Test your knowledge Answers:

1) The correct answer would be: Recertification to Discharge.

A qualifying episode of care consists of a beginning (SOC or ROC) and an end (transfer or discharge). A recertification does not qualify as a beginning, but rather a continuation of the existing care episode.

2) The Medicare Home Health Flexibility Act (H.R.3127/S.1725), effective January 1, 2022 does not alter Medicare’s criteria for establishing eligibility for the home health benefit as it relates to occupational therapy (OT). The expanded OT role only applies to rehabilitation cases. Specifically, an occupational therapist may conduct the initial assessment and SOC Comprehensive Assessment if the physician's referral order does not include skilled nursing care but does include (1) occupational therapy, and (2) physical therapy or speech language pathology.

(Courtesy of the OASIS Quarterly Q & A, October 2021)

Answer for question 3:

• Admission Source (two subgroups): Community or Institutional Admission

• Timing of the 30-day period (two subgroups): Early or late

• Clinical Grouping (twelve subgroups): musculoskeletal rehabilitation; neuro/stroke rehabilitation; wounds; medication management, teaching and assessment (MMTA) - surgical aftercare; MMTA - cardiac and circulatory; MMTA - endocrine; MMTA - gastrointestinal tract and genitourinary system; MMTA - infectious disease, neoplasms, and blood-forming diseases; MMTA - respiratory; MMTA- other; behavioral health; or complex nursing interventions

• Functional Impairment Level (three subgroups): Low, Medium, or High

• Comorbidity Adjustment (three subgroups): None, Low, or High; based on the secondary diagnoses