OASIS Alert

The Centers for Medicare & Med-icaid Services will soon test a patient assessment tool across post-acute care settings. The Continuity Assessment Record and Evaluation (CARE) tool takes the "best" items from OASIS, nursing homes' MDS and rehab facilities' patient assessment tool, CMS' Mary Weakland said at the National Association for Home Care & Hospice's Washington, DC policy conference April 23.

The aim is for hospital discharge planners to be able to use the tool to help place patients in the appropriate setting. The tool would be filled out before hospital discharge, upon admission to a post-acute setting such as home care, nursing home or rehab, and again upon discharge from that post-acute provider.

The idea is to track the patient across settings, Weakland explained. CMS and NAHC are soliciting agencies to participate in the Chicago demonstration project starting in January.

The CARE tool "will collect information that will enable CMS to better understand the relationships among patient needs, post-acute care placement, patient outcomes, and post-acute care related costs in the Medicare program," CMS says in a notice in the April 19 Federal Register regarding the assessment tool.

Bottom line: CMS is trying to formulate "a proposal for site-neutral payment for post-acute care services," the agency says in the notice. In other words, nursing homes, HHAs, rehab facilities and other providers would receive the same payment for a post-acute patient.

• Palmetto GBA has added electromagnetic therapy (G0239) to its local coverage determination (LCD) for home health physical therapy (RHHI LCD 99HH-021-L). The change, along with other minor revisions, were effective May 23, Palmetto says.

• If your test of the practice grouper CMS has provided for the prospective payment system refinements was yielding some strange results, you may want to give it another try.

CMS has corrected problems with the "toy grouper" it issued in June. "The revised version corrects several typos related to determining the Home Health Resource Groups (HHRGs) and case mix weights," CMS ex-plains in an email message.

The revised grouper is available at www.cms.hhs.gov/center/hha.asp.  

More grouper-related downloads, such as the grouper logic guidelines and pseudocode, are also on the CMS home health site.

• The HHS Office of Inspector General has combined its Red and Orange Books on unimplemented cost-cutting recommendations. The OIG wants physicians to have to examine beneficiaries before ordering home health services because "unallowable services [continue] to be provided because of inadequate physician involvement," it say.