Comprehensive Assessment and OASIS Reporting (Refer to

2202.4 - Comprehensive Assessment and OASIS Reporting (Refer to §484.20 and §484.55) (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) All HHAs participating in the Medicare/Medicaid program are required to comply with the comprehensive assessment and OASIS reporting regulations as summarized in the following chart. PATIENT CLASSIFICATION COLLECT ENCODE TRANSMIT SKILLED Medicare (traditional fee-for service) Medicare (HMO/Managed Care) Medicaid (traditional fee-for-service) Medicaid (HMO/Managed Care) Yes Yes Yes SKILLED Non-Medicare/Non-Medicaid: No No No PATIENT CLASSIFICATION COLLECT ENCODE TRANSMIT Workers’ Compensation Title Programs Other Government Private insurance Private pay patients under a HMO/ PPO/Managed Care plan Self-pay; other; unknown Temporarily Suspended PERSONAL CARE ONLY Medicaid (traditional fee-for service) Non-Medicaid: Workers’ Compensation Title Programs Other Government Private insurance Private HMO/Managed Care Self-pay; other; unknown No No No Patients under age 18; Patients receiving pre and postpartum maternity services; Patients receiving only chore and housekeeping services No No No 2202.4A - Comprehensive Assessment and OASIS Collection (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) The comprehensive assessment regulations require a comprehensive assessment (that includes certain OASIS data items) be conducted at specific time points during a patient’s admission. Those specific times are: 1. SOC After admission to the HHA, the SOC comprehensive assessment should be completed in a timely manner consistent with the patient’s immediate needs but no later than 5 calendar days after the SOC. 2. ROC The comprehensive assessment is completed within 48 hours of the patient’s return to the place of residence or of the HHA’s knowledge of the patient’s return after an inpatient admission of 24 hours or more for any reason other than diagnostic tests. This applies when the patient was not discharged from the HHA during the inpatient admission. If the physician’s order requests that the HHA resume care at a point later than 48 hours or if the patient refuses a visit within this 48-hour period, a note to this effect should be documented in the patient’s chart for future reference. 3. Follow-Up - The comprehensive assessment that is performed at the end of the current 60-day period. This assessment must be performed within the last 5 days of the current 60-day episode. For example: Start of Care Certification Period Follow-Up Assessment Due 1/15/20xx 1/15/20xx - 3/14/20xx 3/10/20xx - 3/14/20xx 1/15/20xx 3/15/20xx - 5/13/20xx 5/09/20xx - 5/13/20xx 1/15/20xx 5/14/20xx - 7/12/20xx 7/08/20xx - 7/12/20xx 4. Transfer to an Inpatient Facility An assessment update is performed when a patient is transferred to an inpatient facility for 24 hours or more for any reason except diagnostic testing, regardless of whether the patient is discharged from the HHA at that time. The update must be completed within 48 hours of the patient’s transfer to the inpatient facility or within 48 hours after the HHA becomes aware of the transfer and includes a limited number of OASIS items. 5. Discharge The comprehensive assessment is performed when a patient is discharged from home care. These updates must be completed within 48 hours of the discharge/death or within 48 hours after the HHA becomes aware of the discharge/death. 2202.4B - OASIS Encoding and Locking (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) HHAs should use HAVEN or HAVEN-like software to encode or enter OASIS data into their computers. HAVEN will accommodate data entry of OASIS items from all required time points. Regardless of the time point, OASIS data items should be encoded, and checked for errors using HAVEN or HAVEN-like software, and made export/transmission-ready. 1. Availability of HAVEN The HAVEN software is available for downloading free of charge from the CMS OASIS and QIES Technical Support (QTSO) Web site. See https://www.qtso.com/havendownload.html The HAVEN help line can be reached at: 1-877-201-4721. Specific information describing how to operate the HAVEN software can be found at https://www.qtso.com/download/haven/hhahelp32.pdf. 2. Errors and Warnings in Encoding See Error Messages and Description Guide -- https://www.qtso.com/download/Guides/hha/errors/Errors_sec2.pdf HHAs may experience two types of messages at completion of data entry. a. Error Message. If the HHA uses HAVEN for data entry, an error message may occur if a mandatory field is left blank. The HHA will receive an error that the field must be filled in before the assessment can be marked as complete. HHAs should correct their errors before an assessment may exported to the OASIS Data Management System. Along with the error message is the name of the window tab where the error was detected. b. Warning Message If the HHA uses HAVEN for data entry, a warning message may occur if timing criteria for date fields do not match OASIS data specifications. These messages are informational only and do not preclude an HHA’s assessment from being exported. Along with the warning message is an explanation of that message and direction on where the discrepancy was detected. 2202.4C - OASIS Reporting (Refer to §484.20) (Rev. 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) 1. HHA Submissions HHAs must submit their OASIS data within 30 days of the M0090 date, date assessment completed. Data received outside of this time frame is considered overdue. Specific information describing how HHAs are to transmit OASIS data to the SA is in the OASIS System Users Guide. 2. Errors and Warnings in OASIS Reporting When submitting OASIS records, a fatal error message may occur if the HHA’s data record layout does not follow OASIS data specifications. This message should not occur if the HHA is using the HAVEN software to encode the OASIS items. 3. SA Access In States where the non-long term care agency is in a location separate from the OASIS State System (where the MDS Data System resides and is not under the direct jurisdiction of the home health survey agency), CMS provides access to the OASIS State System by installing a computer work station at the home health survey agency address to link to the OASIS State System. The CMS will provide additional support to the SA to access and operate the off-site server by providing appropriate software, and technical assistance from CMS and the CMS OASIS contractors.