Home Health & Hospice

OASIS-C and Diabetic Foot Care

Homecare Insider, June 13, 2011

There are many procedures that Medicare considers to be unskilled, meaning they do not require the skills of a nurse to be performed safely and effectively. Those unskilled procedures include administration of oral medications and eye drops, application of topical ointments, prefilling syringes, simple wound care, routine ostomy care, and routine foot care, even for diabetic patients. In the past couple of years, diabetic foot care has been receiving more attention because of its inclusion as a process data element in OASIS-C.

OASIS-C data element M2250 addresses the plan of care synopsis. This data element identifies specific physician-ordered best practices that are included on the plan of care. This means that the patient condition has been discussed with the physician and he/she agrees to the plan of care. This item can be answered “yes” prior to the receipt of signed orders if the clinical record reflects evidence of that communication with the physician.

In regard to diabetic foot care, if the physician-ordered plan of care contains both orders for monitoring the patient’s lower extremities for evidence of skin lesions and patient education on proper foot care, the clinician should respond “yes” to this item in row b. Even though diabetic foot care is unskilled, the patient, caregivers, and/or home health aides should be instructed appropriately on care of the diabetic patient, including foot care.

Beacon Health offers Home Health Aide On-the-Go In-services on caring for the diabetic patient and diabetic foot care, which are essential components in an agency’s aide education program given the emphasis placed on best practices.