As always, we listen and take to heart what others are saying.  There were many legitimate points made by our readers regarding the layout of the quiz.  Honestly?  It was the first one listed and we had no idea it would be that difficult to read.

The question about bathing has been taken off the quiz.  Many of you found it very difficult to understand so it has been removed.  I have also reset the quiz to show the results against my better judgment.  For those of you who have already taken the quiz, you can find the answers Answers.  Let me know if it doesn’t work.

What we remain adamant about are the definitions of the time points.  We don’t make this stuff up.  I promise.  According to the OASIS manual, chapter 1,

Day of assessment is defined as the 24 hours immediately preceding the home visit and the time spent by the clinician in the home.

If the patient’s ability or status varies on the day of the assessment, report the patient’s “usual status” or what is true greater than 50% of the assessment time frame, unless the item specifies differently (e.g., for M2020 Management of Oral Medications, M2030 Management of Injectable Medications, and M2100e Management of Equipment, instead of “usual status” or “greater than 50% of the time,” consider the medication or equipment for which the most assistance is needed).

Most times, the definition of the time frame will not change the answer but it can change it dramatically in some situations.

Patient 1

Patient 1 is scheduled for a recertification visit on day 56 of the episode.  His wife calls you the day before and asks if you can reschedule for the following day because Pt. 1 is having major dental work.  When you arrive on day 57, you learn that he was heavily sedated and in a great deal of pain for most of the prior day.  He took a pain pill before going to sleep and woke up better.  Currently he using Advil to control his pain and he is awake and alert and at no risk related to the oral surgery the day before.

Patient 2

Patient 2 is admitted after a cardiologist calls your agency.  Patient 2 was out playing golf yesterday and had a cardiac cath this morning.  His physician found a greater degree of heart failure than he anticipated and the patient was a very difficult stick.  He has a moderate hematoma at the insertion site and the physician asks if you could please admit the patient as soon as possible.   You arrive at the house late in the morning just as the patient is arriving home from the cath lab.

Can you see how the definition of ‘day of assessment’ would affect the responses to each of these questions?

When referencing our beloved Chapter 3, the instructions do mention that if ability varies, consider what the patient is able to do greater than 50% of the time.  Chapter 3 does not go on to clarify what a day is.   We are supposed to know what a day is.  So, pull out chapter 1 and have a look and meanwhile, I pulled out question 10.  Let me know if you still have problems with the layout.