About the HCS-O Certification

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1 About the The (BMSC) now offers a professional certification in OASIS-C for home health clinicians. The new Home Care Clinical Specialist- OASIS certification () certification assures home health agencies that clinicians are able to conduct a comprehensive patient assessment and accurately complete the OASIS-C form. This leads to improved outcomes, accurate claims submission, and prompt and proper claims payment. This credential goes well beyond understanding CMS guidelines. certification is granted only to clinicians who have demonstrated the clinical skills and judgment necessary to assess a patient s condition correctly and the knowledge to complete an OASIS-C assessment form accurately. For coders, having your certification provides an important boost to your career, because it means you have a complete understanding of all the OASIS-C items and are qualified to perform audits of OASIS assessment forms as part of your agency's Quality Assurance team. credential holders know how to: Complete the OASIS-C assessment form the first and most important step in the home health revenue cycle Document medical necessity critical to compliance and proper reimbursement Make connections between OASIS, documentation and coding a key to filing accurate claims Measure and report outcomes essential to ensuring quality care You know that nothing compares to the satisfaction of knowing you have the skills and experience to excel in your career except being recognized for it. Now you can earn the same mark of excellence as a clinician that you already bear as a coder. Your managers will have increased confidence, as well, knowing their OASIS-C assessments are being performed by a well-trained, certified professional. 1

2 Study Resources Make sure you re ready. DecisionHealth provides these exclusive study resources developed specifically to help clinicians prepare and take the exam with confidence: Study Guide for Examination Shows clinicians which OASIS-C competencies they need to focus on as they prepare for the certification exam. Authored by the experts who wrote the exam, the study guide contains important OASIS assessment tips, practice questions and an exam outline. The OASIS-C Practice & Answer Book - Contains more than 100 real-life home health patient scenarios covering every item on the OASIS-C form. It s an indispensable guide for understanding how to complete OASIS-C assessments accurately. This book contains similar to scenarios that will be found on the exam. The OASIS-C Case-Mix Library A set of 5 self-paced online courses from which clinicians can pick and choose as needed. From basic OASIS-C introduction to advanced wound case mix details, this library helps clinicians with in-depth instruction on any OASIS-C case-mix challenge they have. OASIS listserv Click on the link that says OASIS & Outcomes and then get on the listserv and to interact with their peers who are familiar with OASIS-C. Provides a great forum to vet questions. OASIS-C Resource Guide Updated for 2011, the OASIS-C Resource Guide includes new chapters, including a POC (M2250) and intervention synopsis (M2400) chapter, best practices on each of the process items that include new tools and forms, strategies and tips, and much more. The OASIS-C Resource Guide 2011 includes 35 articles packed with tips and strategies, and more than 40 tools that focus on best practices for answering the OASIS-C process measure items. OASIS-C & Outcomes Solutions Get the critical data you need to make smart decisions that ensure your agency s long-term success. OASIS-C & Outcomes Solutions is the only publication that delivers to home care clinical managers exclusive OASIS assessment, quality improvement and coding guidance every month. 2

3 Frequently Asked Questions about the Examination 1. How much does the exam cost? The examination costs $ This examination fee includes one free retake, should you not pass your examination on the first attempt. This examination fee is the same whether you elect to take your examination online or at a live, in-person conference. You can download your registration form from our website: 2. Where can I take my examination? You can take your examination online with a proctor or at a live, in-person conference where the examination is being offered. (You can always check our BMSC events page to see upcoming certification and CEU opportunities.). 3. How does the online testing work for the examination? Here s an overview of our Individual Proctoring Protocol for candidates who elect to take their examinations online: The proctor will: 1) Receive the UserID and Password for the candidate to use for the examination via . This will also include links to appropriate forms (proctor instructions and supporting documents) for candidates to use during the exam. Candidate will have 30 days from the time the proctor receives the login instructions to take the exam. 2) Schedule a time and place for candidate to sit for the examination. 3) Administer the examination according to instructions provided by BMSC. 4) Keep exam content confidential and not duplicate in any way. 5) Log exam candidate into the online examination and monitor the time during the examination. 4. How soon will I get my examination results for the? If you take your examination at a live, in-person conference, it may take up to six weeks for your examination results to be mailed to you. If you take your examination online, you will receive your examination results at the conclusion of the examination, as your examination will be electronically graded once you click the Submit the Exam button. 5. What resources can be used during the examination? During the examination, your proctor will provide you with a copy of an OASIS form to be used with your examination. You will also be provided with OASIS guidance and recent Q&A s from CMS for use when taking your certification examination. You will not need to bring any resources with you for your examination. All resources will be provided by your proctor. 3

4 6. How long do I have to take the examination? The examination contains 53 questions. You will be allowed 2 ½ hours (or 150 minutes) to complete the examination. 7. What is the maintenance process for the certification? The maintenance process for the certification is identical to the maintenance process for all BMSC certifications: Year 1: Get Certified Year 2: By the anniversary of your certification date, submit your renewal form and show that you ve earned 10 CEUs toward the maintenance of your OASIS certification. Year 3: Take a brief recertification examination, which will test you on OASIS changes that have taken place in the last months. Year 4: Renew Year 5: Recertify 8. I want to take the certification examination online, but I haven t finished studying yet. Will you hold my registration form until I m ready to take the examination? We advise that you submit your BMSC examination registration form once you are ready to take the examination. We will process your examination fees within 3-5 business days, and then, if you are taking your examination online, we will send log-in instructions to your proctor. 9. I m not a clinician, but I m a coder who audits OASIS-C forms. Would I be a good candidate for the examination? Great question! You do not have to be a clinician in order to sit for the examination. We believe our best candidate for the examination is for the person who has demonstrated the clinical skills and judgment necessary to assess a patient s condition correctly and the knowledge to complete an OASIS-C assessment form accurately. We also believe our best candidate for the certification has at least 1+ year with completing an OASIS form accurately and has experience in auditing OASIS-related documentation. 10. Are there ICD-9 coding questions on the examination? There are no ICD-9 coding questions on the examination. 4

5 Practice Questions for the Homecare Clinical Specialist OASIS () Examination These practice questions are provided to help you get acquainted with the types of questions that will be asked on the certification examination. The rationale for each question/answer can be found in the OASIS-C guidance manual and/or CMS s Q&A updates that are released every quarter. These practice questions are valid as of 4/1/ Which of the following are included in M2030 (mark all that apply)? a. IM injections and Subcutaneous injections b. Injections through a central line c. Filling of an insulin pump d. a and c e. All of the above 2. In M1510 (heart failure follow up) in order to choose Response 1 - Patient s physician (or other PCP) contacted the same day, you must have had same day communication with the MD or primary care practitioner by telephone, fax, voic or any other means to convey the patient s status and the MD must respond to the agency communication with acknowledgement of receipt and/or further advice or instruction. a. True b. False 3. The WOCN s OASIS-C wound guidance combines healing criteria for surgical wounds healing by primary and secondary intention. a. True b. False 4. Mrs. Long has multiple medications which she takes in the morning, at noon, in the evening, and at bedtime. She manages her meds with the assistance of her daughter who fills her med box. Her medications include aspirin 625 mg. as needed for arthritis pain every 4 hours which she admits to taking at least once every morning and at bedtime for arthritis pain. At the SOC assessment the nurse documents that the patient has multiple large areas (as large as 5 cms. x 5 cms. each) of ecchymoses on her arms and legs. What is the most appropriate response to M2000 (Drug Regimen Review)? Does a complete drug regimen review indicate potential clinically significant medication issues, e.g., drug reactions, ineffective drug therapy, side effects, drug interactions, duplicate therapy, omissions, dosage errors, or noncompliance? a. 0 - Not assessed/reviewed [ Go to M2010 ] b. 1 - No problems found during review [Go to M2010] 5

6 c. 2 - Problems found during review d. NA - Patient is not taking any medications [Go to M2040] 5. Your patient Mrs. Olsen has just been admitted to your agency for care for an exacerbation of COPD. The patient has co-morbid diagnoses of hemiplegia due to a stroke 2 years ago and dementia. She lives with her daughter who is also the patient s caregiver. Her daughter does not drive and states that she doesn't know how she will get her mother to the MD. She has arranged for Meals on Wheels to deliver to the home, has arranged for deliveries of new medications and refills from the pharmacy, and currently schedules all of her mother s medical appointments. (M2100) Types and Sources of Assistance: Determine the level of caregiver ability and willingness to provide assistance for the following activities, if assistance is needed. (Check only one box in each row.) How would you answer M2100(g) Advocacy or facilitation of patient s participation in appropriate medical care (includes transportation to or from appointments)? a. No assistance needed b. Caregiver(s) currently provide assistance c. Caregiver(s) need training /supportive services to provide assistance d. Caregiver(s) not likely to provide assistance e. Unclear if Caregiver(s) will provide assistance f. Assistance needed but no Caregiver(s) available 6. Mrs. Black is admitted to your agency for aftercare following a hospital admission for pneumonia. She lives alone and uses a walker to ambulate. Mrs. Black tells the nurse that she takes all her baths at the sink in the bathroom. She states that she fell in the tub two years ago and has not taken a tub bath since. There is a separate shower in her bathroom with a grab bar and integrated shower seat but Mrs. Black says she has doesn t like showers. As part of the assessment, the nurse takes Mrs. Black to her bathroom and asks her to demonstrate a tub transfer. When approaching the tub, Mrs. Black becomes visibly anxious. However, using the grab bar, she is able to enter the shower and sit on the shower seat without assistance. She is able to demonstrate washing safely and does not exhibit the same emotional response as she did during the tub transfer. Based on the scenario, what is the best response for M1830: Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair)? a. 0 - Able to bathe self in shower or tub independently, including getting in and out of tub/shower. b. 1 - With the use of devices, is able to bathe self in shower or tub independently, including getting in and out of the tub/shower. 6

7 c. 2 - Able to bathe in shower or tub with the intermittent assistance of another person: (a) for intermittent supervision or encouragement or reminders, OR (b) to get in and out of the shower or tub, OR (c) for washing difficult to reach areas. d. 3 - Able to participate in bathing self in shower or tub, but requires presence of another person throughout the bath for assistance or supervision. e. 4 - Unable to use the shower or tub, but able to bathe self independently with or without the use of devices at the sink, in chair, or on commode. f. 5 - Unable to use the shower or tub, but able to participate in bathing self in bed, at the sink, in bedside chair, or on commode, with the assistance or supervision of another person throughout the bath. g. 6 - Unable to participate effectively in bathing and is bathed totally by another person 7. Your agency allows all qualified professionals to perform an OASIS assessment. Based on Mrs. T s schedule for the last week, who should complete the discharge OASIS? Week of 3/6 3/12 Adm. SOC (RN) Week of 3/13 3/19 Week of 3/20 Mon Tues Wed Thurs Fri Sat Sun 9 am RN 1pm COTA 2 pm HHA 1 pm PT 3 pm OT 9 am HHA 1 pm OT 9 am HHA 1 pm PTA 9 am RN 10 am - HHA 1 pm PTA 9 am HHA RN (discharge) 10 am COTA 1 pm PTA 3 pm COTA 9 am HHA NA NA 1 pm PTA 9 am HHA NA NA NA NA NA NA NA NA a. RN completes D/C OASIS based on visit to patient on Thursday 3/16 at 9 am. b. PT completes D/C OASIS based on visit to patient on Monday 3/20 at 1 pm. c. OT completes D/C OASIS based on visit to patient on Monday 3/20 at 3 pm. d. No additional OASIS discharge data are required an RN in the agency office may perform an administrative discharge based on assessments in record. 8. Mr. Wagnall is admitted following a hospital admission for pneumonia. He also has stage 3 chronic kidney disease associated with HTN. A vascular shunt was placed two months ago in anticipation of the patient s going on dialysis when his kidneys fail completely. There is a scar at the sight of the implant in his left forearm. How will you answer M1340 Does this patient have a surgical wound? a. 0 No b. 1 Yes c. 2 Surgical wound known but not observable due to a non- removable dressing End of Practice Questions 7

8 Study Outline for the (Home Care Clinical Specialist OASIS) Examination This outline is designed to provide representative examples of the issues covered on the 2011 certification examination. It is not inclusive of every issue addressed within the examination. It is recommended that you have an understanding of each of the items listed below prior to sitting for the examination. OASIS-C and the Medicare Prospective Payment System (PPS) o OASIS as a Payment Tool o Three Dimensions of care that influence the HHRG o How correct responses to OASIS items affect patient outcomes OASIS Conventions and Definitions o General OASIS item conventions o Definitions found in OASIS-C Guidance Day of Assessment Complete care episode Assistance One Calendar Day Minimal assistance Bedfast Active Treatment Diagnosis Coding Items o M1010 Inpatient Diagnosis o M1012 Inpatient Procedure o M1016 Diagnoses requiring medical regimen or treatment change Clinical Case-Mix Items o M0110 Episode timing o M2200 Therapy need o M1030 Therapies at home o M1200 Vision o M1242 Pain frequency o M1400 Dyspnea o M1620 Bowel incontinence o M1630 Bowel ostomy o M2030 Injectable medication Wound Case-Mix Items o M1308 Pressure ulcer numbers and stage o M1320 Pressure ulcer status o M1324 Stage of most problematic pressure ulcer o M1330 Stasis ulcer o M1332 Number of stasis ulcers o M1334 Stasis ulcer status o M1340 Surgical wound 8

9 o o M1342 Surgical Wound status M1350 Skin lesion or an open wound Functional Case-Mix Items o M1810 Dressing upper body o M1820 Dressing lower body o M1830 Bathing o M1840 Toileting o M1850 Transferring o M1860 Ambulation Other OASIS Items o M1100 Living arrangements o M M1220 Hearing/Speaking o M M1615 Urinary o M M1720, M1740-M1745 Neuro/cognitive o M1900 Prior Functioning Process Measures o M0102 and M0104 Start of Care and Referral Date o M1040 M1055 Immunization Status o M1240 Pain Assessment o M1300 Pressure Ulcer Assessment o M1500 M1510 Heart Failure assessment and follow-up o M1730 Depression Screening o M1910 Fall risk assessment o M2000 M2015 o M2250 POC Synopsis and M2400 Intervention Synopsis 9

10 Answers to Practice Questions 1. a 2. a 3. a 4. c 5. c 6. b 7. c 8. b 10