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Date: December 19, 2000  DSL-BQA-00-083

To: Home Health Agencies HHA 36

From: Jan Eakins, Chief, Provider Regulation & Quality Improvement Section

cc:  Sue Schroeder, Director, Bureau of Quality Assurance

The purpose of this memorandum is to provide you with information related to:

Satellite Training on OASIS Reports

 On January 19, 2001, the federal Health Care Financing Administration (HCFA) Center for Medicaid and State Operations will broadcast a two hour satellite training on the Case Mix and Adverse Event Reports based on OASIS data.

The program will be broadcast 12:00 noon – 2:00 p.m. CST (1:00 – 3:00 p.m. EST). A draft program agenda is attached to this memorandum.

The intended audience for the broadcast is home health agencies (HHAs), home health provider associations, the State Survey Agency and the HCFA Regional Offices. The broadcast will consist of a demonstration on how the reports can be generated from the State OASIS System, how to read the reports, what actions HHAs can take on the reports, and how the reports will be used by HCFA Regional Office and State surveyors. The presenters for this broadcast will include staff from HCFA and the Center for Health Services Policy Research, University of Colorado. The broadcast will have prerecorded presentations followed by a live question and answer session via phone and fax.

The Wisconsin Homecare Organization (WHO) has arranged viewing sites for all home health providers and interested persons at various locations throughout the state. The following table lists each viewing location, maximum seating, telephone number, and contact person.

Viewing Site City

Maximum Seating

Telephone #

Contact Person

Madison

55

608-278-1115

Judi Loos,
Wisconsin Homecare Organization

Jefferson

20

920-674-7186

Sue Johann
Jefferson County Health Department

La Crosse

Not provided

608-791-9790

Kathryn Olson
Franciscan Skemp Home Health

Eau Claire

30

715-831-0100 Ext. 250

Sue Timm
Northwest WI Home Care

Ellsworth

30

715-273-6756

Caralynn Hodgson
Pierce County HH

Since seating is limited at the viewing sites, you must call the contact person for the site to reserve seating. The contact will provide you with the site address, directions and parking options.

Training materials for the satellite session will be available the first week of January on the HCFA OASIS website under "Training" at http://www.hcfa.gov/medicaid/oasis/oasishmp.htm [replaced by www.cms.hhs.gov/oasis/hhoview.asp (exit DHFS)]. Providers should download these materials to bring to the training. Training materials will not be provided at the viewing sites.

The Case Mix and Adverse Event Reports will be available to HHAs through the State OASIS system at the end of January.

Updated Interpretive Guidelines for Home Health Agencies

HCFA has updated the Medicare State Operations Manual, Appendix B, Interpretive Guidelines for Home Health Agencies. The update provides instructions for surveying OASIS regulations and includes regulatory language and guidance on the conditions of participation that were recently amended for the implementation of the prospective payment system (PPS) for HHAs.

This new/revised material became effective October 1, 2000. The cover page of HCFA Transmittal 21 (exit DHFS; PDF), in which this revised material was published, is attached for your information.

Electronic copies of the change pages of the Interpretive Guidelines are available on the HCFA website at http://www.hcfa.gov/pubforms/transmit/R21SOM.pdf [replaced by www.cms.hhs.gov/manuals/pm_trans/R21SOM.pdf (exit DHFS; PDF)].

The Interpretive Guidelines for Home Health Agencies in effect prior to October 1, 2000, and Transmittal 21 with the change pages are also available electronically on the State OASIS System website under "Bulletins."

OASIS Data Item M0825 (Therapy Need)

When a HHA estimates the number of therapy visits to be under 10, but during the course of the 60-day episode, determines that the patient requires 10 or more visits, the HHA should take the following steps:

  • Obtain physician orders/update plan of care to reflect the need for additional therapy.

  • Provide necessary documentation in the clinical record.

  • Conduct an Other Follow-up OASIS Assessment, reason for assessment (RFA) 05, to reflect the current status of the patient.

  • Transmit the Other Follow-up Assessment, RFA 05, to the State OASIS System.

For questions related to payment, contact Medicare Provider Relations at United Government Services, 1-877-309-4290.

Change in Time Frame for Follow-up Assessments

The final federal rule for PPS changed the OASIS timing requirements for OASIS follow-up assessments from an interval requiring a follow-up assessment every two months to a 60-day assessment schedule.

Effective October 1, 2000, HHAs must perform a follow-up comprehensive assessment within the last 5 days of the each 60-day certification period, i.e., between and including days 56-60. This 60-day time frame for follow-up assessments applies to all patients subject to OASIS.

Consult "What’s New" on the HCFA OASIS website at http://www.hcfa.gov/medicaid/oasis/oasishmp.htm [replaced by www.cms.hhs.gov/oasis/hhoview.asp (exit DHFS)].HCFA guidance on this issue can be found under "OASIS Considerations for Non-Medicare PPS Patients" and "OASIS Considerations for Medicare PPS Patients."

Warning message related to revised timing interval

The revised assessment interval may cause warning messages related to timing on OASIS follow-up assessment records to appear on the Final Validation Report produced by the State OASIS System. The following information will help HHAs know how to respond to this warning message.

For patients on service prior to October 1, 2000: The revised assessment interval may cause warning message number 262 related to timing on OASIS follow-up assessment records to appear on the Final Validation Report when the assessment is submitted for patients with a start of care prior to October 1, 2000. In this situation, the HHA can ignore the warning message.

For patients admitted after October 1, 2000: Patients admitted to the HHA after October 1, 2000, who remain on service beyond a single 60-day episode, are expected to be re-assessed with OASIS follow-up data collected during the last 5 days of each 60-day certification period, based on the start of care date. In this case, a warning message indicating deviation from the required time frame for collection of OASIS follow-up data would be valid and a cause for the HHA to examine its OASIS follow-up data collection schedule.

For more information, refer to the attached memorandum from HCFA dated November 20, 2000.

Review of OASIS Applicability

 OASIS Data Collection

The comprehensive assessment and OASIS data collection requirements apply to all patients receiving skilled care, including Medicare, Medicaid, managed care, and private pay patients with the following exceptions: patients under the age of 18, patients receiving maternity services, and patients receiving only chore or housekeeping services.

OASIS Encoding and Transmission

HHAs must also encode and transmit OASIS data on all Medicare/Medicaid patients receiving skilled care (with the above exceptions).

A patient is considered a Medicare/Medicaid patient if Medicare or Medicaid reimburses for any service, including non-skilled care.

For example: A patient who receives skilled nursing services reimbursed by private insurance and home health aide services reimbursed by Medicare or Medicaid is considered a Medicare/Medicaid patient. OASIS data must be collected, encoded and transmitted for this patient.

OASIS Not Required

OASIS requirements continue to be delayed for patients receiving only non-skilled (personal care or home health aide) services.

Frequently Asked Questions

BQA will post frequently asked questions with their appropriate answers on the State OASIS System website under Bulletins. The date is noted each time that the Bulletins area is updated. The Bulletins area is a quick method for conveying information to providers, so please check the website frequently.

OASIS Training Video and Workbook

HCFA has developed a training video with an accompanying workbook that demonstrates patient assessment strategies for HHA clinicians. The purpose of the video is to illustrate how clinicians acquire patient information as part of the comprehensive assessment process using a variety of assessment techniques.

When the video is available to the State, BQA will post directions for obtaining the instructional material and the cost on the State OASIS System website under Bulletins.

Bureau of Quality Assurance Resources

Please direct any questions related to OASIS data collection to the following resources:

Software and OASIS data transmission:

  • Chris Benesh, OASIS Automation Coordinator, 608/266-1718 or benesce@dhs.state.wi.us.

  • Cindy Symons, OASIS Technical Analyst [no longer available]

Clinical issues regarding OASIS data collection:

  • Andrea Henrich, OASIS Education Coordinator, 608/267-3807 or henriam@dhs.state.wi.us.

  • Barbara Woodford, Nurse Consultant [replaced by Marianne Missfeldt, 715/836-4036].

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