Home Health & Hospice Week

Plus: If you can’t get your ‘Services Provided’ data corrected in iQIES, you’re not alone — but CMS is on the case.

If you have a question about completing OASIS, it’s worth checking to see whether Medicare has addressed the issue in its quarterly OASIS question-and-answer sets.

The Centers for Medicare & Medicaid Services issued the latest Q&As April 20 on the QIES Technical Support Office (QTSO) webpage, noted a CMS official in the Home Health Open Door Forum that day.

For example, CMS tackles the issue of required assessments when a patient dies at the hospital, but is not actually formally admitted.

Question: “Our patient was transported to the hospital and was placed in observation where they expired. Would we complete the RFA 7 - Transferred to an inpatient facility - patient discharged from agency or RFA 8 - Death at home?”

Answer: “Complete an RFA 8 - Death at home OASIS when a patient dies anywhere other than after being admitted for a qualifying inpatient stay,” CMS instructs. “A qualifying inpatient stay is defined as a patient being admitted to an inpatient facility for 24 hours or more for reasons other than diagnostic testing. Only use RFA 7 - Transferred to an inpatient facility - patient discharged from agency when a patient is transferred from your agency for a qualifying inpatient stay and return to your agency is not expected.”

Another question: “A patient is independent with self-feeding but requires encouragement for adequate intake. Would the encouragement to increase food and/or fluid intake be considered when scoring GG0130A - Eating?” an agency asks.

Answer: “The intent of GG0130A - Eating is to assess the patient’s ability to use suitable utensils to bring food and/or liquid to the mouth and swallow food and/or liquid once the meal is placed before the patient. The adequacy of the patient’s nutrition or hydration is not considered for GG0130A - Eating,” CMS says. Therefore, “if the patient is able to meet the intent of the activity with no assistance (physical, verbal/nonverbal cueing, setup/clean-up) then code 06 – Independent,” the agency directs.

A link to the April Q&A set, as well as links to previous sets, are at https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals under the “OASIS Quarterly Q&As” heading.

Other home health-related topics covered in the forum include:

• Value-Based Purchasing. A number of VBP preparation materials are on CMS’ expanded VBP webpage, with more slated to premiere soon, a CMS official noted (see related specifics, p. 108).

Agencies can expect CMS to issue benchmarks in mid-May, sample interim performance reports and sample annual report in iQIES in July followed by a webinar about them in August, and materials such as an implementation guide, a guide to the quality measures, and more specifics about the composite measures, the CMS official revealed.

• New Compare preview reports. Preview Reports and Star Rating Preview Reports for the July 2022 Care Compare refresh are now available in iQIES. For this refresh, OASIS-based measures “will be based on the standard number of quarters,” CMS notes on its Home Health Quality Reporting Program webpage.

“This refresh resumes the reporting of all claims-based measures for the Home Health Quality Reporting Program,” CMS adds. But “due to the COVID-19 reporting exceptions, the claims-based measures have been calculated excluding Q1 and Q2 2020 data from measure calculations,” the agency points out on its website.

• OASIS-E. CMS plans to post the draft OASIS-E Guidance Manual, the updated draft OASIS-E instrument, and an updated version of the OASIS Q&As “in early summer,” according to a CMS speaker in the forum.
• PHE waivers. In the question-and-answer portion of the forum, a home health caller urged CMS to consider making permanent certain regulatory waivers tied to the COVID-19 public health emergency. In particular, the caller recommended that CMS continue to allow all types of therapists to conduct the initial comprehensive assessment.

CMS is looking at all waivers and carefully considering which ones could be made permanent, a CMS official assured the caller.

• iQIES confusion. CMS has recently instructed HHAs to check their “Services Provided” information in the iQIES system (see HCW by AAPC, Vol. XXXI, No. 12). Agencies should “reach out to their state OASIS Education Coordinator (OEC) or OASIS Automation Coordinator, should inaccuracies be identified,” CMS says in a recent message to providers. “If the values are incorrect for your agency, please contact your State Automation or State OEC and request an update of your Services Provided data in iQIES,” CMS continues later in the message.

The problem: When one HHA contacted its state OASIS official, it was told the information couldn’t be corrected unless it had been surveyed in 2019 or later, said a caller in the forum. The person said they received the same response when contacting the iQIES Help Desk.

That’s not correct, a CMS staffer responded, noting a “disconnect somewhere.” The CMS speaker asked the agency to send in its information for resolution.