M1830 (Bathing) 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 when the Patient-Driven Groupings Model (PDGM) launches on or after Jan. 1, 2020.
If a patient appears physically able to shower or bathe, but refuses to do so, you must delve into why. Focus on a patient’s safety and ability, not on the patient’s willingness to perform the task.
If the patient needs assistance to bathe in the shower or tub, then note the level of assistance needed and select:
- 1–With the use of devices, is able to bathe self in shower or tub independently, including getting in and out of the tub/shower,
- 2–Able to bathe in shower or tub with the intermittent assistance of another person: (a) for intermittent supervision or encouragement or reminders, OR (b) to get in and out of the shower or tub, OR (c) for washing difficult to reach areas or
- 3–Able to participate in bathing self in shower or tub but requires presence of another person throughout the bath for assistance or supervision.
If a patient uses their tub/shower as a storage area but is physically and cognitively able to bathe in the tub/shower:
- Respond to M1830 in a way that best reflects their ability to bathe when the tub/shower was empty, according to CMS Static Q&A guidance in Category 4b, Q141.4.
If, however, patients have physical or cognitive/emotional barriers and that’s why they’re treating the tub/shower as a storage area:
- Score them as either a 4, 5 or 6 depending on their ability at the time of assessment. The selection of one of those responses is “due to the patient’s inability to safely bathe in the tub/shower (even with help) due to the physical and/or cognitive barrier, not due to the alternative use of the tub for storage,” CMS states in its guidance.
Know what to do if the patient’s tub or shower is unsafe or doesn’t work. If that’s the case:
- Apply response “4,” “5” or “6” depending on the patient’s ability to participate in bathing activities outside the tub or shower, according to CMS Static Q&A guidance found in Category 4b, Q134.