CMS has released a proposed update to the OASIS assessment tool that adds A1110 (Language), B0200 (Vision) and B1000 (Hearing) to the resumption of care (ROC) time point.
 
If finalized, the OASIS-E2 will be used beginning April 1, 2026.
 
The new questions at ROC are expected to enhance risk adjustment for value-based purchasing metrics, ensuring agencies are evaluated fairly based on patient acuity at the beginning of a new quality episode of care, notes Adriana Molina, coding and OASIS educator for Trilogy/Humana CenterWell, who was pleased to see this planned change.
 
This is a significant advancement for home health agencies, Molina says.
 
“Sensory impairments such as hearing and vision loss are closely associated with cognitive, physical and emotional decline, which can directly influence patient outcomes and OASIS-based cognitive assessments,” she adds.
 
Molina notes that in her OASIS reviews, hearing-impaired patients have reportedly felt isolated and depressed because they cannot participate in social gatherings.
 
And Molina was not alone in her excitement.
 
“I think it’s great that these areas will now be reassessed at time of ROC,” says Apryl Swafford, QA specialist with SimiTree based in Hamden, Conn. “They have a huge impact on multiple areas of a patient’s care including the ability to understand verbal and/or written education but also in their ability to read things like medication labels, food labels, etc.”
 
Vision and hearing can deteriorate or improve based on the advancement or improvement in the disease process, and decline can sometimes be an early indicator of a new disease process, adds Anna Powers, executive director of SunCrest Home Health, based in Manchester and Murfreesboro, Tenn.
 
In addition, revisiting may lead to the discovery of the need for an update to equipment such as hearing aids and eyeglasses, she says.
 
Time to retire O0350 (COVID-19 vaccine)
 
Current OASIS item O0350 (Patient’s COVID-19 vaccination is up to date) is set to be retired with the new April version. The change was detailed in the 2026 Home Health Prospective Payment System proposed rule, released June 30.
 
Swafford notes that this item has been a struggle and point of confusion for many agencies, so she wouldn’t be surprised if some are glad to see it go.
 
“The guidance, which relied on the current CDC information at the time of patient assessment, was subject to frequent change,” she says. “And it was yet another step that clinicians had to take to complete the OASIS information.”
 
“I never felt that this should have been on the OASIS in the first place,” Powers adds. “It was never a required vaccine, so often it set a tone for political judgment and at times, uncomfortable conversations.”
 
Updates planned for A1250
 
The updated assessment is also proposed to replace A1250 (Transportation) with a revised, more simplified transportation item — A1255 (Transportation).
 
The new item will ask: “In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?”
 
The response options will include:
  • 0 — Yes
  • 1 — No
  • 7 — Patient declines to respond
  • 8 — Patient unable to respond
“The new version is so much less cluttered and is likely to be understood better when presented to the patient by the interviewer,” Powers notes.
 
Note: In the 2026 proposed rule, CMS also noted it no longer planned to add questions about food security, utilities and housing that had been finalized in previous rulemaking.
 
Changes coming for M0069
 
Finally, a replacement is also planned for the current OASIS item M0069 (Gender) on the new OASIS-E2, starting in April. It will be replaced with A0810 (Sex).
 
The response options will remain the same with:
  • 1 — Male
  • 2 — Female
“Gender is related to social or cultural descriptions of a person’s identity, whereas sex is a biological characteristic,” adds Diane Link, owner of Link Healthcare Advantage in Littlestown, Pa. “I am assuming that by switching from gender to sex, it makes it clear for the patient to state their physical identity versus their cultural description.”
 
Some experts feel that this change results from the current administration’s ideology on transgender individuals.
 
“It will unfairly force those who identify as transgender to identify as their sex of birth (assuming that’s what the final guidance will say) rather than as their preferred gender which may be how they present to the world,” Swafford explains. 
 
More info: To view the proposed changes for the OASIS-E2 OASIS assessment, see https://tinyurl.com/4bta64c3.