Medicare's OASIS-E assessment, effective January 2023, expanded its data collection on the patient's nutritional status to include four (4) more questions on Start of care, Resumption and Discharge.
The presence of Parenteral/IV feeding and Feeding tube (e.g., nasogastric or abdominal (PEG)) was recorded on the SOC at M1030 Therapies the Patient receives at Home. Mechanically altered diet – required change in texture of food or liquids (e.g., pureed food, thickened liquids) and Therapeutic diet (e.g., low salt, diabetic, low cholesterol) are the 2 unique additions.
The presence of any of these items on assessment would indicate the need for inclusion in the careplan, notably patient teaching & recall.
K0520. Nutritional Approaches
On Admission
Check all of the nutritional approaches that apply on admission
- A. Parenteral/IV feeding
- B. Feeding tube (e.g., nasogastric or abdominal (PEG))
- C. Mechanically altered diet – require change in texture of food or liquids (e.g., pureed food, thickened liquids)
- D. Therapeutic diet (e.g., low salt, diabetic, low cholesterol)
- Z. None of the above
On Discharge
Check all of the nutritional approaches that were received in the last 7 days and check all of the nutritional approaches that were being received at discharge.
- A. Parenteral/IV feeding
- B. Feeding tube (e.g., nasogastric or abdominal (PEG))
- C. Mechanically altered diet – require change in texture of food or liquids (e.g., pureed food, thickened liquids)
- D. Therapeutic diet (e.g., low salt, diabetic, low cholesterol)
- Z. None of the above
M1870 Feeding & Eating included OASIS-E Admission & Discharge
M1870 continues to be present on OASIS-E, as it has been (in various forms) since the original OASIS released in 1998.
Feeding or Eating: Current ability to feed self meals and snacks safely. Note: This refers only to the process of eating, chewing, and swallowing, not preparing the food to be eaten.
- 0 Able to independently feed self.
- 1 Able to feed self independently but requires: (a) meal set-up; OR (b) intermittent assistance or supervision from another person; OR (c) a liquid, pureed or ground meat diet.
- 2 Unable to feed self and must be assisted or supervised throughout the meal/snack.
- 3 Able to take in nutrients orally and receives supplemental nutrients through a nasogastric tube or gastrostomy.
- 4 Unable to take in nutrients orally and is fed nutrients through a nasogastric tube or gastrostomy.
- 5 Unable to take in nutrients orally or by tube feeding.
Intent of M1870...Per the Medicare Guidance Manual
- M1870 identifies the patient’s ability to feed him/herself, including the process of eating, chewing, and swallowing food.
- The intent of the item is to identify the patient’s ABILITY, not necessarily actual performance. “Willingness” and “adherence” are not the focus of these items.
- These items address the patient’s ability to safely self-feed, given the current physical and mental/emotional/cognitive status, activities permitted, and environment.
- The patient must be viewed from a holistic perspective in assessing ability to perform ADLs. Ability can be temporarily or permanently limited by:
- physical impairments (for example, limited range of motion, impaired balance)
- emotional/cognitive/behavioral impairments (for example, memory deficits, impaired judgment, fear)
- sensory impairments (for example, impaired vision or hearing, pain).
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