OASIS-B1 (1/2008) Start of Care
CLIENT REFERRAL TO PRIVATE DUTY PROVIDER
For the best possible outcomes, Medicare-certified providers work closely with providers specializing in non-medical care. For the sake of this form, non-Medicare providers are referred to as private duty providers. Where noted, your client may experience the best outcomes by referring the client to a private duty provider. Refer to OASIS Data Set for complete wording of OASIS items.
ADL/IADLsOASIS M0 Item Number / OASIS M0 Item Category / Consider Referral to Private Duty Provider when Answers are the Following
(M0640) / Grooming / 0 - Able to groom self unaided
1 - Grooming utensils must be placed within reach
(M0650) / Ability to Dress Upper Body / 0 - Able to get, put on, removeclothes without assistance
1 -Able to dress without assistance if clothes laid out/handed
(M0660) / Ability to Dress Lower Body / 0 - Able to get, put on, removeclothes without assistance
1 -Able to dress without assistance if clothing laid out/handed
(M0670) / Bathing / 0 - Able to bathe self in shower or tub independently
1 -With devices, bathes self in shower/tub independently
(M0680) / Toileting / 0 -Able to get to and from the toilet independently
1 –Gets to/from toilet when reminded/assisted/supervised
(M0690) / Transferring / 0 - Able to independently transfer
(M0700) / Ambulation/Locomotion / 0 - Able to independently walk without assistance or device
(M0710) / Feeding or Eating / 0 - Able to independently feed self
1 - Able to feed self independently but requires: (a) meal set-up; OR (b) intermittent assistance/supervision; OR (c) a liquid, pureed or ground meat diet
(M0720) / Planning and Preparing Light Meals / 0 - Able to independently plan and prepare all light meals
1 - Unable to prepare light meals on regular basis due to physical, cognitive, or mental limitations
2 -Unable to prepare light meals or reheat delivered meals
(M0730) / Transportation / 0 -Able to independently drive a regular/adapted car; OR uses a regular or handicap-accessible public bus
1 -Able to ride in car only when driven by another person; OR able to use bus/handicap van only when assisted
(M0740) / Laundry / 0 - Able to independently take care of all laundry tasks
1 -Able to do only light laundry
2 - Unable to do any laundry
(M0750) / Housekeeping / 0 - Able to independently perform all housekeeping tasks
1 - Able to perform only light housekeeping
2 - Able to perform housekeeping tasks with intermittent assistance or supervision
3 - Unable to consistently perform any housekeeping tasks unless assisted by another person throughout the process
4 -Unable to effectively participate in any housekeeping tasks
(M0760) / Shopping / 0 - Able to plan for shopping needs/performshopping tasks
1 - Able to go shopping, but needs some assistance
2 -Unable to go shopping
3 - Needs someone to do all shopping and errands
(M0770) / Ability to Use Telephone / 0 -Able to dial numbers/answer calls appropriately
1 - Able to use a specially adapted telephone
2 -Able to answer the telephone/carry on a normal conversation but has difficulty with placing calls.
3 - Able to answer telephonesome of the time or is able to carry on only a limited conversation.
4 - Unable to answer telephone but can listen if assisted
5 - Totally unable to use the telephone.
MHCA 2008 Annual Conference Presentation: Private Duty Team Page 1 of 1