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Home Health & Hospice Week

OASIS:

OASIS Rules Your World, So Get It Right

Published on Sun Oct 12, 2003

Take advantage of free OASIS training. 

What do efficient billing, successful quality improvement and stellar surveys all have in common? You guessed it - accurate OASIS collection and reporting.

"It's really important that you have accurate OASIS data," emphasized Mary Weakland in the Centers for Medicare & Medicaid Services Oct. 3 satellite broadcast on the Home Health Quality Initiative.

Under the prospective payment system, home health agencies' OASIS data is used for all the following purposes, Weakland enumerated:

  • Payment. The answers to 24 OASIS items set the home health resource group, which indicates the HIPPS payment code that goes on the PPS Medicare claim.

  • Payment integrity. CMS and the HHS Office of Inspector General are using OASIS answers to track down fraud and abuse of the Medicare program. In its latest campaign, the OIG is going after inaccurate answers to M0175 (see Eli's HCW, Vol. XII, No. 27, p. 210).

  • OBQI/OBQM reports. How your clinicians fill out OASIS, rather than what actually happens to the patient, could determine whether you receive adverse events and low patient outcomes on your outcome-based quality improvement and monitoring reports.

  • Surveys. Surveyors find your weak spots before they even hit your doorstep by using OASIS data to prepare for a site visit (see Eli's HCW, Vol. XII, No. 13, p. 98).

  • Quality improvement. Both you and the Quality Improvement Organization you may consult to help you will use your OASIS-generated patient outcomes to formulate an improvement plan.

  • Care planning. OASIS as part of the comprehensive assessment keeps agencies on top of patients' conditions and assists in formulating their plans of care.

    To help agencies improve their OASIS accuracy, CMS now offers Web-based OASIS training at www.oasistraining.org, Weakland announced. The online training for HHAs and their clinicians will cover a variety of topics ranging from how to conduct a comprehensive assessment to nitty gritty instructions and quizzes for each OASIS item.

    One of its most helpful features is a definitive answer to a nagging pressure ulcer question. HHAs have wondered how to answer pressure ulcer-related OASIS items (M0445, M0450, M0460 and M0464), which generate extra payment, when patients are admitted with fully healed ulcers.

    In the training, CMS makes clear it is OK to claim those Stage 3 or 4 pressure ulcers even when they're healed before admission, thereby raising your PPS payment rate for the patient.

    Weakland also recommends that HHAs give each clinician her own copy of the newly revised OASIS User's Manual, which contains specific instructions on how to answer OASIS items.

    Editor's Note: For more helpful information on mastering OASIS, see Eli's OASIS Alert at www.eliresearch.com.

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