M1710: CMS OASIS Q&As

The response options for M1710 - When Confused, identify the time of day or situations when the patient experienced confusion, if at all, within the last 14 days. Response 0 is selected if the patient had no confusion in the last 14 days. Responses 1 - 4 are selected if the patient has experienced confusion and each response represents a worsening of confusion. Response 1 is selected when the patient's confusion is isolated to a new or a complex situation, e.g. the patient became confused when a new caregiver was introduced or when a complicated procedure was taught for the first time. Response 2, 3, & 4 are selected when confusion occurs without the stimulus of a new or complex situation, or when confusion which initially presented with a new or complex situation persists days after the new or complex situation become more routine. Responses 2, 3 & 4 differ from each other based on the time when the confusion occurred. Response 2 is selected if the confusion only occurred when the patient was awakening from a sleep or during the night. Response 3 is selected if the confusion occurs during the day and evening, but is not constant. If confusion was not constant, but occurred more often than just upon awakening or at night, select Response 3.

It means the patient is unable to respond or the patient responds in a way that you can’t make a clinical judgment about the patient’s level of orientation. A patient who only demonstrates reflexive or otherwise involuntary responses may be considered nonresponsive. A patient with language or cognitive deficits is not automatically considered “nonresponsive”. A patient who is unable to verbally communicate may respond by blinking eyes or raising a finger. A patient with dementia may respond by turning toward a pleasant, familiar voice, or by turning away from bright lights, or by attempting to remove an uncomfortable clothing item or bandage. A patient who simply refuses to answer questions should not automatically be considered “nonresponsive”. In these situations, the clinician should complete the comprehensive assessment and select the correct response based on observation and caregiver interview.

When completing M1710 - When Confused and M1720 - When Anxious, the clinician should report any episodes of confusion or anxiety that meet the descriptors contained in the item that occurred during the last 14 days, without regard to the cause or potential relevance of the confusion/anxiety to this episode of care.