her staples have been removed recently without incident. The surgical site is well approximated with a small amount of serosanguinous drainage noted during the dressing change. There are no signs or symptoms of infection. The best response option for M1342 Status of the Most Problematic Surgical Wound that is Observable would be:
- 0 – Newly epithelialized
- 1 – Fully granulating
- 2 – Early/partial granulation
- 3 – Not healing
Correct Response = d. 3 – Not healing
Rationale = Surgical wounds healing by primary intention (approximated incisions) do not granulate, therefore the only appropriate responses would be Response 0 – “Newly epithelialized” or Response 3 – “Not healing”. If the wound is healing solely by primary intention, observe if the incision line has re- epithelialized. Epithelialization is regeneration of the epidermis across a wound surface. (If there is no interruption in the healing process, this generally takes within a matter of hours to three days post- operatively.) If there is not full epithelial resurfacing such as in the case of a scab adhering to underlying tissue, the correct response would be “Not healing” for the wound healing exclusively by primary intention.
Sidman requires supervision and a walker to complete a transfer from his bed to a nearby chair. The best response option for M1850 Transferring would be:
- 0 – Able to independently transfer.
- 1 – Able to transfer with minimal human assistance or with use of an assistive device.
- 2 – Able to bear weight and pivot during the transfer process but unable to transfer self.
- 3 – Unable to transfer self and is unable to bear weight or pivot when transferred by another person.
Correct Response = c. 2 – Able to bear weight and pivot during the transfer process but unable to transfer self.
Rationale = Per OASIS Item Guidance: If the patient transfers either with minimal human assistance (but not device), or with the use of a device (but no human assistance), select Response 1. If the patient requires both minimal human assistance and an assistive device to transfer safely, select Response 2. In order for the assistance to be considered minimal, it would mean the individual assisting the patient is contributing less than 25% of the total effort required to perform the transfer.
Intermittent verbal cues provided to a patient due to concerns about falls risk would align with which response option when coding GG items:
- 05 – Setup or clean-up assistance
- 04 – Supervision or touching assistance
- 03 – Partial/moderate assistance
- 02 – Substantial/maximal assistance
Correct Response = b. 04 – Supervision or touching assistance
Rationale = Supervision or touching assistance is defined as: “Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently.”
Rogers has recent endurance limitations due to an exacerbation of heart failure and is only walking about 30 feet before he tires, loses strength and must sit and rest. He reports he was walking 150 feet or more with his cane prior to this exacerbation of his heart failure. The correct response for GG0170K Walk 150 Feet would be:
- 01 – Dependent
- 09 – Not applicable
- 10 – Not attempted due to environmental limitations
- 88 – Not attempted due to medical conditions or safety concerns
Correct Response = d. 88 – Not attempted due to medical conditions or safety concerns
Rationale = The activity was not attempted due to Mr. Rogers’ recent endurance limitations and current medical condition, but he was able to complete the activity prior to the recent exacerbation of his condition.