Home Health & Hospice

Bid Farewell to a Nonsensical Data Element

Homecare Insider, March 16, 2009

One data element in OASIS-B1, M0440, skin lesion or open wound, seemed to generate the same question from many Beacon Institute members.  Why does the OASIS ask about skin lesions when everyone has one?  The definition of a lesion is very broad, including any area of pathologically altered tissue with the exception of ostomies and peripheral IV sites.  Anything from a freckle, mole, or scar to dandruff, rash, or edema constitutes a lesion.  It’s likely that every person has at least one skin abnormality, if not more.  

The confusion is compounded by one instruction.  “If the patient has any skin condition which should be observed and described, mark ‘Yes’ to this item.”  That leads some clinicians to believe that if the lesion did not merit observation, the answer to M0440 should be “No.”  However, M0440 simply asks if the patient has a lesion, whether or not it needs to be observed.

Now, it looks as though the OASIS-C will finally replace this useless question.  A proposed data element, M1350, asks about any lesion or open wound that requires observation or care.  This data element will provide some insight for care planning.  

Download the latest iteration of OASIS-C.  And get a jumpstart of preparation with the audio recording, “Introduction to OASIS-C.”  Order this CD.