How to Answer M1311 (Current Number of Unhealed Pressure Ulcers at Each Stage) on the OASIS
M1311 replaced what we knew before as M1308. This OASIS question asks us to report the number of stage 2 or higher pressure ulcers at each stage present at the time of admission. Pressure ulcers that are covered with slough/eschar or covered with a non-removable dressing and deep tissue injuries are considered unstageable and also reported in this item. There are two questions associated with each of the different stage pressure ulcers. The first line in each section is answered at SOC, ROC, follow up and discharge. Here you report the number of pressure ulcers of that stage present on the day the assessment is completed.
The second question is only answered at follow up and discharge. It wants to know the number of pressure ulcers listed in the first question that were present at the most recent SOC/ROC. In order to be reported in this second question, the pressure ulcer must have been present AT THE SAME STAGE at the time of the most recent SOC/ROC.
Here are a few other things to keep in mind when answering this item:
- Closed stage 3 & 4 pressure ulcers are considered healed and not reported in this item
- If the pressure ulcer was unstageable at the SOC/ROC, but becomes numerically stageable later, the “present on admission” stage should be considered the stage at which it first becomes numerically stageable.
- A previously closed stage 3 or 4 pressure ulcer that is currently opened again should be reported at its worst stage
- Debridement does not make a pressure ulcer a surgical wound. It should continue to be reported as a pressure ulcer.
- A pressure ulcer treated with a muscle flap, skin advancement flap or rotation flap is no longer reported as a pressure ulcer on the OASIS. It is reported as a surgical wound.
- New! A pressure ulcer treated with a skin graft should no longer be reported as a pressure ulcer. It should be reported as a surgical wound until the graft edges completely heal.
Please take time to read the guidance on this new item in Chapter 3 of the OASIS Guidance Manual.