OASIS Alert

Q: If a patient hasn't received an emergency visit between transfer to hospital and start of care , would you answer "no" to M0830?

A: There's considerable confusion about M0830, explains Chapel Hill, NC-based senior consultant Judy Adams with Larson Allen Health Care Group. The question asks about emergent care since the last OASIS data collection, either in one episode or in a series of continuous episodes, she says. But the structure of the question means it will not be on a start of care or resumption of care assessment, she adds.

Say a patient is transferred to the hospital and is in the hospital when recertification is due. In that case, when the patient is referred back to the home health agency, the HHA would do a new start of care assessment for a new episode and M0830 would not apply, Adams advises.

Clinicians might be confused by the term "emergent care." Emergency room care is only one type of emergent care covered in M0830, Adams instructs. If the patient had any unscheduled visit to an emergency room, physician's office,urgent care center or outpatient department between two OASIS assessments, you can't answer "0 - No emergent care," she says.

The patient's need for emergent care is one of the 11 outcomes CMS will use to compare agency quality, making this a crucial OASIS question.

This question covers "the entire period since the last OASIS data was collected, including current events," according to the Centers for Medicare & Medicaid Services' guidance for M0830. If the clinician is preparing a transfer OASIS because a patient is being seen for an unplanned hospital visit, the correct response to M0830 is number 1, to cover the current situation. "But if the patient is being transferred to the hospital for a scheduled admission, the correct answer would be 0," Adams notes.