OASIS Alert

Industry Notes:

FILTER PATIENT TALLY REPORTS FOR DATA YOU CAN USE

Think about coffee.You filter out the grounds and are left with the essence just like the QIES Workbook does with your OBQI data.

The Quality Improvement Evaluation System Technical Support Office provides a tally report workbook tool to make patient reports more useable. The "workbook" consists of Excel spreadsheets into which you transfer data once you have downloaded your agency's OBQI case mix report and your OBQI outcome report. You then can filter the combined data to select specific cases for review based on patient outcomes and case mix characteristics.

Tip: Speakers at the recent annual OASIS Coordinators Conference, sponsored by the Centers for Medicare & Medicaid Services and held in New Orleans, suggested filtering first by outcome criteria and then by case mix criteria. The tool helps "avoid manual review of lengthy printed reports," CMS says.

The corrected tool is available for download at www.cms.hhs.gov/oasis/obqi.asp. If you downloaded it when it was first available, it gave incorrect results when no cases met the the criteria, CMS says.

  • HIPAA privacy rules don't cancel OASIS privacy requirements. With all the media focus on the April 14 deadline for implementing the Health Insurance Portability and Accountability Act privacy regulations, remember to continue complying with the OASIS privacy rules also (see OASIS Alert Vol. 4, No. 1, p. 2).

    CMS instructs agencies to notify patients about the requirement to collect OASIS data at certain points during their care, to transmit that data to the government and to keep the data confidential. Sample privacy notices in both English and Spanish are at Appendix G of the OASIS Implementation Manual at www.cms.hhs.gov/oasis/Appendices_pdf.zip.

  • The National Association for Home Care & Hospice and Fazzi Associates will work together on a nationwide project underwritten by 3M Home Health Systems to identify strategies and protocols home health agencies can use to ensure OASIS data accuracy.

    Researchers will interview top clinicians, and participants "will design and recommend standardized OASIS interview protocols that agencies can use to improve the accuracy and consistency of the assessment process," Salt Lake City-based 3M says in a release. Researchers will recommend problematic OASIS questions to CMS for revision or deletion from the assessment tool.

    Fazzi researchers have found in their OASIS audits that 60 percent of assessments contain errors, says Robert Fazzi. The error rate affects both quality measures derived from OASIS and reimbursement.

    The organizations will present their findings at NAHC's annual conference in October and will make a report available to the industry.

  • The HHS Office of Inspector General has undertaken a nationwide audit after finding in a sample of claims that HHAs had been incorrectly answering OASIS question M0175 (previous inpatient stays) and receiving more money than they might deserve (see OASIS Alert, Vol. 4, No. 2, p. 19).

    The OIG plans to issue a separate report for each regional home health intermediary, said a CMS regional office staffer in the April 1 home health Open Door Forum. It has finished studying claims from Associated Hospital Service of Maine and plans to issue its report on the region next month, with reports from the other three RHHIs to follow.

    In RHHI Palmetto GBA's region, the OIG has gathered "considerable claims payment data" and is contacting a sample of agencies for more information, Palmetto reports in a question-and-answer document posted March 27.

  • Come Jan. 1, 2004, agencies will have to answer the branch identification item (M0016), a CMS spokesperson said at the OASIS Coordinators Conference in New Orleans April 1. Branch ID numbers already have been assigned in 19 states, and will ultimately allow for branch-specific outcome reports, the spokesperson noted. However, those reports won't be a reality until early 2005.

    CMS isn't asleep at the wheel on this one, though. At the end of March the agency determined that come Jan. 1, edits will be in place to reject assessments with mistakes in M0016.

    To answer M0016 correctly: If the assessment is performed by a parent agency that has branches, simply enter "P" on M0016, since parent agencies won't receive branch IDs. If the assessment is performed by a parent agency with no branches, enter "N." Otherwise, enter the 10-digit branch ID number.

     

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