Home Health & Hospice

OASIS-C Start of Care Questions May Cause Survey Issues

Homecare Insider, March 1, 2010

There are two new data elements in OASIS-C that ask about the start of care date:

  • M0102, date of physician-ordered start of care (resumption of care), and
  • M0104, date of referral (date the agency received the written or verbal referral for initiation of care).

According to the Conditions of Participation, §455(a), the start of care visit must be within 48 hours of referral or the patient’s return home, or on the physician-ordered start of care date.  If the dates in either of these data elements combined with the date of the agency’s visit to start or resume care (date in M0090) do not demonstrate compliance with the Conditions, the agency can be cited.

Here are some tips to avoid problems.

  • Review intake and referral processes to ensure that the documentation of information and dates reflect what happened.  If the referral information comes in over a period of days, designate the last day as the date of referral.  Example:  The agency received a call from the discharge coordinator about a new patient on February 3.  The agency received additional information on February 5 and 8.  The intake coordinator noted February 8 as the date the agency received the verbal referral.
  • Add a space to the intake/referral form to record the physician-ordered date.  Example:  On January 18, the physician referred a patient for physical therapy that was to start on January 18.  The intake coordinator recorded January 18 as the physician-ordered start of care.
  • Recognize the role of an existing data element with a new number, inpatient discharge date (M1005), in demonstrating compliance.  The third criterion in the Conditions of Participation is that the start of care visit must be within 48 hours of the patient’s return home.  Example:  On Monday, the agency receives referral orders.  The patient is discharged on Friday morning.  The nurse visits that afternoon.  This visit did not occur within 48 hours of referral, and there is no physician-ordered start of care date.  However, the visit did occur within 48 hours of the patient’s return home.

The audio recording, “The Good and Bad about New OASIS-C Data Elements,” addresses some “survey traps” in OASIS-C.  Learn about what other information is on this CD at — http://www.beaconhealth.org/item--The-Good-and-Bad-about-New-OASIS-C-Data-Elements--J111909D.html.