Provider Questions

Provider Questions:

1) Several clients have a TIF- Transfer to the Hospital and marked "Transfer to Inpatient Facility- patient not discharged from the agency"; the chart then ends and we don't see any further information on where the patient went after the hospital. Is the agency required to complete an OASIS Discharge before the end of the certification in addition to the TIF? Or is the agency required to update the TIF to reflect agency discharge?

2) We admit a patient and complete an OASIS because the patient has applied for Medicaid, but it is not approved yet. We do not submit the OASIS to the state, because M0150 is not answered 1,2,3 or 4.

At some point, we become aware that the patient’s Medicaid has been approved, retroactive to the Home Health SOC date. We change M0150 to 3 and submit it. The OASIS is accepted, but it is late because the acceptance date is more than 30 days after M0090. Is there a way to avoid this late OASIS acceptance? 

3) The EMR system that we use had a significant update following Medicare guidelines, which is affecting the certification flow with clients who are remaining on service after skilled service goals have been met. The issue is that when we do a SOC with skilled services ( nursing, PT, and OT ) they no longer require those skilled services but remain a client receiving HHA services only. In the past, we did a Discharge oasis, and it could be exported and still keep the cert period open. Now due to the changes, the DC OASIS ends/shortens the episode. 

Is there a way to keep the sequential flow per Medicare guidelines while doing the summary only? Otherwise, we will have to be doing a lot of unnecessary SOCs when we are not discharging a client. 

Questions from the January 2024 CMS Quarterly OASIS Q&As:

1) The Home Health Final Rule for Calendar Year 2024 finalized the removal of OASIS items M0110 - Episode Timing, M2200 - Therapy Need and the GG Discharge goals in 2025 but does not specify when exactly these items would be removed. Can CMS please provide the date for when these items will be removed from OASIS and if these changes, along with adding the new COVID item, will result in a new version of OASIS (OASIS-F?)? Do providers still need to continue to complete these items until they are removed from the OASIS, or can a dash be used?

2) When is IV access used for, or during, hemodialysis considered for O0110O1 - IV Access? For example, a patient has an AV fistula and IV access is temporarily obtained during hemodialysis at an outside dialysis center. Would the IV access be considered for O0110O1, or would it be excluded since it is only accessed during dialysis, similar to the exclusions with medications and transfusions that were administered during dialysis in item O0110?