Oasis-E Spotlight: Hearing

May 1, 2023

Making sense of CMS guidelines is more challenging than ever after the launch of OASIS-E and the abundance of changes that go along with it. KanTime’s OASIS Spotlight series will spotlight specific OASIS items to simplify the ruling and help clinicians significantly improve their understanding of OASIS so they can move forward with accuracy.


Per the OASIS Guidance Manual:

“ Problems with hearing can contribute to sensory deprivation, social isolation, and mood and behavior disorders. Unaddressed communication problems related to hearing impairment can be mistaken for confusion or cognitive impairment.”

It is absolutely essential to accurately determine the cause of any hindrances to effective communication as this directly impacts the plan of care.

B0200 identifies the patient’s ability to hear (with assistive devices, if they are used).

Time points:

Start of Care

Ability to hear (with hearing aid or hearing appliances if normally used)

Code 0, Adequate, No difficulty hearing in normal conversation, social interaction, or listening to TV
Code 1, Minimal difficulty, Difficulty in some environments (e.g., when a person speaks softly or the setting is noisy)
Code 2, Moderate difficulty, Speaker has to increase volume and speak distinctly
Code 3, Highly impaired, Absence of useful hearing
Dash is a valid response for this item.

To accurately assess hearing for this item clinicians should:

    • Be sure the patient is utilizing their normal hearing appliance (if used) and that it is functioning correctly.
    • Ask the patient about their ability to hear adequately in various situations.
    • Observe the patient’s ability to hear during interaction with the clinician or others.
    • Review available documentation.
    • Consider input from family/caregivers and/or speech or hearing specialists.

We provide clinicians that are part of the KanTime enterprise system with links to the guidance from CMS for each individual OASIS item.

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