OASIS-C tip of the Week: Toileting

I don’t have a lot of time to post today, since I’m LIVE FROM BRAINERD! at our Annual Meeting. But know, dear readers, that I will never abandon you, no matter how far from home I am!

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A: What if a patient has a new colostomy and is completely dependent on someone to empty the appliance (bag) as well as change the appliance but she can cleanse herself and care for her clothing with voiding? The patient usually changes the bag one to two times per week — unless there are problems. Is this patient a “0″? Are we interpreting correctly that the only way we would ever score this patient a “3″ is if she is changing the appliance more often than she is voiding?

 Q: CMS Response: M1845

”Toileting Hygiene” assesses the patient’s ability on the day of the assessment to manage personal hygiene and clothing when toileting. If the patient has a colostomy, the hygiene would include cleaning (wiping) the perineal area after voiding and around the stoma when necessary. M1845 does not include the patient’s ability to manage the ostomy bag, stoma wafers, or other ostomy equipment. On the day of the assessment, if the patient has the ability to safely manage his or her clothing and perform the personal hygiene as described above, the appropriate score would be a “0.″ How often the appliance (equipment) is changed does not factor into the scoring of this item.

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