OASIS PPS Timing
Requirements:
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DEPARTMENT OF HEALTH &
HUMAN SERVICES
Health Care Financing Administration
Center for Medicaid and State Operations
7500 Security Boulevard
Baltimore, MD 21244-1850
DATE: November 20, 2000
FROM: Director, Survey and Certification Group, Center for Medicaid
and State Operations
SUBJECT: Outcome and Assessment Information Set (OASIS) Timing
Requirements—INFORMATION
TO: Home Health Agency OASIS Submission
Staff, State Agency OASIS Educational Coordinators, State Agency OASIS Automation
Coordinators
The purpose of this memorandum is to provide guidance to Home
Health Agencies (HHAs) and State survey agencies concerning OASIS timing requirements
during the transition period into the home health Prospective Payment System (PPS).
The Final Rule for PPS published in the Federal Register
(exit DHFS) (65 FR 41128)
on July 3, 2000, revised the timing requirements for the scheduling of OASIS follow-up
assessments. Specifically, on page 41221, the OASIS timing schedule was changed from an
interval requiring a follow-up assessment every two months to a 60-day assessment
schedule.
This revised assessment interval will cause warning messages related to timing on OASIS
follow-up assessment records to appear on the validation report produced by the State when
the assessment is submitted for patients with a start of care prior to October 1, 2000.
The warning message results from the fact that the software will calculate due dates
for follow-up assessments according to the new 60-day follow-up schedule, regardless of
whether the start of care date is before or after October 1, 2000. In this situation, the
warnings can be ignored with no consequence to the HHA.
The specific warning message generated by the State system (message number 262)
cautions that the follow-up assessment completion date (M0090) does not meet the Health
Care Financing Administration (HCFA) 60-day timing guidelines. The system edit that
determines whether to generate this warning message considers the 60-day follow-up
assessment schedule only. It is unable to consider the two-month schedule in effect
prior to October 1, 2000. For that reason, the message can be ignored.
Note that the situation is unique to patients already on service prior to October 1,
2000, who are involved in the transition from one regulatory time frame (every 2 calendar
months) to another (every 60 days). Generally speaking, HCFA does not encourage HHAs to
ignore warning messages; however, in this exceptional situation, the warning message is
unavoidable. Patients admitted to the HHA after October 1, 2000, and 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 the current 60-day 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 follow-up data collection schedule.
HCFA is providing this memorandum for those who require documentation in addition to
information provided on HCFA's web pages. We recognize the concern that a warning message
may cause in the circumstances described above. For more information, please consult the
HCFA OASIS web page at http://www.hcfa.gov/medicaid/oasis/oasishmp.htm
[changed to http://cms.hhs.gov/oasis/hhoview.asp
(exit DHFS)]
and particularly information related to the transition to PPS at http://www.hcfa/gov/medicaid/oasis/oasispps.htm.
[no longer operable]
If you have any questions about these instructions, please contact your State OASIS
Educational Coordinator or State OASIS Automation Coordinator.
/s/ Steven A. Pelovitz
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