OASIS-Central

Q: If the patient is discharged from Medicare and we check response 0, able to ambulate independently, in M1860, ambulation, will we set ourselves up for an audit because the patient is not homebound?

A: An agency’s goal is for patients to improve, to become as independent as possible. Given that the Centers for Medicare and Medicaid Services (CMS) publicly reports some end-result outcomes and Pay for Performance (P4P) is coming, improvement in ambulation is important. (Ambulation was one measure in the P4P demonstration.) If the discharge assessment shows that the patient is independent in ambulation, that status supports the agency’s decision to discharge him or her.

The key to avoiding a denial is to show that the patient was homebound during the home health episode and the independent status is a recent development. The most important indicator to support homebound status during the last week or so of care is documentation of absences. The patient’s strength and mobility were increasing. However, he or she was not ready to venture forth outside the home on a regular basis until the day of discharge decision.

Every clinician needs access to Chapter 3 of the OASIS-C Guidance Manual. Learn more about this product at — http://www.beaconhealth.org/cgi-bin/ccp51/cp-app.cgi?pg=prod&ref=OASISCIM03.

This article is from yesterday’s edition of Homecare Insider. Sign up for the free newsletter today!