Home Health & Hospice Week

The longer OASIS-E is in effect, the more home health agencies are learning about it and its impact.

In its newest set of OASIS Questions & Answers, the Centers for Medicare & Medicaid Services addresses what a discharge to a non-institutional hospice means for quality measures under OASIS-E.

Question: What assessment-based quality measures exclude patients who are transferred or discharged from home health to hospice?

Answer: Patients who were transferred to an inpatient hospice or discharged to a non-institutional hospice (on or after January 1, 2023) are excluded from the calculation of the following OASIS-based quality measures:

• Improvement in Ambulation/Locomotion
• Improvement in Bathing
• Improvement in Bed Transferring
• Improvement in Toilet Transferring
• Improvement in Lower Body Dressing
• Improvement in Upper Body Dressing
• Improvement in Management of Oral Medications
• Improvement in Bowel Incontinence
• Improvement in Confusion Frequency
• Improvement in Dyspnea
• Discharged to Community

These hospice exclusions apply to quality episodes with a M0906 Discharge/Transfer/Death Date of 1/1/2023 or later:

1. That end in a transfer to an inpatient hospice (M0100 Reason for assessment - RFA 6 or 7 Transferred), and M2410 - Inpatient Facility response is 4 - Hospice, OR

2. That end in a discharge to a non-institutional (home) hospice (M0100 Reason for assessment - RFA 9 Discharge from Agency), and M2420 - Discharge Disposition is response

3 - Patient transferred to a non-institutional hospice.

In these OASIS Q&As, CMS also repeats the VBP FAQ regarding Discharged to Community exclusions that it published in its March update (see related story, p. 106).

And the six-page Q&A set addresses new risk adjustment models, the PHQ-2 to 9 timeline, nutritional items, and more. 

Note: The new Q&As are at https://qtso.cms.gov/system/files/qtso/508_CMS_OAI_1st Qtr_2023_QAs_April_2023_final_0.pdf.