Include the following best practice (Medicare) guidelines for completing OASIS M1630:
(M1630) Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay; or b) necessitated a change in medical or treatment regimen?
- 0 - Patient does not have an ostomy for bowel elimination.
- 1 - Patient's ostomy was not related to an inpatient stay and did not necessitate change in medical or treatment regimen.
- 2 - The ostomy was related to an inpatient stay or did necessitate change in medical or treatment regimen.
Medicare Assessment Strategies for M1630
- Applies to any type of ostomy for bowel elimination (for example: colostomy, jejunostomy, ileostomy). This item only addresses bowel ostomies, not other types of ostomies (for example: urinary ostomies, tracheostomies).
- If an ostomy has been reversed, then the patient does not have an ostomy at the time of assessment.
- If patient does not have an ostomy for bowel elimination, enter Response 0 – Patient does not have an ostomy for bowel elimination.
- If the patient does have an ostomy for bowel elimination, determine whether the ostomy was related to an inpatient stay or necessitated a change in the medical or treatment regimen within the last 14 days.
- The term “past fourteen days” is the two-week period immediately preceding the Start/Resumption of Care or Follow-Up assessment. This means that for purposes of counting the 14-day period, the Start of Care date is day 0 and the day immediately prior to the Start of Care date is day 1. For example, if the patient’s SOC date is August 20, any ostomy related to an inpatient stay or requiring medical or treatment regimen change that occurred on or after August 6 would be considered.
Physical Assessment for Colostomy, Jejunostomy, Ileostomy
For patients with a bowel ostomy, report any of the following symptoms to the physician:
• persistent oral temperature greater than 99.0F
• peripheral skin irritation
• bowel obstruction
• stoma retraction
• parastomal hernia