M1100: CMS OASIS Q&As

Report the patient’s living arrangement as “c. Patient lives in congregate situation (e.g., assisted living)” because the patient is living in the ALF. The availability of assistance selected should be determined using instructions from the OASIS Item guidance.

For M1100 - Patient Living Situation, a response from row C should be selected for a patient living in an assisted living setting (ALF). This would be true regardless of the services provided to the patient. To determine the frequency of availability of assistance, the clinician may refer to the ALF service contract or may gather information from the patient or family.

If, in a congregate housing situation, the patient has available in-person assistance in response to a call bell 24 hours a day, the correct answer would be "around the clock."

When answering M1100 - Patient Living Situation, if a patient lives with their family, Row b., Patient lives with other person(s) in the home, would appropriately depict their living arrangement, even if the patient pays their family member to provide care or the family member is being paid through another source, e.g., another family member or state funded program.

In M1100 - Patient Living Situation, “availability of assistance” refers to in-person assistance provided in the home of the patient. If the daughter leaves the home to work during the day, but plans to be there for all the nighttime hours for the entire upcoming episode of care (with infrequent exceptions), “8 - Patient lives with another person with Regular nighttime assistance” would be appropriate. If the daughter is gone some nights or not present all the hours of the nighttime, “9 - Occasional/short-term assistance” would be appropriate. Assistance provided outside the home is not reported in M1100.

M1100 - Patient Living Situation, Response-specific instructions state "Lives in congregate situation: The patient lives in a setting where assistance, supervision and/or oversight are provided as part of the living arrangement, such as an assisted living facility, residential care home or personal care home. The patient may live alone, or with a spouse or significant other, in an apartment or room that is part of an assisted living facility, for example, and still be considered living in a congregate situation." In the large care continuum complexes, the patient is living in a congregate setting when "assistance, supervision and/or oversight are provided as part of the living arrangement." This is true even if, as described above, they are in an independent cottage or an independent apartment and they are getting services, like meals, housekeeping, or laundry services, as part of the living arrangement. Since they have a call bell in their apartment, the assistance is considered “Around the Clock” if onsite care continuum staff is available to respond to the bell 24/7 for the entire upcoming episode of care.

Assuming that the option for the patient to receive assistance, supervision or oversight is not a part of the living arrangement with the continuum of care community, a response from Row b - Patient lives with other person(s) in the home would be appropriate. If assistance, supervision, or oversight is provided to the patient as part of the living arrangement, (for example weekend brunches in the main dining hall, or a morning check-in call), but the patient doesn’t need and/or chooses not to utilize the available services, a response from Row c Patient lives in congregate situation would be appropriate.