When it comes to educating staff about how to respond to M1850 (Transferring), the key is paying close attention to the word “or” and how it’s used.
The one-syllable word causes clinicians to be “chronically wrong” on M1850, says Cindy Krafft, CEO of Kornetti & Krafft Health Care Solutions. In fact, it’s a large part of why she contends clinicians mark M1850 inaccurately on more than 50% of the forms she is asked to review.
Ensuring staff truly understand what M1850 asks is crucial now and will continue to be under the Patient-Driven Groupings Model (PDGM), which takes effect on or after Jan. 1, 2020. Clinicians who respond inaccurately on M1850 as a result of the word “or” could cost their agency functional points.
M1850 is one of six OASIS items that affect functional case-mix adjustment under the PPS, and it will be one of eight items that affect functional case-mix adjustment under PDGM. The sum of the functional points for the eight items will lead to a score used to group home health periods into a functional level: low, medium or high. It’s possible for a patient to generate up to 89 total functional points — including up to eight points for transferring.
With M1850, clinicians commonly lack understanding about response “1 – Able to transfer with minimal human assistance or with use of an assistive device.”
The key is educating clinicians that 1 would be an incorrect response for patients who only are able to transfer with human assistance and with use of an assistive device, Krafft says.
“If the patient is able to transfer self but requires standby assistance or verbal cueing to safely transfer, Response ‘1’ would apply,” according to CMS Static Q&A guidance in Category 4b, Q151.2. “If the patient is unable to transfer self but is able to bear weight and pivot when assisted during the transfer process, then Response ‘2’ would apply.”