Home Health & Hospice Week

The right answer to the OASIS question on prior inpatient stays can mean $600 per patient. You can boost the accuracy of your M0175 answers by training your clinicians to put on their Sherlock Holmes hats when first visiting patients in their homes.
 
Why it matters: Correctly answering the OASIS question on prior inpatient stays can mean a difference of up to $250 for non-therapy patients and up to $600 for patients who break the 10-visit therapy threshold.
 
The combination of no hospital stay with a rehab or skilled nursing facility stay in the 14 days prior to admission will increase your prospective payment system reimbursement level. And if you claim that upgrade when there really was a hospital stay you didn't know about, everyone from the HHS Office of Inspector General to the regional home health intermediary could be highly skeptical of your innocence.
 
Visiting clinicians filling out the start of care OASIS assessment should go beyond the initial question on M0175 and really dig down for an accurate answer, urged consultant Karen Vance at a recent teleconference sponsored by Eli Research and The Coding Institute. "Remind your clinicians to probe for as much information as they can in the home," said Vance, with BKD in Springfield, MO.
 
Increasing M0175 accuracy could be elementary if your staff employ the following strategies for ferreting out prior inpatient stay information in the home. Ask Patients Questions Patients may not always be the most reliable sources of information, Vance admitted in the teleconference, "M0175: Get It Right the First Time." But there are important questions you can ask patients that will be clues as to whether you need to dig deeper for information on prior inpatient stays.
 
Try these crucial queries:   "Did you stay in the same room the whole time? What floor were you on? Did you move to a different floor?" Most HHAs employ nurses who once worked in area hospitals. It should be relatively simple for an agency to compile a list of what hospital floors contain what kind of beds - acute care, rehab, etc. "Commit that information to paper and make sure that everybody in your agency knows that," Vance instructed. Then clinicians can check their patients' information against that master list.   "Did they make you get dressed or eat your meals in a different room?" Rehab units typically require patients to get out of bed, get dressed and eat in a common room, Vance noted. So if the patient took part in those activities, it's a clue that should spur you to confirm the rehab stay.   "Did you get a lot of therapy?" High therapy utilization is another clue that a rehab stay occurred, Vance added. Observe Carefully [...]