OASIS Alert

Start of care is not the same as first visit

Remember OASIS data collection has its own vocabulary.

Scenario: The patient is admitted to home care for "therapy only" on May 10. Your agency's policy is that the skilled nurse goes to the home to open the case, including assessing homebound status and medical necessity, getting the patient's consent, filling out forms etc. The SN also does the SOC OASIS and some teaching. The physical therapist visits the next day, May 11.

Question: Which is correct?

A) The SOC date in M0030 is May 10 because that is the day the SN performed the OASIS assessment.

B) The SOC date is May 11, the date of the PT visit, because it is a therapy only case, so that is the first billable visit. The OASIS assessment must be redone because it was done before the first billable visit.

C) The SOC date is May 10, the date of the SN visit, because the SN provided a skilled service, so that is the first billable visit.

Answer: B. The nursing visit in this case is non-billable; therefore, this visit cannot be the SOC date, says Lisa Selman-Holman consultant and principle of Selman-Holman & Associates in Denton, Texas. A visit made by an SN solely for the purpose of establishing eligibility for care (homebound, medically necessary care, etc.) is not considered skilled care.

Even if the SN provides teaching at the visit, it still will not be considered skilled care because the medically necessary care must be intermittent for the SN's visit to be considered billable. One visit is not intermittent.

Any information collected for the comprehensive assessment prior to the May 11 SOC date (the therapist's visit date) is void and must be completed once the SOC has been established by a billable visit, Selman-Holman explains.