Fazzi Associates, Inc.

Question: We continue to have problems with our OASIS assessments. Our case mix weights are low and we have problems with our outcomes. Are other agencies having problems? Is there anything we can do to help improve our assessments?

Answer: First the good news (if this is good). You are not alone. Many agencies are reporting problems. Now the better news! There are a number of things you can do to that will have an immediate impact on helping you improve your accuracy. And now the best news of all, improvement in the accuracy of your assessments will impact your financial outcomes, your patient outcomes and your OBQI and Home Health Compare outcomes!

How serious is the problem? As you know, since OASIS has become reality, Fazzi Associates has been doing OASIS audits and training throughout the country. In a recent period, we conducted audits on over 1,800 admission records in 62 different agencies representing most regions of the country. For each audit, we reviewed a broad range of clinical information including information from the referral source, the completed OASIS assessment, the plan of care, visit notes from the assessment visit and initial therapy evaluation(s) if ordered at admission.

What we found was a significant number of inaccuracies and inconsistencies.

41% had variances in the Clinical Domain

33% had variances in the Functional Domain

22% had variances in the Utilization Domain

What affect did these variances have on the HHRGs and the case mix weight? 62% of the records were underscored, 6% over-scored and 32% were found to have no change. Inaccurate assessments, particularly underscoring, often lead to inaccurate quality outcome scores. If your patient was inaccurately scored as low -on the initial RAP assessment, then the discharge assessment if scored correctly would not show much change even if the patient experienced significant improvement due to your services. Poor OASIS assessments often lead to poor quality scores.

It doesn't stop here. As most agencies know, poor assessments often lead to poor financial performance. Consider the implications of underscoring on the 62% of agencies who were found to have underscored on our audits. If you had 500 annual start-of-care assessments and you were off just .001, it would mean a loss of $11,255. That's enough to do an OASIS audit, an OASIS training and still have enough to buy lunch for all of your staff. What happens if it is more the .001 or your SOC is more than 500? Consider the following chart:

Affects of Inaccurate OASIS Scoring with 500 SOC Annually

OASIS is critical to the future of every agency. OASIS controls your quality outcomes. OASIS controls your financial outcomes. OASIS controls and influences public perception of your agency! If you are having trouble with your OASIS assessments and/or if your case mix weight is below the national averages, consider an OASIS audit and/or training! These are services that normally pay for themselves and they certainly make you a stronger agency.