Outcome and Assessment Information Set (Oasis) Requirements

2202 - Outcome and Assessment Information Set (Oasis) Requirements (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) The home health regulations at §484.55 require that each patient receive from the HHA a patient-specific, comprehensive assessment. As part of the comprehensive assessment of adult skilled patients, HHAs are required to use a standard core assessment data set, the OASIS. See note below for information regarding collection of OASIS data on the non- Medicare/non-Medicaid patients of an HHA. The regulations also require that OASIS data be electronically transmitted to the SA or CMS OASIS contractor. These requirements are detailed at §484.20. This regulation is referred to as the “reporting regulation.” The CMS uses the data to achieve broad-based improvements in the quality of care furnished, through measurement of that care, as well as to maintain a home health prospective payment system. In addition to requiring the reporting of OASIS data, the OASIS regulations at §484.11 require HHAs to maintain privacy of their OASIS data and not release patient identifiable OASIS information to the public. Regulations concerning State survey, certification, and enforcement responsibilities are found at §488.68. Effective July 19, 1999, all HHAs participating in the Medicare/Medicaid program have been required to comply with the comprehensive assessment and OASIS reporting regulations. NOTE: HHAs must comply with the comprehensive assessment regulation at §484.55 for all its patients. However, until further notice, HHAs are not required to incorporate OASIS items into their patient-specific comprehensive assessment for the HHA’s (1) non- Medicare/non-Medicaid patients, (2) patients under the age of 18, (3) patients receiving maternity services, or (4) patients receiving personal care services only (regardless of payer source). (See additional information in section 2180E.) • The collection of OASIS data on the non-Medicare/non-Medicaid patients of an HHA was temporarily suspended on December 8, 2003, as a provision of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. HHAs must continue to comply with the aspects of the regulation at §484.55 regarding the comprehensive assessment of patients. HHAs must provide each agency patient, regardless of payment source, with a patient-specific comprehensive assessment that accurately reflects the patient’s current health status and includes information that may be used to demonstrate the patient’s progress toward the achievement of desired outcomes. The comprehensive assessment must also identify the patient’s continuing need for home care, medical, nursing, rehabilitative, social, and discharge planning needs. • HHAs may continue to collect OASIS data on their non-Medicare/non-Medicaid patients for their own use. • Surveyors must continue to examine the completeness of the comprehensive assessment for all patients during a survey. However, surveyors must not investigate whether the HHA included the specific OASIS items in its patient- specific comprehensive assessments of non-Medicare/non-Medicaid patients, nor cite deficiencies based solely on this finding. • HHAs must continue to collect, encode, and transmit OASIS data for their non- maternity Medicare and Medicaid patients that are age 18 and over and receiving skilled services.