Medicare monitors seven (7) OASIS items for improvement between admission and discharge. M1830 Bathing is one of the 7 'process' outcomes tracked for improvement.
The following guidelines are adapted from Medicare's Guidance Manual, including the assessment of M1830 Bathing ability.
(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).
• 0 - Able to bathe self in shower or tub independently, including getting in and out of tub/shower.
• 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.
• 2 - Able to bathe in shower or tub with the intermittent assistance of another person:
o (a) for intermittent supervision or encouragement or reminders, OR
o (b) to get in and out of the shower or tub, OR
o (c) for washing difficult to reach areas.
• 3 - Able to participate in bathing self in shower or tub, but requires presence of another person throughout the bath for assistance or supervision.
• 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.
• 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.
• 6 - Unable to participate effectively in bathing and is bathed totally by another person.
INSTRUCTIONS FOR ASSESSMENT
• Specifically excludes washing face and hands, and shampooing hair.
• The patient’s ability may change as the patient’s condition improves or declines, as medical restrictions are imposed or lifted, or as the environment is modified. The clinician must consider what the patient is able to do on the day of the assessment. If ability varies over time, choose the response describing the patient’s ability more than 50% of the time period under consideration.
• A combined observation/interview approach with the patient or caregiver is required to determine the most accurate response for this item.
• Ask the patient what type of assistance is needed to wash entire body in tub or shower.
• Observe the patient’s general appearance to determine if the patient has
been able to bathe self as needed.
• Observe patient actually stepping into shower or tub to determine how much assistance the patient needs to perform the activity safely.
• The patient who only performs a sponge bath may be able to bathe in the tub or shower if person or device is available to assist. Evaluate the amount of assistance needed for the patient to be able to safely bathe in tub or shower.