Oasis-E Spotlight: Vision

April 21, 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.

B1000: VISION

B1000 identifies the patient’s ability to see objects nearby in their environment, in adequate light, and with glasses or other visual appliances.

The OASIS Guidance manual defines adequate lighting as:
“Lighting that is sufficient or comfortable for a person with normal vision to see fine detail.”

Time points:

Start of Care

Ability to see in adequate light (with glasses or other visual appliances)

Code 0,  Adequate – sees fine detail, such as regular print in newspapers/books
Code 1, Impaired – sees large print, but not regular print in newspapers/books
Code 2, Moderately impaired – limited vision; not able to see newspaper headlines but can identify objects
Code 3, Highly impaired – object identification in question, but eyes appear to follow objects
Code 4, Severely impaired – no vision or sees only light, colors or shapes; eyes do not appear to follow objects
Dash is a valid response for this item.

To accurately assess vision for this item clinicians should:

    • Be sure the patient is utilizing their normal visual appliance (if used).
    • Ensure adequate lighting.
    • Ask the patient, family/caregivers about the patient’s usual vision patterns.
    • Have the patient read from a newspaper or book and assess their ability from larger to finer print. Adjust the reading material accordingly to determine the size of print they can see.
    • If they are unable to read out loud, utilize pictures or numbers in the appropriate print size.
    • If the patient is unable to communicate or follow your directions for testing vision, observe the patient’s eye movements to see if their eyes seem to follow movement and objects. For patients who appear to do this, code 3, highly impaired.

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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