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COS-C Exam
 Exam Preparation  Description of COS-C Exam Domains with Sample Questions and Study Resources Time Points Domain Description: The Time Points Domain tests your knowledge of situations and events which trigger mandatory OASIS data collection. You will need to understand when Start of Care, Resumption of Care, Recertification, Other Follow-up, Transfer, Death at Home and Discharge data is required to be collected. A good understanding of Time Points means that you must be able to not only identify specific situations when OASIS data must be collected, but also be able to discern when OASIS data collection would not be required. You could be presented with scenarios that include information such as the patient's age, payer, discharging facility, services ordered, events occurring during or following the clinician's visit and questioned about which OASIS data would be required. Study Focus: • OASIS-C Guidance Manual, Chapter 3, M0100 • CMS OASIS Q&As included in Category 2, 3 and the M0100 Category 4b Q&As • CMS OASIS Assessment Reference Sheet • OASIS Considerations for Medicare PPS Patients Sample Question: Question: On a routine revisit, your patient tells you that since the last time you visited she has had a three-day hospital stay to treat an exacerbation of COPD and now has several new medications which she doesn't know how to take properly. Select the response that reflects the OASIS data collection required by the scenario described. a. No OASIS data collection is required. b. RFA 5 Other Follow-up data collection is required. c. RFA 6 Transfer to an inpatient facility-patient not discharged from agency, followed by RFA 3 Resumption of Care assessments are required. d. RFA 4 Recertification Assessment collection is required. Correct Response (c)  Description: The Patient Populations Domain tests your knowledge regarding which patients require OASIS data collection. You could be presented with a scenario that describes a patient's payer, age, services ordered, and be required to apply the CMS guidance to determine if OASIS data collection is or is not required, based on the information provided. Study Focus: • OASIS-C Guidance Manual, Chapter 3, M0150 • CMS OASIS Q&As, Category 1 • Comprehensive Assessment Requirements for Medicare-Approved HHAs Sample Question: Question: Which of the following patients requires OASIS data collection? a. A 78-year-old patient with a primary diagnosis of Heart Failure admitted to the Hospice Medicare benefit. b. A 17-year-old victim of a gunshot who requires daily packing of a wound; Medicaid is the payer. c. A 47-year-old patient who qualifies for Medicare disability insurance and requires diabetic teaching and drug monitoring. d. A 31-year-old patient with a wound infection that is status-post Cesarean section. Correct Response: (c) Description: The Regulations Domain tests your knowledge of the OASIS CMS Regulations regarding OASIS data collection. Specifically, you will need to have a good working knowledge of the Condition of Participation, Section 484.55, The Comprehensive Assessment of Patients; including each of the five Standards: Initial assessment visit, Comprehensive assessment, Drug regimen review, Update of the comprehensive assessment and Incorporation of OASIS data items. Study Focus: • Condition of Participation, 484.55, Comprehensive Assessment of Patients • CMS OASIS Q&As, Category 2 and Category 4b, M0080 Q&As Sample Question: Question: The Conditions of Participation require that a drug regimen review be performed as part of: a. Every comprehensive assessment b. The Start of Care comprehensive assessment c. The Start of Care, Resumption of Care and Discharge comprehensive assessments d. The Start of Care, Resumption of Care, Recertification, and Discharge assessments Correct Response: (a) Description: The Item-by-Item Guidance Domain tests your mastery of OASIS item-specific guidance and scoring conventions for the various content areas of the OASIS data set: Demographics, Sensory Status & Wounds, Respiratory, Elimination & Neurobehavioral Status, ADLs & IADLs, Medication, Equipment, Therapy & Care Management, and Emergent Care, Inpatient Admission, Intervention Synopsis and Discharge. You will need to understand the intent of each OASIS item and have a working familiarity with all the special rules included in the Response-Specific Instructions for each item in Chapter 3 of the OASIS-C Guidance Manual and with related CMS Q&As. You may be presented with a question that is testing you knowledge of a fact regarding an M item. Alternatively, you may be presented with a scenario, and asked to determine with response option should be selected for a particular OASIS item, based on the details provided in the Exam scenario. The Exam scenario will provide you all the details needed to successfully apply the CMS guidance and select the single correct response. The Exam is open book, so as time allows, you will be able to consult your references as needed. Study Focus: • OASIS-C Guidance Manual, Chapter 1, Conventions • OASIS-C Guidance Manual, Chapter 3, Item Guidance • CMS OASIS Q&As, Category 4b Item-by-Item Content Area 1: Demographics M0010-M1100 Sample Question: Question: Your patient had orthopedic surgery on her right hip on January 5th. After postoperative complications, she was discharged from the hospital to a rehabilitation facility on January 11th for therapy. She was discharged from the facility on January 19th. You are conducting the Start of Care assessment for an episode with a January 20th SOC date. The correct response(s) to M1000, Inpatient Facility Discharges during the past 14 days, would be: a. 3 - Short-stay acute hospital b. 5 - Inpatient rehabilitation hospital or unit (IRF) c. 3 - Short-stay acute hospital and 5–Inpatient rehabilitation hospital or unit (IRF) d. NA - Patient was not discharged from an inpatient facility Correct Response: (c) Item-by-Item Content Area 2: Sensory Status & Wounds M1200-M1350 Sample Question: Question: At the Start of Care, your patient has a Stage I pressure ulcer on his right elbow, a Stage II pressure ulcer on his left elbow and an old Stage IV pressure ulcer on his left hip that closed 4 years ago. Select the answer that contains the best responses for M1308 at the SOC assessment:
b. Row a = 1, Row b = 0, Row c = 1, Row d1 = 0, Row d2 = 0, Row d3 = 0 c. Row a = 0, Row b = 0, Row c = 1, Row d1 = 0, Row d2 = 0, Row d3 = 1 d. Row a = 1, Row b = 1, Row c = 0, Row d1 = 0, Row d2 = 0, Row d3 = 0 Correct Response: (b) Item-by-Item Content Area 3: Respiratory, Cardiac, Elimination & Neuro/Behavioral M1400-M1750 Sample Question: Question: Your patient requires intermittent catheterization to relieve urinary retention and also experiences stress incontinence when sneezing. The best response for M1610, Urinary Incontinence or Urinary Catheter Presence would be: a. 1 - Patient is incontinent and 2 - Patient requires a urinary catheter b. 0 - No incontinence or catheter (includes anuria or ostomy for urinary drainage) c. 1 - Patient is incontinent d. 2 - Patient requires a urinary catheter (i.e. external, indwelling, intermittent, suprapubic) Correct Response: (d) Item-by-Item Content Area 4: ADLs/IADLs M1800-M1910 Sample Question: Question: Your patient had abdominal surgery last week and now has an open wound which requires daily dressing changes. You are completing your comprehensive assessment and note that she is wearing a housedress with slippers and no socks. She tells you that she hasn't tried to put on her regular clothes (which she describes as her underwear, pants, shoes and socks) because she is "afraid something will break" referencing her open wound if she bends too much. You ask her if she would try to dress while you are there with her and she demonstrates that she is too afraid and uncomfortable for the mobility required to dress her lower body. The patient usually wears pants, underwear, socks, and shoes with orthotic inserts. The correct response for M1820, Ability to Dress Lower Body, would be: a. 1 - Able to dress lower body without assistance if clothing and shoes are laid out or handed to the patient. b. 2 - Someone must help the patient put on undergarments, slacks, socks or nylons and shoes. c. 3 - Patient depends entirely upon another person to dress lower body d. UK – Unknown Correct Response: (c) Item-by-Item Content Area 5: Medication/Equipment, Therapy & Care Management M2000-M2200 Sample Question: Question: On the Start of Care date, in order to complete the drug regimen review, the physical therapist provided the office nurse with a list of all medications the patient was taking, the patient's physical and cognitive status and details regarding the patient's stated noncompliance with her prescribed oral antibiotic regimen. The nurse followed up with both the physician and the patient on the same day and an appointment for the patient to see the physician to resolve the medication issue was scheduled for next week. The nurse communicated all this information to the PT the following day, and the SOC assessment was completed. Based on this information, how would M2000, Drug Regimen Review and M2002, Medication Follow-up be answered on the Start of Care assessment? a. M2000 = 0 – Not assessed/reviewed; M2002 = skipped b. M2000 = 1 – No problems found during review; M2002 = 0 - No c. M2000 = 2 - Problems found during review; M2002 = 1 - Yes d. M2000 = 2 - Problems found during review; M2002 = 0 - No Correct Response: (c) Item-by-Item Content Area 6: Emergent Care, Inpatient Admission, Intervention Synopsis & Discharge M2300-M2440, M0903-M0906 Sample Question: Question: The home health nurse made a prn visit after receiving a call that the patient's port-a-cath, used for chemotherapy, was oozing blood. After assessing the patient, the nurse placed a call to the physician who arranged for the patient to be directly admitted to a hospital bed on the Oncology floor where the port would be assessed, followed by the administration of the next dose of chemotherapy. The patient remained in the hospital bed as an inpatient for 2 days. The patient had not visited the hospital Emergency Room since the last time OASIS data were collected. When completing the Transfer to Inpatient OASIS assessment, the correct response(s) for M2300, Emergent Care, would be: a. 0 – No b. 1 – Yes, used hospital emergency department WITHOUT hospital admission c. 2 – Yes, used hospital emergency department WITH hospital admission d. UK – Unknown Correct Response: (a) |
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