Educating Staff On Oasis E: If You Don't Educate ICD 10 Coders, It Is Like Only Utilizing One Side Of The Brain.

June 9, 2023

While working with agencies throughout the United States, we have the opportunity to see how many operate. This leads us to talk today about the new Oasis E tool being implemented  January 1st 2023. For those who have been in the industry for decades, the implementation of a changed tool is not unusual. In our experience, when agencies educate on Oasis changes, it is normally limited to clinical staff who complete the tool. We need to look at this from the standpoint of ICD 10 coders. It is imperative for your ICD 10 coders to know the assessment tool inside and out.

What Are The Changes From Oasis D to Oasis E?

CMS updated the Oasis E tool on May 16th, 2022 and provided a PDF to the changes from the February 1, 2022 version. The changes are in line with expansion of Home Health Value Based Purchasing (HHVBP). So, it aligns with outcome based reimbursement. Now more than ever, the Oasis must be marked properly. We see the implementation of 3 different assessments within the tool: Brief Interview for Mental Status (BIMS),Signs and Symptoms of Delirium from the Cognitive Assessment Method (CAM), and the Patient Mood Interview (PHQ 9) which allows for expanded screening for depression. McBee and Associates offers a nice visual crosswalk tool to illustrate the changes from the Oasis D to E.

What Does This Do For ICD 10 Coding?

It means your Oasis needs to paint the actual clinical picture. Your ICD 10 coding isn't accurate if the documentation doesn't align. This isn't new.  Now, HHVBP is going to need to see the outcomes on our patients come to fruition or your reimbursement will suffer. The check and balance of the certified coder means they need to understand the assessment tool as well or better than the nurse who does the assessment. The nurses look at the tool in a different way than the certified ICD 10/ Oasis coder. This is the analogy of the 2 sides of the brain. Putting both of these clinical pieces together is the whole picture and therefore, the whole brain completes the Oasis and coding puzzle. The coder is able to catch discrepancies or address items that don't fully align with the diagnoses based upon other documentation. You may currently have your agency doing coding in-house and if your coders are Oasis and ICD 10 certified, then great. Check their ongoing accuracy and whether it makes financial sense to keep it in-house. Spend the time and money to make sure your ICD 10 coders keep up-to-date on changes.  If you don't have certified coders in place, then outsource your coding and Oasis review or you may really be penalized for errors in the tool. If you are looking to outsource, then make sure the person doing the coding is certified in ICD 10 and Oasis. Agencies Can't afford to have Oasis or ICD 10 coding errors cost them money. If you are looking to check the accuracy of your current coding system, outsource your coding, or need someone to provide educational assistance on the new Oasis E tool, Kenyon Homecare Consulting can help. Call us today at 206-721-5091 or contact us online to see how we can help!


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controlling chronic diseases
By Ginny Kenyon April 25, 2026
In the rapidly evolving landscape of healthcare, the burden of care is increasingly shifting from clinical facilities to the home. As the population ages, the prevalence of chronic conditions—such as heart disease, diabetes, and respiratory disorders—has reached unprecedented levels. For home care agencies, the quality of service is no longer just about assistance with daily living; it is more and more defined by the clinical competencies and disease-specific knowledge of your field staff. Chronic disease education for home care staff is not a luxury, is a strategic necessity that directly impacts patient outcomes, caregiver confidence, and the business’s bottom line. 1. Enhancing Clinical Outcomes and Safety Home care staff are the "eyes and ears" of the healthcare system. When aides and clinicians are highly educated on chronic disease processes, they can identify subtle shifts in a patient's condition before they escalate into emergencies. · Early Intervention: An educated caregiver can recognize the early signs of fluid retention in a Congestive Heart Failure (CHF) patient or skin changes in a diabetic patient, allowing for proactive adjustments rather than reactive ER visits. · Medication Adherence: Understanding why a medication is prescribed for a specific chronic condition helps staff reinforce the importance of adherence to the patient, reducing the risk of complications. 2. Reducing Hospital Readmissions Hospital readmission rates are a primary metric for home health success. Chronic diseases are the leading cause of "revolving door" hospitalizations. By providing specialized education, agencies empower their staff to implement Evidence-Based Practices at the bedside. When staff can effectively manage symptoms and educate patients on self-care, the likelihood of a patient staying stable at home increases dramatically. This not only benefits the patient but also strengthens the agency’s reputation with referral sources like hospitals and physician groups. 3. Boosting Staff Confidence and Retention The home care industry faces significant challenges with staff turnover. Often, burnout is fueled by the stress of feeling unprepared for complex patient needs. Knowledge is Empowerment: When staff members receive robust training, they feel more confident in their roles. This professional growth fosters a sense of value and belonging within the organization, leading to higher job satisfaction and lower turnover rates. 4. Improving Documentation Accuracy In an era of increased regulatory scrutiny, clinical documentation must be precise. Education on chronic diseases ensures that staff members use the correct terminology and focus on the most relevant clinical indicators during their assessments. · OASIS Accuracy: For Medicare-certified agencies, a deep understanding of chronic conditions leads to more accurate OASIS scoring, which directly influences reimbursement and quality ratings. · Audit Readiness: Well-educated staff produce notes that clearly reflect the necessity of care, making the agency much more resilient during regulatory surveys or audits. 5. Bridging the Communication Gap Effective chronic disease management requires a multidisciplinary approach. A caregiver who understands the nuances of a disease can communicate more effectively with: · Physicians: Providing clear, clinical updates that help doctors make informed decisions. · Family Members: Offering clear explanations and peace of mind to stressed family caregivers. · The Internal Team: Ensuring a seamless transition of care and consistent messaging across all disciplines. Conclusion Investing in chronic disease education is an investment in the agency’s future. By elevating the knowledge of the frontline workforce, home care providers can transform from basic service agencies into high-value clinical partners. In the end, the goal is simple: providing the highest quality of life for patients in the comfort of their own homes, a goal that can only be met through a highly trained and knowledgeable staff. If you do not know where to get comprehensive education for Chronic diseases, contact Kenyon Homecare Consulting at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help
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