“Solutions” to some of the special issues associated with the initial visit and comprehensive assessment may actually be misconceptions. That’s because those putting forth these solutions may not have read the rules. Here are two common ones with the facts to set them straight.
Misconception: If an initial visit can be done prior to start of care (SOC), then you can also do the OASIS. We don’t have to wait until after the SOC to do the OASIS.
Reality: In 2008, the Centers for Medicare and Medicaid Services discussed the fact that an initial assessment visit can occur prior to the SOC, but did not mention the comprehensive assessment with OASIS. The scenario was that of a nonskilled initial visit. Some readers assumed that this meant the OASIS could be done at the same time. The OASIS Implementation Manual, Chapter 2, §B(1)(a) stated, “If a skilled service is delivered at the initial assessment visit, thus establishing the SOC, the comprehensive assessment may be initiated at this visit and completed within the time frames discussed….” Therefore, while it’s possible to make an initial visit without a skilled service, it does not establish the SOC, so the OASIS cannot be completed. (OASIS data collected prior to the SOC date are not valid.) Avoid survey citations by scheduling the OASIS during or within five days after the SOC visit.
This article was adapted from Homecare Administrator, Volume 7, Number 6. Every month, administrators get the information they need to operate their agencies in an efficient, effective, and compliant manner. Learn more about this newsletter at — http://www.beaconhealth.org/cgi-bin/ccp51/cp-app.cgi?pg=prod&ref=33-570-00.
This is an excerpt from the March 22, 2010 issue of Homecare Insider. Sign up for the free newsletter today!
May 22nd, 2010 at 3:20 pm
Dear Casey,
I never thought I’d be doing this type of nursing…however it all came suddenly, so here I am doing my ‘first Oasis’….the company is new bringing n skilled nursing care. I must admit the Oasis is over-whelming…the assessement is very time comsuming for the client and me! Thankfully, my client was very paitent and cooperative …I hope as I become more familiar with all of the questions and my hands on assessemnts, head to toe, psychological, and physical..etc…I will improve….On my initial visit, I preformed the Oasis assessement as well as finding medical errors, comfirming doctor orders…found the pharmacy had givne double doses of a med…so that stopped the day I began instructing the patient…doing this ‘skilled med’and teaching service…should I then count this as the SOC? I didn’t realize the 5 day threshold to complete the Oasis–thanks so much took 6 hours to complete..:(
June 26th, 2010 at 10:25 am
Is there a training manual for someone is very familiar with “old” medicare billing, highly trained in clinical, trained in Intakes with full assessments. I need assistance in making the transition to Oasis for Home Health.