Five months ago, we shared the following as part of a blog about OASIS item M1860:
During our most recent free Q&A event (click here for session), we added a polling element to engage our audience and we were happy to see how many people participated. I asked a question regarding M1860 Ambulation and what to do when a patient is completely safe and able to walk on all surfaces in their environment, including stairs, using a walker. The reaction from attendees of both the live and recorded versions indicates there are some differences of opinion.
Those who know me know how strict I am about following the guidance even if we do not like or agree with it. I understand that the interpretation that was shared may not have sat well with some and there absolutely should be an “official” response. To that end, the scenario and rationale have been submitted to the CMS Q&A mailbox and when I get a response, we will share it ASAP.
We never want to contribute to confusion or misinformation so stay tuned……….
I never thought it would take this LONG to get a response. I diligently followed up for months and even tried an alternative email to get an answer – with no success. In April I asked for help from a friend who often submits questions to CMS. She posed the question herself and received a response in LESS THAN 24 HOURS. That response basically quoted back the current guidance for M1860 without connecting it to the example provided – a person completely safe and able on ALL surfaces in their environment using a walker. A follow up question was submitted and responded to a few days later with basically the same response.
What was the response? Someone who is safe and able on all surfaces in their environment with a walker is scored as a 2 – Requires use of a two-handed device (for example, walker or crutches) to walk alone on a level surface and/or requires human supervision or assistance to negotiate stairs or steps or uneven surfaces.
- Do I agree with that response? NO.
- Do I think that the guidance needs to be changed for this specific example as response 2 does not fit with that level of independence? YES.
- Did that get communicated to the Q&A people?
- Am I going to continue to try to get this addressed?
In the meantime, we remain committed to adhering to the official guidance and will continue to do so in our educational, outsourcing and testing programs. Challenging 10+ year old guidance for OASIS items that have not changed in over 20 years is never a bad idea and we encourage individuals and agencies to submit questions with real life examples that do not fit the current options well. One voice may not make it change BUT it is a start.