M1850 assesses the patient’s current ability to move safely from bed to chair, or, if the patient is bedfast, the ability to turn or position themselves in bed at the time of the assessment.
M1850 is a common area of error and inconsistency in the OASIS. The challenge is often not knowing the response options, but determining which functional details should drive the answer. The key is to focus on the patient’s current functional ability and what the patient can actually do safely.
To make M1850 easier to assess and document consistently, here are some practical tips to keep in mind during the assessment:
1. Focus on the Patient’s Overall Ability
Assess what the patient is currently capable of doing safely, considering their physical, cognitive, and emotional status, as well as permitted activities, assistive devices, and the environment. Willingness or usual participation should NOT be the primary factor.
2. Determine if the Patient Is Truly Bedfast
A patient who requires extensive assistance or a mechanical lift is not automatically bedfast. If the patient routinely gets out of bed and tolerates time in a wheelchair or chair, assess the patient’s ability to safely transfer instead.
If the patient is truly bedfast, focus on whether they can turn and position themselves in bed.
Ask:
- Is the patient confined to bed?
- Can the patient safely tolerate being out of bed?
- Does the patient routinely get up to a chair or wheelchair?
- Can the patient independently turn or reposition?
3. Assess Current/Usual Functional Ability
M1850 reflects the patient’s current functional status at the time of assessment.
Don’t base the response solely on:
- Previous OASIS responses
- Historical baseline
- Diagnosis
- Old therapy documentation
- What the patient could do before hospitalization
If ability varies over time, choose the response describing the patient’s ability more than 50% of the time period under consideration rather than automatically basing it on a single unusually good or poor performance.
4. Assess for Safe Performance
Consider whether the patient can complete the transfer safely under their current circumstances, rather than simply whether they have performed the task previously.
5. Don’t Let the Equipment Determine the Answer
A Hoyer lift, transfer board, walker, or other device describes how the transfer occurs—it does not automatically determine the response.
For example, a patient who uses a Hoyer lift but routinely spends time in a wheelchair is not necessarily bedfast.
Always consider the patient’s overall functional status and ability to safely participate in the transfer, rather than letting the equipment alone determine the answer.
6. Ensure Documentation Supports the M1850 Response
Make sure functional findings documented throughout the OASIS support the selected M1850 response. Vague statements such as “dependent with mobility,” “requires assistance with transfers,” or “uses Hoyer” may not provide enough detail. Look for specific information about the type and level of assistance, weight-bearing ability, and transfer method, and reconcile any conflicting information across the assessment.
The goal is not more documentation—it is more relevant documentation.
A Quick M1850 Check
Before finalizing M1850, ask:
1. Is the patient truly bedfast?
→ If yes, assess turning and positioning.
2. If not bedfast, what can the patient actually do during the transfer?
3. Can the patient transfer independently and safely?
4. If not, what assistance or equipment is required?
5. Under what circumstances can the patient complete or participate in the transfer safely?
6. Can the patient bear weight and pivot?
7. Does the documentation support the selected response?
M1850 is less about identifying whether a patient is “independent” or “dependent” and more about accurately describing what the patient can physically do, whether they can do it safely, and what assistance or circumstances are needed to do so.
For a more consistent assessment, focus on the patient’s current functional ability, ability to safely participate in the transfer, weight-bearing and pivoting ability, level of assistance or equipment required, and true bedfast status when applicable.
When the documentation describes the function clearly, the M1850 response usually becomes clear as well.
