Contact Information

Wendy Castro

OASIS Training Coordinator COQS

 wendy.castro@state.co.us

cdphe_oasis_colorado@state.co.us

303-692-2854

Test Your Knowledge Answers:

1) When an agency does not complete a recertification assessment within the required 5-day window at the end of the certification period, the agency should not discharge and readmit the patient. Rather, the agency should send a clinician to perform the recertification assessment as soon as the oversight is identified. The date the assessment was completed (M0090) should be reported as the actual date the assessment was completed, with documentation in the clinical record of the circumstances surrounding the late completion. A warning message will result from the non-compliant assessment date, but this will not prevent assessment transmission. 

No timeframe has been set after which it would be too late to complete this late assessment, but the agency is encouraged to make a correction or complete a missed assessment as soon as possible after the oversight is identified. This situation should be avoided, as it does demonstrate non-compliance with the comprehensive assessment update standard (of the Conditions of Participation). 

For the Medicare PPS (PDGM) patient, payment implications may arise from this missed assessment. Any payment implications must be discussed with the agency's Medicare Administrative Coordinator (MAC).

2) Information regarding F2F or questions regarding Medicare payment (eligibility, coverage requirements, PDGM) for home health may be sent to: HomeHealthPolicy@cms.hhs.gov 

3) The initial assessment visit is conducted to determine the immediate care and support needs of the patient and, in the case of Mecidare patients, to determin eligibility for the home health benefit including homebound status. If no reimbursable serive is delivered, this visit is not considered the SOC and does not establish the SOC date. The SOC comprehensive assessment must be completed within 5 calendar days after the SOC date and in compliance with agency policies. In the interest f cost-effectiveness, many agencies have combined the initial assesment with the delivery of skilled service(s), assuming the patient is eligible for home care. This would make the initial assesment and the SOC the same date. If the admitting clinician was able to complete the SOC comprehensive assessment including OASIS on this initial visit as well, the SOC date (M0030) is the same as the date the assessment is completed (M090). These protocols and procedures are a matter of agency choice and agency policy, as long as the regulatory requirements are met. 

4) See the RAI User's Manual, Chapter 3, Section A, pages A-45, and A-46: 

• In the case of a standalone Medicare Part A PPS Discharge assessment (A0310A = 99, A0310B = 99, A0310F = 99, and A0310H = 1) with the resident staying on the same unit and with the same team of interdisciplinary professionals, code A2121. Provision of Current Reconciled Medication List to Subsequent Provider at Discharge as 1, Yes 

• In the case of a standalone Medicare Part A PPS Discharge assessment (A0310A = 99, A0310B = 99, A0310F = 99, and A0310H = 1) and the resident is moving to a different unit and/or interdisciplinary team (IDT), code A2121. Provision of Current Reconciled Medication List to Subsequent Provider at Discharge based on whether a member of the resident's IDT transferred the resident's current reconciled medication list to the subsequent unit and/or IDT.