Welcome to this video series for home health agencies.
We will be discussing OASIS which is the Outcome and Assessment Information Set for CMS submissions.
As always, if you need more information than this short video can provide please
go to the OASIS Manual in the current edition on www.cms.gov.
Congratulations! You have a new home health patient! So now what comes next for OASIS?
You likely heard about this person from someone or from somewhere.
In other words from a referral source.
To count as an OASIS referral this information must be received from a physician source. Not from a case manager or from a family member.
In OASIS a physician means a medical doctor (in other words an MD) or an osteopath (or a DO).
This referral can be oral (by telephone) or written (by forms or fax).
All are acceptable to your agency.
When you get a new referral try to get a Start of Care (SOC) date with that information.
The first thing to do is to contact the new patient and set up an initial home visit.
This visit should take place within 48 hours of the referral.
An initial visit is required to decide if there's a fit with your agency's offerings and available personnel.
An important thing for the initial visit to determine is the face-to-face visit status and the homebound status.
If the new patient or the family does not have a physician that they can name
it is likely that they might not meet the face-to-face visit requirement of Medicare.
In that case ask to see an appointment card for a follow-up physician visit
that will soon establish this Medicare eligibility.
If the patient is not homebound they might not meet the requirements for Medicare Part A eligibility either.
That does not mean that there is no need for an OASIS assessment
but you should stop and check with your agency on next steps.
It is important to let them know right away because your agency only has 48 hours
to inform the physician of the need to make a different referral if your agency cannot take this patient.
If the Medicare requirements are met you might need to proceed with the OASIS Start of Care assessment.
Remember the M0030 Start of Care Date is feet in the door by someone with orders:
an RN, a PT (Physical Therapist) or a Speech Pathologist/Speech and Language Therapist (SP/SLT).
If you do not have any of these licenses you cannot start the OASIS Start of Care assessment.
You can take notes and you can document non-clinical observations and impressions
but you should call your agency before proceeding further.
Once you start your OASIS assessment with a valid M0030 date
this now sets that the last day for M0090: Date the Assessment is Completed.
This M0090 date is no longer than five days away by looking on a calendar and counting the M0030 date as day zero.
All clinical advisors on the OASIS team should give their opinions by the M0090 date.
This includes information from OASIS team members who cannot sign the assessment
but have important information for your consideration.
An example of such an OASIS team member might be a pharmacist
or a non-skilled CNA or an LPN who is looking after the patient.
It might be a social worker and even your agency's billing department.
All orders should be known and items answered by the M0090 date.
This is the responsibility of the person whose professional license
is claimed on M0080: Discipline of Person Completing Assessment.
Always remember M0080 is the last authorized person into the home with orders to treat the patient.
That visit had to have happened sometime on or between the M0090 date and the M0030 date.
Also remember M0080 is the license responsible for accuracy of the overall assessment.
CMS and most nurses strongly prefer the professional is an RN if there are any orders for skilled nursing care at all.
But it can be that the orders are for therapy only or the last person in the home is a therapist,
so in this case the therapist is expected to take responsibility
for the overall accuracy of the entire assessment on M0080.
Thank you for your interest in OASIS and for watching this video.
As always, you can get more information on OASIS by going to the www.cms.gov website
for the most recent OASIS Manual.
There's also a list of the OASIS coordinators on that website which is a great reference for further information.
Thank you so much for your time.