Home Health & Hospice Week

CMS issues another OASIS-D question-and-answer set.

Home health staff performing OASIS-D assessments are encountering confusion, but at least they are getting some clarification from Medicare on trouble spots — even if they don’t like all the answers.

A 105-question-and-answer set posted in late December has shed light on matters including new Section GG, Section J, and more (see Eli’s HCW, Vol. XXVIII, Nos. 1 and 2). Now the Centers for Medicare & Medicaid Services has posted its quarterly OASIS Q&As on the QTSO website.

Reminder: After a hiatus, CMS issued a Q&A set last July and announced it would again begin issuing quarterly sets this month (see Eli’s HCW, Vol. XXVII, No. 19). Now it has posted the 32-question set hitting on many OASIS-D confusion hot spots.

For example: Many home health agencies protested when CMS added the Section J items on falls, and a new clarification on the topic won’t make them any happier.

Question: Items J1800 & J1900 indicate ANY fall since the SOC/ROC, whichever is more recent. If the fall (or intercepted fall) occurred at another facility such as doctor’s office, hospital or SNF, is the home care agency still responsible to report this data, or is the home care agency only responsible to report those falls/intercepted falls that occur in the patient’s home?

Answer: “J1800 & J1900 reflect falls that occurred at any time during the quality episode, regardless of where the fall occurred,” CMS responds. “In your example, a fall that occurred at the doctor’s office during the HH quality episode would be reported. If a HH patient has a qualifying inpatient facility transfer (e.g., hospital or SNF), and falls in the facility, that fall would not be reported by the home health agency, as it did not occur within a HH quality episode (i.e., the fall would have occurred after the transfer and before the ROC).”

Note: See the new Q&A set at https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals — scroll down to the “OASIS Quarterly Q&As” section and click on the January 2019 document.