CMS will not pick standardized risk of falls tool

CMS addresses valid risk of falls tools and M1910 …

Question: We see that a validation study has been published for the Missouri Alliance for Home Care’s Fall Risk Assessment Tool (MAHC-10). Does this mean that we can now use that tool as the single standardized, validated, multifactor tool to meet the “Yes” response for M1910? And if so, should the threshold of “4” or “6” be used to indicate fall risk?

Answer from CMS: Per existing guidance, if you want to report M1910 as “Yes” (that Fall Risk Assessment was conducted), you must use a multifactor standardized tool that has been scientifically tested and validated, and the tool must be appropriately administered based on established instructions. CMS does not approve or disapprove individual tools.

It is the agency’s responsibility to determine if the tool you are using includes these elements. If an agency has evidence (from published literature, the tool developer, or another authoritative source) that the tool they are using assesses multiple factors that contribute to the risk of falling, has been scientifically tested and validated on a population with characteristics similar to that of the patient being assessed, and shown to be effective in identifying people at risk for falls, and includes a standardized response scale, then the agency can consider the tool to meet the requirements for the OASIS-C best practice assessment.

In determining if a patient is at risk for falls, the standardized tool should have a standardized response scale, and/or established and validated threshold at which fall risk exists. A tool may have multiple thresholds identifying various levels of risk (i.e, “no risk”, “low risk”, “high risk”). Select Response 1 if the standardized response scale rates the patient as no-risk, low-risk, or minimal risk. Select Response 2 if the standardized response scale rates the patient as anything above low/minimal risk. If the tool does not provide various levels, but simply has a single threshold separating those “at risk” from those “not at risk”, then patients scoring “at risk” should be reported as Response 2.

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