OASIS-Central

If you are doing a ROC assessment in the middle of the episode, should you answer M0110 “NA”- No Medicare case mix group to be defined by this assessment?

Q: If you are doing a ROC assessment in the middle of the episode, should you answer M0110 “NA”- No Medicare case mix group to be defined by this assessment? I believe this is the correct answer since there are no SCIC adjustments, but have not been able to get a clear answer.  We do [...]

Physician Verification of Diagnoses Is Important

Diagnoses play an important role in supporting reasonable and necessary services. The diagnoses must correlate with the services the agency provides. The primary support for the patient’s plan of care comes from the principal diagnosis. The pertinent diagnoses listed first can also support the plan. Other diagnoses identify relevant comorbidities. [...]

Agency Competence: Clinical Records, Part II

Homecare episodes can be tracked by “events”—admission, resumption, new orders, recertification, discharge. Clinical record evaluation should address each one.
Admission and recertification

Ensure that all required documentation is present, whether via hard copy or as indicated by electronic processing of the admission.
Conduct reviews related to OASIS in conjunction with review of other record documents. OASIS should not [...]

Refine Referral Process for Start of Care Data Elements

Two new data elements in OASIS-C have been responsible for many questions submitted to Ask an Expert. Those data elements are:

M0102, date of physician-ordered start of care (resumption of care)
M0104, date of referral

Here are some important facts about these data elements:

Enter all dates in eight-digit fashion—two-digit date and month, and four-digit year.
The source [...]

Is there a rule on grace days concerning M0090?

Q: Is there a rule on grace days concerning M0090?  For example, I have a SN SOC on 6/1 and a PT eval on 6/7. Can I add PT to the admission plan of care?
A: The assessing clinician has up to five (5) days after the start of care date to complete the assessment. When [...]

Survey Trap: Referral and Start of Care Dates

An agency can be cited if the date in either M0102 or M0104 combined with the date of the agency’s visit to start or resume care (date in M0090) does not demonstrate compliance with the Conditions of Participation.
Compliance Tips:

Designate the last day of information gathering as the date of referral and document that
Add a spot [...]