The new guidelines for documenting falls are among the most significant updates in OASIS‑E2, effective April 1, 2026. The updates are designed to make fall reporting more complete, accurate, and consistent, helping clinicians keep patients safe and improving quality reporting.

CMS recognized that the Falls with Major Injury (FMI) quality measure was underreporting events when relying solely on OASIS data. To address this, CMS finalized the OASIS‑E2 fall documentation updates, clarifying definitions of falls, injury severity, and counting rules. This ensures that the information recorded in J1800 and J1900 is accurate and consistent, creating a reliable foundation for CMS as it implements future updates to the FMI measure in the Home Health Quality Reporting Program (QRP).

Here is an overview of the key changes in OASIS‑E2 for falls:

1. Broader Definition of a Fall

Under OASIS‑E2, any event where a patient loses balance and hits the ground counts as a fall — even if it occurred outside the home or was caused by an external force, such as tripping over an object or being bumped by someone. All falls since the last Start of Care (SOC) or Resumption of Care (ROC) must be recorded.

2. Clearer Injury Categories

Falls are now classified by severity:

• Major injuries: Includes, but is not limited to, traumatic bone fractures, joint dislocations/subluxations, internal organ injuries, amputations, spinal cord injuries, head injuries, and crush injuries.
  
• Non-major injuries: Includes, but is not limited to, skin tears, abrasions, lacerations, superficial bruises, hematomas, and sprains; or any fall-related injury that causes the patient to complain of pain.

3. How to Document Falls in OASIS‑E2

• J1800: indicate if any falls occurred.
• J1900: record the total number of falls since SOC/ROC and the highest level of injury for each.
• If the patient has multiple injuries in a single fall, record the fall at the highest level of injury.
• Use a dash (“–”) only if no information is available after asking the patient or caregiver.
• Fractures confirmed to be pathological (rather than traumatic) should NOT be considered a major injury resulting from a fall.

Remember that every fall should be documented, including the injury level, and recorded accurately. The updated rules make it easier to identify patterns, prevent future falls, and keep patients safe.

Ensuring Accuracy in Fall Documentation

As clinicians adjust to the new OASIS‑E2, leverage your QA team to review assessments and confirm that all falls are documented, totals in J1900 match clinical events, and injury severity is coded correctly. Beyond falls, QA should also ensure that all OASIS‑E2 updates are properly applied, helping clinicians as they adapt to the new requirements while maintaining agency compliance throughout the transition.

Why This Matters

By updating fall documentation in OASIS‑E2, CMS ensures that home health agencies capture all relevant falls accurately and classify injuries consistently. This not only enhances patient safety tracking but also provides reliable data for the FMI quality measure and other quality reporting programs. Aligning documentation with the FMI measure helps agencies remain CMS-compliant, supports meaningful performance comparisons, and ensures that quality reporting reflects the true care patients receive.

Resources:
Home Health J1800 and J1900 Errata for the OASIS Guidance Manual
October 2025 CMS Quarterly OASIS Q&As with 3 Q&As specific to J1800 and J1900 coding guidance

Read more about preparing for the new OASIS-E2:
CMS Released Final OASIS-E2 Resources >
Getting Ready for OASIS-E2 Rollout on April 1 >

The post Documenting Falls in OASIS‑E2: Updated Guidance first appeared on Qavalo.

In preparation for the April 1, 2026 implementation of OASIS-E2, CMS has released the final set of materials to support agencies during the transition. Below is a brief overview of what each resource includes.

Home health agencies are encouraged to review these documents carefully, as several updates were made after the draft versions. Beginning preparation now is important, since changes to data items and guidance may impact workflow, documentation, and reporting. Early review and planning can help ensure a smoother transition.

• OASIS-E2 Instrument
  The final All-Item version and all time-point versions of OASIS-E2 are now posted on the HHQRP OASIS Data Sets webpage.
  
  Key updates from the draft versions include:
  • Revised descriptions for the Fall Injury items (J1900B and J1900C)
  • Addition of item A1110 (Language) at the Resumption of Care time point
• OASIS-E2 Guidance Manual
  The final OASIS-E2 Guidance Manual is now available in the download section of the HHQRP OASIS User’s Manual webpage.
  
  It includes a 50-page appendix that clearly outlines what changed from OASIS-E1 to OASIS-E2.

• CMS OASIS Q&As
  CMS also posted the updated February 2026 OASIS Q&As on the QTSO website to provide additional guidance for agencies on implementing the new OASIS-E2.

Read our blog with an overview of key OASIS-E2 updates: Getting Ready for OASIS-E2 Rollout on April 1>

Quick Links:

• Final OASIS-E2 Instruments (ZIP)
• Final OASIS E2 Change Table (PDF)
• OASIS-E2 All Item Data Set
• Final OASIS-E2 Guidance Manual

The post CMS Released Final OASIS-E2 Resources first appeared on Qavalo.

The implementation of OASIS-E2 is just ahead, scheduled for April 1, 2026. Home health agencies should start preparing now, as the changes to data items and guidance can impact workflow, documentation, and reporting. Staying informed about the updates is important for a smooth transition.

Here are some of the main item changes in OASIS-E2. Along with data set changes, there are associated guidance changes that agencies need to understand:

• Gender/Sex
  • Item Change: M0069 (Gender) → A0810 (Sex)
  • Guidance Update: Previous instructions referencing “If the patient does not self-identify” have been removed.
• Transportation
  • Item Change: A1250 (Transportation) → A1255 (Transportation)
  • Collection and Coding Updates:
    • No longer “check all that apply”
    • No longer collected at discharge (DC)
    • Updated instructions, coding tips, and examples provided
• Patient Communication & Sensory Items
  • Collection Update: These items will now also be collected at Resumption of Care (ROC).
  • Items Affected: A1110 (Language), B0200 (Hearing), B1000 (Vision)
• Falls Since SOC/ROC
  Item: J1900 (Number of Falls Since SOC/ROC)
  • Updates:
    • Revised item descriptions
    • Guidance changes from October 2025 Quarterly OASIS Q&As and January 2026 OASIS-E1 Guidance Manual Errata
    • Impacts the Respecified Falls with Major Injury quality measure
• Retired Item: O0350 (Patient’s COVID-19 Vaccination is Up to Date)

Changes to item names or collection points, though seem minor, may affect how agencies record and report patient information. This is only a brief overview of the revisions from OASIS-E1 to OASIS-E2. More detailed descriptions and guidance can be found in the change table in Appendix D of the OASIS-E2 Draft Guidance Manual.

Preparing for OASIS-E2: What Agencies Should Focus On

Although CMS describes these updates as “minor,” the change table is over 40 pages long and can affect daily workflows. Agencies should dedicate time to review all updated items and guidance carefully for an effective implementation.

QA plays a crucial role in the OASIS-E2 transition, so it is important for QA staff to review and understand the changes in advance. This allows them to ensure that new items are functioning as intended and that data is recorded accurately according to the updated definitions and guidance. QA staff who understand the updates can also support clinicians as they adapt to new workflows, making it easier for teams to learn and apply the changes correctly. Taking this proactive approach can help maintain data quality and make the overall transition smoother for all staff.

OASIS-E2 Resources

Since last year, CMS has released several resources to help agencies prepare for OASIS-E2. Agencies should actively review these documents, which provide the updated items, guidance, and instructions needed to navigate the transition:

• Final OASIS-E2 Instruments (ZIP)
• Final OASIS E2 Change Table (PDF)
• OASIS-E2 All Item Data Set
• Final OASIS-E2 Guidance Manual

The post Getting Ready for OASIS-E2 Rollout on April 1 first appeared on Qavalo.

As part of the CY 2026 Home Health Proposed Rule, CMS announced the introduction of OASIS-E2—an updated version that includes changes to the assessment items and data collection. To support the rollout, CMS has released the OASIS-E2 Paperwork Reduction Act (PRA) package, which outlines the planned updates in more detail. OASIS-E2 is scheduled to be implemented on April 1, 2026.

The OASIS-E2 PRA Package includes four key documents:

1. Supporting Statement – Part A
2. Attachment A – OASIS-E2 Change Table
3. Attachment B – OASIS-E2 All-Item Instrument
4. Attachment C – OASIS-E2 Itemized List of Data Elements

The main update in OASIS-E2 is the proposed retirement of item O0350 – Patient’s COVID-19 vaccination is up to date.

Additional sub-regulatory changes indicated in the PRA supporting statement include:

• Transportation Item Update
  • Replace A1250 – Transportation with a revised version: A1255.
• New Items Added to OASIS ROC (Resumption of Care)
  • A1110 – Language
  • B0200 – Vision
  • B1000 – Hearing
• Gender Item Replacement
  • Replace M0069 – Gender with A0810 – Sex

Download the OASIS-E2 PRA Package here>

Although the changes in OASIS-E2 are relatively limited, they are part of the broader updates expected in the CY 2026 Home Health Final Rule. It’s important for home health agencies to stay up to date with these revisions—along with other regulatory changes—to ensure accurate documentation, maintain compliance, and support quality reporting.

The post Preview Changes for OASIS-E2 Effective April 2026 first appeared on Qavalo.