Quarterly Oasis Test 1 - 2016

1. Please match definition of wound with correct wound type:

Intact skin with non-blanchable redness of a localized area

Shallow open ulcer with a red-pink wound bed without slough. May also present as an intact or open/ruptured serum-filled blister

Subcutaneous fat may be visible but bone, tendon or muscle. are not exposed. Slough may be present but does not obscure the depth of tissue loss.

Tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed.

Tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.

Submit

2. You receive notice on 4/2/16 that one of your patients went to an inpatient facilty for uncontrolled pain on 4/1/16 and is now back home. Your patient was on observation status. Which OASIS assessments should be completed?

TRF OASIS effective 4/1/16, ROC OASIS effective 4/2/16

TRF OASIS effective 4/2/16, ROC OASIS effective 4/2/16

No OASIS needs to be completed

If a client stays as observation status in an inpatient facility, a TRF oasis is not required to be completed. If a client is inpatient for less than 24 hours, a TRF oasis is not required to be completed.

Explanation

If a client stays as observation status in an inpatient facility, a TRF oasis is not required to be completed. If a client is inpatient for less than 24 hours, a TRF oasis is not required to be completed.

3. When walking with the patient, they deny any feelings of dyspnea. After walking 40 feet, patient sits down and appears to be breathing at an elevated rate. You did not notice this with any other levels of activity and patient denies feeling short of breath at any other times. (M1400) When is the patient dyspneic or noticeably short of breath?

0 - Patient is not short of breath

1 - When walking more than 20 feet, climbing stairs

2 - With moderate exertion (for example, while dressing, using commode or bedpan, walking distances less than 20 feet)

3 - With minimal exertion (for example, while eating, talking, or performing other ADLs) or with agitation

4 - At rest (during the day or night)

Since dyspnea is only assessed to occur when walking longer distances, option 1 would be the best choice

Explanation

Since dyspnea is only assessed to occur when walking longer distances, option 1 would be the best choice

4. At SOC, you assess the patient ambulating. They deny feeling SOB and you do not notice any. Patient reports that he does get SOB at night when laying down supine and uses 02 to alleviate. Client does not use 02 during the day. (M1400) When is the patient dyspneic or noticeably short of breath?

0 - Patient is not short of breath

1 - When walking more than 20 feet, climbing stairs

2 - With moderate exertion (for example, while dressing, using commode or bedpan, walking distances less than 20 feet)

3 - With minimal exertion (for example, while eating, talking, or performing other ADLs) or with agitation

4 - At rest (during day or night)

If the patient does not use their 02 continuously, you would assess their dyspnea without using 02. Since shortness of breath occurs while they are laying down, 4 would be the correct choice

Explanation

If the patient does not use their 02 continuously, you would assess their dyspnea without using 02. Since shortness of breath occurs while they are laying down, 4 would be the correct choice

5. You perform a 0-10 pain scale on a client and they report their pain is currently at a 4, when they transfer pain increases to an 8.(M1240) Has this patient had a formal Pain Assessment using a standardized, validated pain assessment tool (appropriate to the patient's ability to communicate the severity of pain)?

0 - No standardized, validated assessment conducted

1 - Yes, and it does not indicate severe pain

2 - Yes, and it indicates severe pain

the 0-10 scale is a validated tool that can be used for this item. The patient reports having severe pain in the recent pertinent past, so option 2 would be appropriate.

Explanation

the 0-10 scale is a validated tool that can be used for this item. The patient reports having severe pain in the recent pertinent past, so option 2 would be appropriate.

6. You go to admit a patient who has orders to be non-weight bearing due to a recent surgery. When you go to see the patient, patient answers the door and ambulates back to his chair with the use of a walker. When questioned about non-weight bearing orders, client reports that he can't follow those restrictions all the time but tries to limit his walking. Client does have wheelchair that he is able to safely maneuver around home.(M1860) Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a wheelchair, once in a seated position, on a variety of surfaces.

3 - Able to walk only with the supervision or assistance of another person at all times.

4 - Chairfast, unable to ambulate but is able to wheelself independently

5 - Chairfast, unable to ambulate and is unable to wheelself

6 - Bedfast, unable to ambulate or be up in a chair

Medical restrictions will always trump what the patient is currently doing. Since the patient is ordered to be chairfast, you would choose either option 4 or 5, depending on his ability to wheelself.

Explanation

Medical restrictions will always trump what the patient is currently doing. Since the patient is ordered to be chairfast, you would choose either option 4 or 5, depending on his ability to wheelself.

7. What is the appropriate way to assess (M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast?

Ask the patient how they transfer and if they have any concerns

Watch the patient complete a TUG assessment and answer based on your observations

This question is assessing the patients ability to complete a bed transfer. To appropriately assess, you must watch them lay in bed, sit up in bed and transfer to the next available seated surface.

Explanation

This question is assessing the patients ability to complete a bed transfer. To appropriately assess, you must watch them lay in bed, sit up in bed and transfer to the next available seated surface.

8. A client has reading glasses, but they report that they never wear them and don't know where they are. When you assess if they can read their medication bottle, they are unable to without their glasses. When the client grabs a magnifying glass, they are able to appropriately read their medication label.(M1200) Vision (with corrective lenses if the patient usually wears them):

0 - Normal vision: sees adequately in most situations; can see medication labels, newsprint

2 - Severely impaired: cannot locate objects without hearing or touching them or patient non-responsive

This item is assessed with their corrective lenses if they usually wear them. Client does not usually wear their glasses, so you would assess them without. Magnifying glass does not count as corrective lenses, so the patient would be marked as being unable to see print.

Explanation

This item is assessed with their corrective lenses if they usually wear them. Client does not usually wear their glasses, so you would assess them without. Magnifying glass does not count as corrective lenses, so the patient would be marked as being unable to see print.

9. You are notified on 5/5/16 that your patient went to the hospital on 5/1/16, was inpatient status, and returned home 5/3/16. You are going out today (5/5/16) for a visit. Which OASIS assessments would need to be completed?

TRF OASIS effective 5/1/16, ROC OASIS effective 5/5/16

TRF OASIS effective 5/5/16, ROC OASIS effective 5/5/16

TRF OASIS effective 5/1/16, ROC OASIS effective 5/3/16

No OASIS required

The clients TRF date will be the date they were admitted to an inpatient facility, the client's ROC date is the date you go into the home to complete their ROC visit.

Explanation

The clients TRF date will be the date they were admitted to an inpatient facility, the client's ROC date is the date you go into the home to complete their ROC visit.

10. Check all that are required to mark Yes on:(M2250) Plan of Care Synopsis (b) Diabetic foot care including monitoring for the presence of skin lesions on the lower extremities and patient/caregiver education on proper foot care.

Patient must have a diagnoses of diabetes

Care plan entry for assessing lower extremities for s/s of skin lesions

Care plan entry for educating client/caregiver on proper foot care

Patient must have a skin lesion on their lower extremities

To mark yes on this question, a client must have diabetes and you must both the assessing the lower extremities for lesions and providing education to the client/caregiver on assessing lower extremities and proper footcare.

Explanation

To mark yes on this question, a client must have diabetes and you must both the assessing the lower extremities for lesions and providing education to the client/caregiver on assessing lower extremities and proper footcare.

Submit

11. A client routinely lives alone, but her 2 daughters will be taking turns and staying with her for the next 2 months to help her recover. Someone will be with her 24 hours a day.(M1100) Patient Living Situation: which of the following best describes the patient's residential circumstance and availability of assistance? (check one box only)

01 - Patient lives alone, Availability of Assistance: Around the Clock

05 - Patient lives alone, Availability of Assistance: No assistance available

06 - Patient lives with other person(s) in the home, Availability of Assistance: Around the Clock

10 - Patient lives with other person(s) in the home, Availability of Assistance: No assistance available

Since the client's usual living situation is that they live alone and the daughters staying is not permanent, they are still marked on the oasis as living alone. The daughters are available to assist 24 hours a day, so their availability of assistance is considered around the clock

Explanation

Since the client's usual living situation is that they live alone and the daughters staying is not permanent, they are still marked on the oasis as living alone. The daughters are available to assist 24 hours a day, so their availability of assistance is considered around the clock

12. A client is admitted following hospital discharge for CHF exacerbation. Also has dx of COPD. This is his 2nd hospital admission in 6 months. Patient will receive 2 weeks of SN for education and assessment, PT, and OT to eval and treat. (M1034) Overall Status: Which description best fits the patient's overall status? (check one)

3 - the patient has serious progressive conditions that could lead to death within a year.

UK - the patient's situation is unknown or unclear.

The client has history of CHF, COPD and re-hospitalizations. With those chronic health conditions, it is unlikely that he will return to a stable health status. He will always have an elevated risk beyond those typical for his age.

Explanation

The client has history of CHF, COPD and re-hospitalizations. With those chronic health conditions, it is unlikely that he will return to a stable health status. He will always have an elevated risk beyond those typical for his age.

13. When completing a skin assessment, client appears to have a stage I pressure ulcer to the coccyx. When asking the patient about it, client reports that they used to have a pressure sore there that went straight down to the bone.(M1306) Does this patient have at least one Unhealed Pressure Ulcer at stage II or higher or designated as unstageable? (Excludes Stage I pressure ulcers and healed stage II pressure ulcers)

0 - No

1 - Yes

Based on the client's description they have had a Stage IV pressure ulcer to the coccyx that is currently closed, but reddened. Stage III and IV pressure ulcers never heal, but they can close. If a client has ever had a stage III or IV pressure ulcer, the appropriate answer to this question is Yes.

Explanation

Based on the client's description they have had a Stage IV pressure ulcer to the coccyx that is currently closed, but reddened. Stage III and IV pressure ulcers never heal, but they can close. If a client has ever had a stage III or IV pressure ulcer, the appropriate answer to this question is Yes.

14. At discharge the patient has met all goals. They are independent with medication management and all cares. They will continue to receive meals on wheels.(M2420) Discharge Disposition: Where is the patient after discharge from your agency? (Choose only one answer.)

1 - Patient remained in the community (without formal assistive services)

2 - Patient remained in the community (with formal assistive services)

3 - Patient transferred to a non-institutional hospice

4 - Unknown because patient moved to a geographic location not served by this agency

UK - Other unknown

Meals on wheels counts as a formal assistance service, so option 2 would be the best choice.

Explanation

Meals on wheels counts as a formal assistance service, so option 2 would be the best choice.

15. You receive notice that a client you have died in the ambulance on the way to the hospital. Which OASIS do you complete to discharge the patient?

Transferred to an inpatient facility - patient not discharged from agency

Transferred to an inpatient facility - patient discharged from agency

Death at Home

Discharge from agency

This OASIS assessment is used when a patient dies while under the care of the home health agency. It documents the circumstances surrounding the patient's death and any relevant information for reporting and follow-up purposes.

Explanation

This OASIS assessment is used when a patient dies while under the care of the home health agency. It documents the circumstances surrounding the patient's death and any relevant information for reporting and follow-up purposes.

16. A client reports that they have severe pain whenever they attempt to climb stairs or walk long distances. Due to this, they have started staying in downstairs bedroom and spouse gets the mail so they do not need to walk to the mailbox. They do not report pain in any other situations.(M1242) Frequency of Pain Interfering with patient's activity or movement:

0 - Patient has no pain

1 - Patient has pain that does not interfere with activity or movement

2 - Less often than daily

3 - Daily, but not constantly

4 - All the time

The patient has altered their activities to manage their pain. These activities used to occur daily, so the appropriate answer would be option 3

Explanation

The patient has altered their activities to manage their pain. These activities used to occur daily, so the appropriate answer would be option 3

17. When assessing a client's ability to bathe, patient reports that they have not bathed since getting home from hospital and would like a home health aide or OT to be present for their first shower "just in case". They have a cast on their leg that they will need some assistance with wrapping. Bath is scheduled to be completed later that week. They have done a partial bath at the sink that morning independently and safely.(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, hands, and shampooing hair)

0 - Able to bathe self in shower or tub independently, including getting in and out of tub/shower

6 - Unable to participate effectively in bathing and is bathed totally by another person.

Client is not currently bathing in a shower or tub, but they are bathing safely at the sink. Option 4 would be the correct choice.

Explanation

Client is not currently bathing in a shower or tub, but they are bathing safely at the sink. Option 4 would be the correct choice.

18. Client recently had knee surgery. Incision is approximated and closed with staples. Small amounts of scabbing noted. No S/S of infection. (M1324) Status of most problematic surgical wound that is observable

0 - Newly epithelialized

1 - Fully granulating

2 - Early/partial granulation

3 - Not Healing

Wounds that have the edges brought together and are closed by sutures, staples, or glue are healing by primary intention. Wounds healing by primary intention do not granulate, therefore the only options available are Not healing or Newly Epithelialized. Since scabbing is still present, option 3 not healing would be the correct choice

Explanation

Wounds that have the edges brought together and are closed by sutures, staples, or glue are healing by primary intention. Wounds healing by primary intention do not granulate, therefore the only options available are Not healing or Newly Epithelialized. Since scabbing is still present, option 3 not healing would be the correct choice

19. Client currently has a stage II pressure ulcer to the elbow. Rest of skin is CDI with no other history of pressure ulcers.(M1320) Status of Most Problematic Pressure Ulcer that is Observable: (Excludes pressure ulcer that cannot be observed due to a non-removable dressing/device)

0 - Newly Epithelialized

1 - Fully Granulating

2 - Early/Partial granulation

3 - Not healing

NA - No observable pressure ulcer

Stage II pressure ulcers will always be marked as a 3 - not healing. Stage II pressure ulcers do not granulate and newly epithelialized stage II pressure ulcers are not counted as a current wound.

Explanation

Stage II pressure ulcers will always be marked as a 3 - not healing. Stage II pressure ulcers do not granulate and newly epithelialized stage II pressure ulcers are not counted as a current wound.

20. You are completing the first re-cert on a patient that receives services under their traditional Medicare insurance.M0110 Episode Timing: Is the Medicare home health payment episode for which this assessment will define a case mix group an "early" episode or a "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes?

1 - Early

2 - Later

UK - Unknown

NA - Not Applicable: No Medicare case mix group to be defined by this assessment

The first 2 Medicare episodes (SOC and 1st re-cert) that a client has been on home health services is considered "Early". Therefore, the first 120 days that they are on Medicare is considered "early". Their 3rd + episodes (all re-certs after their SOC and 1st re-cert) are considered "Later" episodes.

Explanation

The first 2 Medicare episodes (SOC and 1st re-cert) that a client has been on home health services is considered "Early". Therefore, the first 120 days that they are on Medicare is considered "early". Their 3rd + episodes (all re-certs after their SOC and 1st re-cert) are considered "Later" episodes.

21. You go into the home 3/9/16 to complete a ROC on a patient following their discharge from an inpatient facility, while you are in the home completing your assessment the patient appears to be in respiratory distress. The client is sent back to the hospital and you are notified that they were re-admitted. Which of the following OASIS assessments should be completed.

ROC OASIS effective 3/9/16, TRF OASIS effective 3/9/16

TRF OASIS effective 3/9/16

No OASIS required

If a client is sent back to the hospital during the ROC assessment, the ROC is not completed. A note should be added to the patients chart explaining the circumstances. A ROC would be performed when the patient returns from the hospital the next time.

Explanation

If a client is sent back to the hospital during the ROC assessment, the ROC is not completed. A note should be added to the patients chart explaining the circumstances. A ROC would be performed when the patient returns from the hospital the next time.

22. A hospital contacts your agency on 3/1/16 to inform you that a patient will be discharging within 2-3 days and will need home care services for wound care. You receive notice on 3/3/16 that the client has discharged from the hospital. You contact the patient on 3/3/16 to set up admission, client refuses visit until 3/6/16 due to dressing change not being due until that date. What should you do?

Document the patient's refusal of admission in a call log

Contact the physician and request a physician ordered SOC date of 3/6

Nothing additional is needed, wait until 3/6 to admit patient

If a client refuses admission until a later date, it must be documented in the client's chart immediately. The physician also needs to be contacted immediately to notify them of the later admission date and to receive a physician ordered SOC date. This is because agencies are required to admit within 48 hours of referral or physician ordered SOC date.

Explanation

If a client refuses admission until a later date, it must be documented in the client's chart immediately. The physician also needs to be contacted immediately to notify them of the later admission date and to receive a physician ordered SOC date. This is because agencies are required to admit within 48 hours of referral or physician ordered SOC date.

Submit

23. When completing a medication reconciliation, you notice the patient does not have a new ordered medication in their home. You call the pharmacy and get the medication set to be delivered to the patient. (M2020) Management of Oral Medications: Patient's current ability to prepare and take all oral medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals. Excludes injectable and IV medications. (Note this refers to ability, not compliance or willingness)

0 - Able to independently take the correct oral medications(s) and proper dosage(s) at the correct times

2 - Able to take medication(s) at the correct times if given reminders by another person at the appropriate times

3 - Unable to take medication unless administered by another person

NA - No oral medications prescribed

The patient did not have all of their medications in the home at the time of assessment, option 3 would be the correct choice.

Explanation

The patient did not have all of their medications in the home at the time of assessment, option 3 would be the correct choice.

24. Improvement rates on OASIS items are determined by comparing a clients last re-cert to their discharge OASIS

True

False

Improvement rates are determined by comparing where a client is scored at discharge to their most recent SOC or ROC

Explanation

Improvement rates are determined by comparing where a client is scored at discharge to their most recent SOC or ROC

25. Patient reports pain with movement. Pain also woke them up last night. They were able to fall back asleep after changing position and using a heating pad. (M1242) Frequency of Pain Interfering with patient's activity or movement:

0 - Patient has no pain

1 - Patient has pain that does not interfere with activity or movement

2 - Less often than daily

3 - Daily but not constantly

4 - All of the time

Patient reports pain that has affected their activities at all hours of the day, correct response would be option 4

Explanation

Patient reports pain that has affected their activities at all hours of the day, correct response would be option 4

26. We are admitting a client for medication management and initiation of a medication machine. Client has difficulties remembering to take their medications at the correct times, which is why client wants to try a medication machine. (M2020) Management of Oral Medications: Patient's current ability to prepare and take all oral medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals. Excludes injectable and IV medications. (Note: This refers to ability, not compliance or willingness)

0 - Able to independently take the correct oral medication(s) and proper dosage(s) at the correct times

2- Able to take medication(s) at the correct times if given reminders by another person at the appropriate times

3 - Unable to take medication unless administered by another person

NA - No oral medications prescribed

The patient currently has difficultly taking her medications appropriately, which is why a medication machine is being installed. It has not been established yet if medication machine will be successful for the patient. This is why 3 is the appropriate choice.

Explanation

The patient currently has difficultly taking her medications appropriately, which is why a medication machine is being installed. It has not been established yet if medication machine will be successful for the patient. This is why 3 is the appropriate choice.

27. When assessing a patient's ability to ambulate, you watch them stand and walk. Patient does not grab their walker because "that's for old people" and they only have it in case of emergency. Patient places their hands against furniture and the wall to steady themselves when they walk to another room.(M1860) Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a wheelchair, once in a seated position, on a variety of surfaces.

3 - Able to walk only with the supervision or assistance of another person at all times

4 - Chairfast, unable to ambulate but is able to wheel self independently

5 - Chairfast, unable to ambulate and is unable to wheel self

6 - Bedfast, unable to ambulate or be up in chair.

The patient is not safely ambulating and is not safely using their two handed device. Option 3 would be the best selection.

Explanation

The patient is not safely ambulating and is not safely using their two handed device. Option 3 would be the best selection.

28. A client's new 485 begins on 6/15/16. On which of the following days can their re-cert OASIS be completed?

6/15

6/14

6/12

6/10

6/9

A client's recertification OASIS must be completed within the last 5 days of their certification period. If a clients new 485 begins on 6/15, their re-cert oasis must be completed between 6/10 - 6/14.

Explanation

A client's recertification OASIS must be completed within the last 5 days of their certification period. If a clients new 485 begins on 6/15, their re-cert oasis must be completed between 6/10 - 6/14.

Submit

29. You admit a client who was recently discharged from a SNF. She suffered a fall and fracture 4 months ago, went to ER, and was hospitalized. She also had an ER visit 5 months ago due to hypoglycemia. Client reports that she is having more health difficulties due to her husband recently dying, and she has been more depressed recently. She has difficulty following her medication regimen and reports that she missed her insulin dose this am. She has 4 ordered medications, and also takes 2 supplements.(M1033) Risk for Hospitalization: Which of the following signs or symptoms characterize this patient as at risk for hospitalization? (Mark all that apply)

2 - Unintentional weight loss of a total of 10 pounds or more in the past 12 months

3 - Multiple hospitalizations (2 or more) in the past 6 months

4 - Multiple emergency department visits (2 or more) in the past 6 months

5 - Decline in the mental, emotional, or behavioral status in the past 3 months

7 - Currently taking 5 or more medications

8 - Currently reports exhaustion

9 - Other risk(s) not listed in 1-8

10 - None of the above

The client reports having a fall with injury, has had 2 or more ER visits, has had a recent decline in her emotional status due to her husbands death, has difficulty complying with ordered medications, and takes more than 5 medications total.

Explanation

The client reports having a fall with injury, has had 2 or more ER visits, has had a recent decline in her emotional status due to her husbands death, has difficulty complying with ordered medications, and takes more than 5 medications total.

Submit

30. Which diagnoses codes should be included on a client's diagnosis code list for home health?

All diagnoses codes that the patient currently has

All diagnoses codes that our home health agency is currently treating

All diagnoses codes that the patient currently has that may affect their treatment or response to treatment

All diagnoses codes that the patient has ever had

The patient's primary diagnosis is the chief reason the patient is receiving home care and is the most related to the plan of care. This diagnosis must be related to the skilled services the client receives. Secondary diagnoses include other conditions that are actively addressed in the patient's plan of care, and have the potential to affect the patient's responsiveness to treatment and rehabilitative prognosis. Diagnoses should be excluded from the code list if they are resolved or do not have the potential to impact skilled services provided by the home health agency

Explanation

The patient's primary diagnosis is the chief reason the patient is receiving home care and is the most related to the plan of care. This diagnosis must be related to the skilled services the client receives. Secondary diagnoses include other conditions that are actively addressed in the patient's plan of care, and have the potential to affect the patient's responsiveness to treatment and rehabilitative prognosis. Diagnoses should be excluded from the code list if they are resolved or do not have the potential to impact skilled services provided by the home health agency

Submit

31. You assess a client's ability to dress their lower body. They are able to put on their pants safely, when they put on their socks and shoes they are unsteady and say that this does cause them some trouble and decide to not wear socks and shoes that day. They currently have no assistive devices to help with lower body dressing.(M1820) Current ability to dress lower body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes:

0 - Able to obtain, put on, and remove clothing and shoes without assistance

2 - Someone must help the patient put on undergarments, slacks, socks or nylons, and shoes

3 - Patient depends entirely upon another person to dress lower body

The client is currently unable to complete 50% of their lower body dressing activities safely. Since they need assistance with the majority of their lower body dressing, option 3 would be the correct option.

Explanation

The client is currently unable to complete 50% of their lower body dressing activities safely. Since they need assistance with the majority of their lower body dressing, option 3 would be the correct option.

32. Client has a history of a stage IV pressure ulcer to the coccyx that closed 2 years ago with no current issues.(M1320) Status of Most Problematic Pressure Ulcer that is Observable: (Excludes pressure ulcer that cannot be observed due to a non-removable dressing/device)

0 - Newly epithelialized

1 - Fully granulating

2 - Early/partial granulation

3 - Not healing

NA - No observable pressure ulcer

A closed stage IV pressure ulcer never fully heals. Due to this, the patient will always be marked as having a stage IV pressure ulcer that is newly epithelialized. Option 0 is the correct choice for this question.

Explanation

A closed stage IV pressure ulcer never fully heals. Due to this, the patient will always be marked as having a stage IV pressure ulcer that is newly epithelialized. Option 0 is the correct choice for this question.

33. A client is admitted with a triple lumen central line. TPN is administered through 1 line, the other 2 are flushed to maintain patency. Client also has a gastrostomy feeding tube that is only being used for administering crushed medications at this time.M1030 Therapies the patient receives at home: (Mark all that apply).

1 - Intravenous or infusion therapy (excludes TPN)

2 - Parenteral nutrition (TPN or lipids)

3 - Enteral nutrition (nasogastric, gastrostomy, jejunostomy, or any other artificial entry into the alimentary canal)

4 - None of the above

The client receives flushes to his IV line at home, which indicates that we can mark option 1. The client also receives TPN at home, which indicates we can mark option 2. The client's gastrostomy is not currently being used for nutrition, so we cannot mark option 3

Explanation

The client receives flushes to his IV line at home, which indicates that we can mark option 1. The client also receives TPN at home, which indicates we can mark option 2. The client's gastrostomy is not currently being used for nutrition, so we cannot mark option 3

Submit

34. Which of the following clients need an OASIS assessment completed at SOC?

59 yo with Medicaid, receiving SN services for medication management

79 yo with Medicare, receiving PT services post fall

17 yo with Medicaid, receiving SN services for tramatic wound care

31 yo with Medicaid, receiving SN services for wound care to C-section wound

80 yo with Medicaid, receiving HCA services for bathing assistance

31 yo with Medicare, receiving SN services for CHF education

26 yo with private BCBS insurance, receiving PT services post car accident

OASIS assessments are required for people receiving skilled care under a Medicare or Medicaid type insurance. OASIS assessments are not required for people under the age of 18, receiving care for anything OB related, or receiving only non-skilled services such as HCA and HM.

Explanation

OASIS assessments are required for people receiving skilled care under a Medicare or Medicaid type insurance. OASIS assessments are not required for people under the age of 18, receiving care for anything OB related, or receiving only non-skilled services such as HCA and HM.

Submit

35. Client was admitted for PT services. He has a diagnosis of CHF as well. at SOC, PT noticed lower leg edema. The PT reported edema to the MD and obtained physician orders for lasix. PT also provided education on monitoring weight and elevating the legs.(M1510) Heart Failure Follow-up: If patient has been diagnosed with heart failure and has exhibited symptoms indicative of heart failure at the time of or at any time since the previous OASIS assessment, what action(s) has (have) been taken to respond? (Mark all that apply.)

0 - No action taken

1 - Patient's physician (or other primary care practitioner) contacted the same day

2 - Patient advised to get emergency treatment (for example, call 911 or go to emergency room)

3 - Implement physician-ordered patient-specific established parameters for treatment

4 - Patient education or other clinical interventions

5 - Obtained change in care plan orders (for example, increased monitoring by agency, change in visit frequency, telehealth)

The PT contacted the physician same day, provided the patient with education, and obtained changes in the patients plan on care (lasix).

Explanation

The PT contacted the physician same day, provided the patient with education, and obtained changes in the patients plan on care (lasix).

Submit

36. Please select all that are considered surgical wounds on the OASIS.

Central IV line

Peripheral IV line

Skin graft donor site

Stage IV pressure ulcer that recently had a muscle flap placed

Thoracostomy (chest tube)

I & D with drain placement

Staple sites

For a full list of surgical wounds, please ask Utilization Nurse

Explanation

For a full list of surgical wounds, please ask Utilization Nurse

Submit

37. Select all the items below that can be counted in the OASIS question:(M1350) Does the patient have a skin lesion or open wound (excluding bowel ostomy), other than those described above, that is receiving intervention by the home health agency?

Diabetic ulcers

Skin tears

Burns

Rashes

Edema

Persistent redness

Cellulitis

Peripheral IV site

Central Line insertion site

Tracheostomy

Thoracostomy

Urostomy

Bowel ostomy

Bowel ostomy does not count for this item since it is captured in the elimination questions, but most other ostomies do. Central lines are counted as surgical wounds.

Explanation

Bowel ostomy does not count for this item since it is captured in the elimination questions, but most other ostomies do. Central lines are counted as surgical wounds.

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