How to Answer M2102 (Types and Sources of Assistance) on the OASIS - Part I
M2102 – Types and Sources of Assistance, Part 1
Over the course of the next few months we will discuss in detail M2102, Types and Sources of Assistance. This month we will spend some time talking through the general guidance on the item and in the following months we will elaborate on what is included in each category.
First, it is important to understand the intent of this item. Chapter three of the OASIS Guidance Manual tells us that the intent of this item is to identify the ability and willingness of the caregiver(s) (other than home health agency staff) to provide categories of assistance needed by the patient. It is also important to understand the time period under consideration. When answering this item on start of care or resumption of care assessments, the responses should report what is known on the day of the assessment regarding the ability and willingness of non-agency caregivers to provide help in the various categories of assistance for the upcoming episode of care. When answering this item at discharge, the responses should reflect the ability and willingness of the caregiver at the time of discharge.
Now let’s look at the possible response in each category:
- 0 – No assistance needed – patient is independent or does not have needs in this area
- 1 – Non-agency caregiver(s) currently provide assistance
- 2 – Non-agency caregiver(s) need training/supportive services to provide assistance
- 3 – Non-agency caregiver(s) are not likely to provide assistance OR it is unclear if they will provide assistance
- 4 – Assistance needed, but no non-agency caregiver(s) available
Responses 0, 1 and 2 are very simple and most clinicians do not have any issues with these. Response three often causes some confusion with assessing clinicians. Chapter three tells us that this response is appropriate is the non-agency caregiver(s) are not likely to provide care due to unwillingness and/or inability on the part of non-agency caregiver(s); and/or if there is a reluctance on the part of the caregiver(s) to provide care. Response four means that the patient has no one involved in providing any level of care to them at all. If there is a caregiver providing assistance for any activity, then response four cannot be selected in ANY row.
It is appropriate to report only one response in each category. If the patient needs assistance with any aspect of a category, the response should be based on the aspect that represents the most need. If more than one response represents the caregiver’s ability, select the response that represents the caregiver’s greatest barrier. For example, let’s take a patient who has Alzheimer’s dementia. The patient’s wife can administer all his medications correctly but does not understand the alternating doses of coumadin. In this example, report that the caregiver needs training/support services to provide assistance, because it represents the caregiver’s greatest barrier to meeting the patient’s need.
Let’s wrap up with two more important points to remember when answering this item. In situations where the physician has ordered the skilled nurse to provide the treatment or procedure (such as catheter changes, wound VAC dressing changes, etc.), response 3 is the appropriate response. And lastly, remember that this item is referring to the assistance needed in the home. It does not capture assistance provided to the patient outside the home setting such as at an adult day care center, dialysis center, wound care clinic, etc.
Join us next look as we explore what is included in each category of this M item.