Home Health & Hospice Week

Your reimbursement hinges on your accuracy for these items.

If you only consider what’s true of your patient’s condition on the day of the assessment for every OASIS item, you won’t get credit for all the care you provide.

The response-specific guidance for each OASIS item provides you with instructions outlining the time period you should consider. Keep this list nearby for an at-a-glance guide to the nitty-gritty of these measures.

Rule of thumb: In general, you will report what is true for your patient on the day of assessment unless the item or related OASIS guidance indicates that you consider a different period of time for a particular item.

Day of Assessment

The Centers for Medicare & Medicaid Services defines "day of assessment" as "the 24 hours immediately preceding the home visit and the time spent by the clinician in the home." While most OASIS items use the "day of assessment" timeframe, there are those items that consider a different time range.

For example: When answering M1400 -- When is the patient dyspneic or noticeably Short of Breath? you would base your answer on the level of exertion that caused your patient to become short of breath during the time you spend in the home doing the assessment and during the 24 hours preceding your arrival.

Day of Assessment & Recent Past

Some OASIS items ask you to look back beyond the day of assessment when reporting the patient’s condition.

For example: When answering M1740 -- Cognitive, behavioral, and psychiatric symptoms that are demonstrated at least once a week (Reported or Observed), you are asked to consider behavior that occurred on the day of the assessment and in the recent past.

Watch for context clues in the item and its responses to see when you’re expected to consider the recent past. In item M1740, the question asks you to look beyond the day of assessment and into the recent past by indicating that the behavior occurs at least weekly. In item M1242 -- Frequency of Pain Interfering with patient’s activity or movement, the responses include "2 -- Less often than daily" so you know you’re considering the recent past.

Within the Last 14 Days

When an item asks you to consider what was true within the last 14 days, you’ll need to look at the day of assessment and the two-week period immediately preceding the start or resumption of care or discharge. To calculate the timeframe for this item, you’ll count the date of admission as day 0 and the day immediately prior to the date of admission as day 1.

For example: When answering M1710 -- When Confused (Reported or Observed Within the Last 14 Days) at start of care for a patient with start of care date of March 19, you would consider any confusion that occurred on or after March 5.

Since the Previous OASIS Assessment

Look back to the time of the previous assessment and to what has transpired since that time to correctly respond to items asking what was true since the previous OASIS assessment. In other words, consider what was true at or since the last OASIS assessment.

For example: Item M1500 -- Symptoms in Heart Failure Patients: If patient has been diagnosed with heart failure, did the patient exhibit symptoms indicated by clinical heart failure guidelines (such as dyspnea, orthopnea, edema, or weight gain) at any point since the previous OASIS assessment? asks you to consider whether the patient exhibited heart failure symptoms on the day of the last OASIS assessment or at any time since then.

Prior to this Current Illness, Exacerbation, or Injury

When asked to consider what was true prior to the current illness, exacerbation, or injury, look back to the patient’s condition before the situation requiring home care.

For example: OASIS item M1900 -- Prior Functioning ADL/IADL: Indicate the patient’s usual ability with everyday activities prior to this current illness, exacerbation, or injury asks you to report what was true prior to the illness, exacerbation or injury that initiated this episode of care.

Date This Episode of Care

Items that ask you to consider this episode of care ask you to determine the dates of the quality episode. To do so, determine whether the start of care or resumption of care is the most recent assessment. Use the SOC or ROC date to identify the starting point of the quality episode and the beginning of the reporting period which ends at transfer or discharge.

For example: OASIS item M1050 -- Pneumococcal Vaccine: Did the patient receive pneumococcal polysaccharide vaccine (PPV) from your agency during this episode of care (SOC/ROC to Transfer/Discharge)? asks you to consider whether the patient was vaccinated on a date within the quality episode, based on the period beginning with the date of the most recent of SOC/ROC and ending at transfer or discharge.