Home Health & Hospice

Home Health & Hospice Articles by Topic: OASIS-C1

CMS shifts from denials to RTPs for home health claims with no matching OASIS

  • Homecare E-News, Issue 39, October 16, 2017

    Home health agencies will now have their claims returned when Medicare systems fail to match those...

We are wondering if an OT can discharge a patient if he or she is the last discipline in? Can the OT do the discharge OASIS or a transfer OASIS?

  • Homecare Q&A, Issue 19, October 3, 2017

    Yes, the OT can perform a discharge, or transfer, or any other OASIS after the SOC.

CMS removing or modifying 35 OASIS elements

  • Homecare E-News, Issue 33, August 28, 2017

    According to CMS’ final rule, 35 OASIS items would be deleted or modified for 2019. NAHC...

New OASIS-C2 guidance manual includes new items, one clinician rule clarification

  • Homecare E-News, Issue 30, August 7, 2017

    CMS released the 2018 guidance manual for OASIS-C2 on August 4. The new guidance manual, which...

New PEPPER available for home health agencies, CMS updates to Home Health Compare

  • Homecare E-News, Issue 28, July 21, 2017

    New Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) through CY 2016 are...

How can we improve on timely initiation of care?

  • Homecare Q&A, Issue 14, July 17, 2017

    As part of a monthly or quarterly quality assurance review, agencies should closely monitor...

Do only CWCN credentials give you necessary authority/scope to answer OASIS questions differently than the scope of a registered nurse with no wound training?

  • Homecare Q&A, Issue 16, August 22, 2016

    Our agency is in the process of evaluating wound certification courses for our nursing staff. We...

I wanted to verify if the discharge reason in these cases would still be "Transferred to Inpatient Facility" (to match the transfer OASIS)? Or would we enter "Pt Expired" (even though the patient expired at the hospital, not at home)?

  • Homecare Q&A, Issue 16, August 22, 2016

    Follow-up question to the one above: Because the patient would not be coming back to us for...

When we enter our discharge reason for home health, is it that the patient was transferred to an inpatient facility, or is the discharge reason that the patient expired?

  • Homecare Q&A, Issue 16, August 22, 2016

    When our patients are admitted to an inpatient facility and we complete a transfer OASIS, we...

If the system changes the response to M2200, is it necessary for us to transmit OASIS data to the state agency so the HIPPS codes match?

  • Homecare Q&A, Issue 15, August 3, 2016

    Therapy visits have a direct impact on the first (grouping step) and fourth (services utilization...

When answering M2200, Therapy Need, what exactly is meant by the ?home health plan of care??

  • Homecare Q&A, Issue 15, August 3, 2016

    M2200 asks about the number of visits on the plan of care, which reflects physician orders. This...

If we have no therapy visits ordered at the start of care, but then the physician orders six or 14, must we change the answer to M2200?

  • Homecare Q&A, Issue 15, August 3, 2016

    The CMS system will automatically change the answer to M2200 to reflect the number of visits...

In Focus: NAHC submits comments on OASIS-C2

  • Homecare E-News, Issue 22, June 6, 2016

    The National Association for Home Care & Hospice (NAHC) has raised concerns regarding...

Is an "MDD" classification sufficient for coding a homecare patient?s depression?

  • Homecare Q&A, Issue 7, April 4, 2016

    No. ICD-10-CM classifies depression under Disorder, depressive, major (MDD), but more information...

In Focus | OASIS-C2 Item Set available

  • Homecare E-News, Issue 14, April 4, 2016

    The OASIS-C2 item stet is now available on the OASIS Data Sets webpage. OASIS-C2 is effective...

Can the OASIS then be updated (by the assessing clinician) within the five-day window, using information gathered from that collaboration, if the M0090 date is also updated?

  • Homecare Q&A, Issue 3, February 3, 2016

    Thank you for your question and commitment to compliance. You are correct that the assessment must...

Patients who experience a decline in their condition upon their discharge from home health are impacting our outcome scores.

  • Homecare Q&A, Issue 1, January 3, 2016

    You are correct, M1034 is risk adjusted. Please be sure clinicians are answering response “3...

Could you provide some M2200 case-mix tips?

  • Homecare Q&A, Issue 23, December 4, 2015

    This therapy M item should be reviewed once all initial orders have been received by the agency...

When answering M2200, Therapy Need, what exactly is meant by the "home health plan of care"?

  • Homecare Q&A, Issue 23, December 4, 2015

    M2200 asks about the number of visits on the plan of care, which reflects physician orders. This...

If the system changes the response to M2200, is it necessary for us to transmit OASIS data to the state agency so the HIPPS codes match?

  • Homecare Q&A, Issue 23, December 4, 2015

    Therapy visits have a direct impact on the first (grouping step) and fourth (services utilization...

For a resumption-of-care assessment, do we count the visits we have already done, or just the one we are going to do, or all of them?

  • Homecare Q&A, Issue 23, December 4, 2015

    Because there will be no adjustments in the HHRG after the RAP is sent, the reporting of therapy...

If we have no therapy visits ordered at the start of care, but then the physician orders six or 14, must we change the answer to M2200?

  • Homecare Q&A, Issue 23, December 4, 2015

    The CMS system will automatically change the answer to M2200 to reflect the number of visits...

If an agency discharges a patient with goals met but then readmits him or her within 60 days of discharge, would the new episode be an early or later one for M0110, Episode Timing?

  • Homecare Q&A, Issue 23, December 4, 2015

    When a patient is discharged and not readmitted during the remainder of the episode, the 60th or...

When determining whether an episode is early or later for M0110, Episode Timing, what is considered day one when counting 60 days? The start of care day or the day prior to admission?

  • Homecare Q&A, Issue 23, December 4, 2015

    When determining the answer for M0110, the concern is what happened before admission. Count...

Can you give tips on working with the HHRG?

  • Homecare Q&A, Issue 23, December 4, 2015

    CMS and medical reviewers pay close attention to patterns in care delivery and HHRG data. They are...

Inside Story | Understand Outcome Measures

  • Homecare E-News, Issue 47, November 30, 2015

    Since 2007, Medicare regulations have mandated Outcome and Assessment Information Set (OASIS...

What kind of events count as "potentially avoidable"? What will and should be in the CASPER Outcome-Based Quality Improvement Report?

  • Homecare Q&A, Issue 20, October 16, 2015

    What kind of events count as "potentially avoidable"? What will and should be in the...

The Inside Story | Start-of-Care and Resumption-of-Care Assessments

  • Homecare E-News, Issue 40, October 12, 2015

    The start-of-care (SOC) assessment is completed as a patient is being admitted to a home health...

How do we update the comprehensive assessment for a major deterioration in status with the PPS payment requirements?

  • Homecare Q&A, Issue 18, September 17, 2015

     This patient’s change in condition has a real impact on resource utilization—an...

What does a comprehensive assessment include for non-OASIS patients, according to the Conditions of Participation (CoP)?

  • Homecare Q&A, Issue 18, September 17, 2015

    The CoPs identify several key components for this assessment. Here are the components and some...

How to score an incomplete OASIS?

  • Homecare Q&A, Issue 15, August 3, 2015

    I am specifically looking for the guidance indicating that, when an OASIS assessment is not...

Can physical therapy go out and have consents signed and perform an evaluation before the nurse gets to the home to complete the OASIS as long as it is all done the same day?

  • Homecare Q&A, Issue 14, July 16, 2015

    The only similar guidance found was according to CMS’ OASIS Q&A:

I am wondering how to answer OASIS assessment "M" items when an OASIS assessment is needed for a payer change, but one does not exist.

  • Homecare Q&A, Issue 14, July 16, 2015

    Thanks for your question and commitment to compliance. In cases where you learn after the fact...

How do we get paid when we have two different payers?traditional Medicare (Part A) and MA?within the same 60-day episode?

  • Homecare Q&A, Issue 13, July 2, 2015

    If a patient switches from traditional Medicare to MA, the agency will receive a partial episode...

What would be the response for M0150, Current Payment Sources, for an MA patient?

  • Homecare Q&A, Issue 13, July 2, 2015

    AM0150 would be answered “2”—Medicare (HMO/managed care/Advantage plan). It is...

Would NA (not applicable) be the correct response to M0110 and M2200 for MA patients?

  • Homecare Q&A, Issue 13, July 2, 2015

    AM0110, Episode Timing, and M2200, Therapy Need, apply when the assessment will determine the...

Do we answer M0063, Medicare Number, with the patient?s now-defunct Medicare number or the new MA policy number?Do we answer M0063, Medicare Number, with the patient?s now-defunct Medicare number or the new MA policy number?

  • Homecare Q&A, Issue 13, July 2, 2015

    When a patient joins a Medicare Advantage (MA) plan, he or she takes on a subscriber number, but...

Homecare Q&A

  • Homecare Q&A, Issue 13, July 2, 2015

    July 3, 2015

If an agency discharges a patient with goals met but then readmits him or her within 60 days of discharge, would the new episode be an early or later one for M0110, episode timing?

  • Homecare Q&A, Issue 12, June 15, 2015

    If an agency discharges a patient with goals met but then readmits him or her within 60 days of...

How do we determine diagnosis and priority?

  • Homecare Q&A, Issue 12, June 15, 2015

    Q: We are seeing a patient with Alzheimer’s disease, who was hospitalized for advanced...

How will OASIS-C1/ICD-10 differ from the data set iteration currently in use?

  • Homecare Q&A, Issue 0, June 9, 2015

     To accommodate the extended effectiveness of ICD-9 after the Protecting Access to Medicare...

Do we answer M0063, Medicare Number, with the patient's now-defunct Medicare number or the new Medicare Advantage (MA) policy number?

  • Homecare Q&A, Issue 9, May 17, 2015

    Do we answer M0063, Medicare Number, with the patient’s now-defunct Medicare number or the...

What should you do about a tardy recertification assessment?

  • Homecare Q&A, Issue 9, May 3, 2015

    What should you do about a tardy recertification assessment? It’s the fifth day of the...

What would be the response for M0150, Current Payment Sources, for an MA patient?

  • Homecare Q&A, Issue 9, May 3, 2015

    What would be the response for M0150, Current Payment Sources, for an MA patient?

Can we get an MD order for a new start of care (SOC) date based on the patient request?

  • Homecare Q&A, Issue 9, May 3, 2015

    Regarding M0102 and M0104: We received a referral and we contacted the patient within the...

Would NA (not applicable) be the correct response to M0110 and M2200 for MA patients?

  • Homecare Q&A, Issue 8, April 17, 2015

    M0110, Episode Timing, and M2200, Therapy Need, apply when the assessment will determine the...

Do we answer M0063, Medicare Number, with the patient?s now-defunct Medicare number or the new Medicare Advantage (MA) policy number?

  • Homecare Q&A, Issue 8, April 17, 2015

    When a patient joins an MA plan, he or she takes on a subscriber number, but the patient’s...

Can you shed some light on specific circumstances that warrant the resumption of care assessment?

  • Homecare Q&A, Issue 7, April 3, 2015

    The ROC assessment is completed any time a patient has returned home following an inpatient stay of...

Is it true that we need to change our process and submit ALL OASIS assessments to the AS

  • Homecare Q&A, Issue 6, March 17, 2015

     Yes, all Medicare, Medicare Advantage, and Medicaid OASIS assessments must be transmitted.

Will home health remain exempt from overtime compensation in most circumstances like it has for 40 years?

  • Homecare Insider, Issue 1, January 5, 2015

    Will home health remain exempt from overtime compensation in most circumstances like it has for 40...