category 4 a - oasis data set forms - Missouri Department of Health ...

impairments that limit the patient’s ability to use their existing vision in a functional way
would be considered. If a patient sustained an injury that limits neck movement, the
patient may not be able to see obstacles in their path. A patient who has sustained a
facial injury may have orbital swelling that makes it impossible for them to see and they
must locate objects by hearing or touching them. Conversely, it is possible for a patient
to be blind in one eye (technically not “normal vision”), but still be appropriately scored a
“0” on M1200 if with the patient’s existing vision, they are able to see adequately in most
situations and can see medication labels or newsprint
[Q&A ADDED 09/09; M number updated 09/09; Previously CMS OCCB 07/08 Q&A #5]
Q64.2. M1200. Our patient has dementia and is unable to answer questions
related to his vision appropriately or read a medication bottle out loud. He has no
obvious visual problems as outlined in M1200 response 1 or 2. How does a
clinician correctly answer this question given this level of verbal impairment?
A64.2. When a patient is cognitively impaired, the clinician will need to observe the
patient functioning within their environment and assess their ability to see functionally.
Does it appear the patient can see adequately in most situations? Can they see eating
and grooming utensils? Do they appear to see the buttons on their shirt/blouse? If so,
the patient would be reported as a “0-Normal vision” even though the constraints of the
dementia may not allow the patient to communicate whether they can see newsprint or
medication labels.
[Q&A EDITED 09/09]
Q65. M1220. Our agency would like clarification concerning M1220 -
Understanding of Verbal Content in patient's own language. If a patient speaks
Spanish and there is an interpreter, it is difficult to ascertain the level of
complexity of interpreted instructions. How are we to answer this?
A65. You will need to ask the interpreter to help you determine at what level the patient
is responding. Responses to 0, Understands: clear comprehension without cues or
repetitions and UK, Unable to assess understanding should be relatively simple to
determine. To determine the difference between levels 1, 2 or 3, you can interact with
the interpreter to determine with what difficulty the patient is responding. Inasmuch as
the assessment includes assistance from an interpreter, your clinical documentation of
the visit should indicate the presence of an interpreter who assists with communication
between clinician and patient.
Q66. [Q&A RETIRED 09/09; Outdated]
[Q&A ADDED 08/07; Previously CMS OCCB 07/06 Q&A #19]
Q66.1. M1220. My patient’s primary language is German, but he does speak
English well enough for us to generally communicate without the use of an
interpreter. Often I need to repeat my request, or reword my statements, but he
eventually adequately understands what I’m asking or saying. When scoring
concerning M1220 - Understanding of Verbal Content, I marked response “2”
based on my assessment, but I wonder if the patient’s hearing/comprehension
would be better (i.e., a Response “0” or “1”) if he were being spoken to in German,
his primary language. Do I have to assess the patient with an interpreter in order
to score M1220 in the patient’s primary language, even if I feel communication is
Category 4 – OASIS Data Set – Forms and Items 09/09