Outcome Assessment
Information Set (OASIS) Update
PDF Version
of BQA 00-083 (PDF, 25 KB) - includes attachment
Introduction | Rules_&_Regulations
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Date: December 19, 2000 DSL-BQA-00-083
To: Home Health Agencies HHA 36
From: Jan Eakins, Chief, Provider Regulation & Quality
Improvement Section
cc: Sue Schroeder, Director, Bureau of Quality Assurance
The purpose of this memorandum is to provide you with information
related to:
Satellite Training on OASIS Reports
On January 19, 2001, the federal Health Care
Financing Administration (HCFA) Center for Medicaid and State Operations will broadcast a
two hour satellite training on the Case Mix and Adverse Event Reports based on OASIS data.
The program will be broadcast 12:00 noon – 2:00 p.m. CST (1:00 – 3:00
p.m. EST). A draft program agenda is attached to this
memorandum.
The intended audience for the broadcast is home health agencies (HHAs), home health
provider associations, the State Survey Agency and the HCFA Regional Offices. The
broadcast will consist of a demonstration on how the reports can be generated from the
State OASIS System, how to read the reports, what actions HHAs can take on the reports,
and how the reports will be used by HCFA Regional Office and State surveyors. The
presenters for this broadcast will include staff from HCFA and the Center for Health
Services Policy Research, University of Colorado. The broadcast will have prerecorded
presentations followed by a live question and answer session via phone and fax.
The Wisconsin Homecare Organization (WHO) has arranged viewing sites for all home
health providers and interested persons at various locations throughout the state. The
following table lists each viewing location, maximum seating, telephone number, and
contact person.
|
Madison
|
55 |
608-278-1115
|
Judi Loos,
Wisconsin Homecare Organization
|
|
Jefferson
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20 |
920-674-7186
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Sue Johann
Jefferson County Health Department
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La Crosse
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Not provided |
608-791-9790
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Kathryn Olson
Franciscan Skemp Home Health
|
|
Eau Claire
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30 |
715-831-0100 Ext. 250
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Sue Timm
Northwest WI Home Care
|
|
Ellsworth
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30 |
715-273-6756
|
Caralynn Hodgson
Pierce County HH
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Since seating is limited at the viewing sites, you must call the contact
person for the site to reserve seating. The contact will provide you with the site
address, directions and parking options.
Training materials for the satellite session will be available the first week of
January on the HCFA OASIS website under "Training" at http://www.hcfa.gov/medicaid/oasis/oasishmp.htm
[replaced by www.cms.hhs.gov/oasis/hhoview.asp
(exit DHFS)].
Providers should download these materials to bring to the training. Training materials will
not be provided at the viewing sites.
The Case Mix and Adverse Event Reports will be available to HHAs through the State
OASIS system at the end of January.
Updated Interpretive
Guidelines for Home Health Agencies
HCFA has updated the Medicare State Operations Manual,
Appendix B, Interpretive Guidelines for Home Health Agencies. The update provides
instructions for surveying OASIS regulations and includes regulatory language and guidance
on the conditions of participation that were recently amended for the implementation of
the prospective payment system (PPS) for HHAs.
This new/revised material became effective October 1, 2000. The cover page of HCFA
Transmittal 21 (exit DHFS; PDF), in which this revised material was published, is
attached for your information.
Electronic copies of the change pages of the Interpretive Guidelines are
available on the HCFA website at http://www.hcfa.gov/pubforms/transmit/R21SOM.pdf
[replaced by www.cms.hhs.gov/manuals/pm_trans/R21SOM.pdf
(exit DHFS; PDF)].
The Interpretive Guidelines for Home Health Agencies in effect prior to October 1,
2000, and Transmittal 21 with the change pages are also available electronically on the
State OASIS System website under "Bulletins."
OASIS Data Item M0825 (Therapy
Need)
When a HHA estimates the number of therapy visits to be under 10, but
during the course of the 60-day episode, determines that the patient requires 10 or more
visits, the HHA should take the following steps:
-
Obtain physician orders/update plan of care to reflect the need for additional therapy.
-
Provide necessary documentation in the clinical record.
-
Conduct an Other Follow-up OASIS Assessment, reason for assessment (RFA) 05, to reflect
the current status of the patient.
-
Transmit the Other Follow-up Assessment, RFA 05, to the State OASIS System.
For questions related to payment, contact Medicare Provider Relations at United
Government Services, 1-877-309-4290.
Change in
Time Frame for Follow-up Assessments
The final federal rule for PPS
changed the OASIS timing requirements for OASIS follow-up assessments from an interval
requiring a follow-up assessment every two months to a 60-day assessment schedule.
Effective October 1, 2000, HHAs must perform a follow-up comprehensive assessment
within the last 5 days of the each 60-day certification period, i.e., between and
including days 56-60. This 60-day time frame for follow-up assessments applies to
all
patients subject to OASIS.
Consult "What’s New" on the HCFA OASIS website at http://www.hcfa.gov/medicaid/oasis/oasishmp.htm
[replaced by www.cms.hhs.gov/oasis/hhoview.asp
(exit DHFS)].HCFA guidance on this issue can be found under "OASIS Considerations for Non-Medicare
PPS Patients" and "OASIS Considerations for Medicare PPS Patients."
Warning message related to revised timing interval
The revised assessment interval may cause warning messages related to timing on OASIS
follow-up assessment records to appear on the Final Validation Report produced by the
State OASIS System. The following information will help HHAs know how to respond to this
warning message.
For patients on service prior to October 1, 2000: The revised assessment interval
may cause warning message number 262 related to timing on OASIS follow-up assessment
records to appear on the Final Validation Report when the assessment is submitted for
patients with a start of care prior to October 1, 2000. In this situation, the HHA can
ignore the warning message.
For patients admitted after October 1, 2000: Patients admitted to the HHA after
October 1, 2000, who remain on service beyond a single 60-day episode, are expected to be
re-assessed with OASIS follow-up data collected during the last 5 days of each 60-day
certification period, based on the start of care date. In this case, a warning message
indicating deviation from the required time frame for collection of OASIS follow-up data
would be valid and a cause for the HHA to examine its OASIS follow-up data collection
schedule.
For more information, refer to the attached memorandum
from HCFA dated November 20, 2000.
Review of OASIS Applicability
OASIS Data Collection
The comprehensive assessment and OASIS data collection requirements apply to all
patients receiving skilled care, including Medicare, Medicaid, managed care, and private
pay patients with the following exceptions: patients under the age of 18, patients
receiving maternity services, and patients receiving only chore or housekeeping services.
OASIS Encoding and Transmission
HHAs must also encode and transmit OASIS data on all Medicare/Medicaid patients
receiving skilled care (with the above exceptions).
A patient is considered a Medicare/Medicaid patient if Medicare or Medicaid reimburses
for any service, including non-skilled care.
For example: A patient who receives skilled nursing services reimbursed by private
insurance and home health aide services reimbursed by Medicare or Medicaid is considered a
Medicare/Medicaid patient. OASIS data must be collected, encoded and transmitted for this
patient.
OASIS Not Required
OASIS requirements continue to be delayed for patients receiving only
non-skilled (personal care or home health aide) services.
Frequently Asked Questions
BQA will post frequently asked questions with their appropriate
answers on the State OASIS System website under Bulletins. The date is noted each time
that the Bulletins area is updated. The Bulletins area is a quick method for conveying
information to providers, so please check the website frequently.
OASIS Training
Video and Workbook
HCFA has developed a training video with an accompanying workbook
that demonstrates patient assessment strategies for HHA clinicians. The purpose of the
video is to illustrate how clinicians acquire patient information as part of the
comprehensive assessment process using a variety of assessment techniques.
When the video is available to the State, BQA will post directions for obtaining the
instructional material and the cost on the State OASIS System website under Bulletins.
Bureau of
Quality Assurance Resources
Please direct any questions related to OASIS data collection to
the following resources:
Software and OASIS data transmission:
-
Chris Benesh, OASIS Automation Coordinator, 608/266-1718 or
benesce@dhs.state.wi.us.
-
Cindy Symons, OASIS Technical Analyst [no longer available]
Clinical issues regarding OASIS data collection:
-
Andrea Henrich, OASIS Education Coordinator, 608/267-3807 or
henriam@dhs.state.wi.us.
-
Barbara Woodford, Nurse Consultant [replaced by Marianne Missfeldt,
715/836-4036].
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