Home Health & Hospice

Facts about a Discharge Assessment

Homecare Insider, November 23, 2009

Over the last few weeks, Ask an Expert has received many questions about the ins and outs of a discharge assessment.  Review these facts with your clincians for accurate completion of the assessment.
•     Complete a discharge assessment for patients who receive two or more visits.  This can include, for example, one visit each by a registered nurse and home health aide or a physical therapist and speech-language pathologist.
•     Complete the discharge assessment during the last scheduled visit by a qualifying clinician, that being an RN, physical or occupational therapist, or speech-language pathologist.  If an RN and therapist visited on the same day, the last discipline in the home is the one to complete the assessment.
•     Enter the date of the last visit in M0090, date assessment completed, for completion of a discharge assessment in a planned discharge.
•     In an unexpected discharge, use the last visit by an RN or therapist as the basis for a discharge assessment.  This visit may have been a day, week, or month before discharge.
•     If discharge was unexpected, enter in M0090 the date the clinician learns about discharge.  The clinician must complete the assessment within 48 hours of that date. This will help prevent any warnings for late submission of OASIS data.  Example:  The nurse visited on Thursday, expecting to see the patient the following Tuesday.  On Monday, she learned the patient has moved out of town.  The nurse enters Monday’s date in M0090 and completes the assessment by Wednesday.  
•     Do not use input from nonqualified staff members, such as therapy assistants, or a telephone call to complete the discharge data elements.  
•     If discharge follows a transfer to an inpatient facility, a discharge assessment is not necessary.  Complete a discharge summary and discharge the patient following agency procedure.

Check out the updated information on assessments and OASIS data elements in the Home Health Pocket Guide to OASIS-C: A Reference for Field Staff.