Information Bulletin 99-26
Information Related To The Outcome And
Assessment Information Set
The purpose of this information bulletin is to provide current information and clarifications related to the implementation of the Outcome and Assessment Information Set (OASIS).
Revised OASIS User's Manual:
The Health Care Financing Administration (HCFA) has revised, "Implementing OASIS at a Home Health Agency to Improve Patient Outcomes" (part one) of the OASIS User's Manual (7/99), due to the numerous changes that have affected OASIS in the past year. Part one of this manual has been revised to stay abreast with current changes. There are eight areas of the "Implementing OASIS at a Home Health Agency" in the OASIS User's Manual that had significant changes. We strongly encourage you to download the new version of the manual and replace the 10/98 version with the 7/99 version. Most recent OASIS manuals can be download on the CMS Oasis User Manuals page.
Coding Specific Payer Sources - MO150:
Item #M0150 - Current Payment Sources for Home Care has created a lot questions regarding the various waiver programs we have in Minnesota and how to code them. Below you will find some of the common waiver programs and how they should be coded in OASIS item MO150. This list is not all inclusive. Remember, MO150 is where you will identify payers to which any services provided during this home care episode are being billed. If the patient is receiving care from multiple payers, mark all that apply. If the payment source is "pending", do not include code it until it is no longer pending for that patient and will be the pay source that will be billed.
- Elderly Waiver, CADI, CAC, TBIW, and MR/RC are considered Medicaid fee for service programs and should be coded as a "3", (Medicaid traditional fee for service).
- PMAP is a Medicaid funded managed care and should be coded as a "4", (Medicaid (HMO/Managed Care).
- MSHO is a blend of Medicare and Medicaid dollars and should be coded both a "2" & "4".
- AC is all state dollars and is not subsidized by Medicare or Medicaid and should be coded as "7", (Other government).
Conducting OASIS Assessments When Patients Go From Skilled Services To Personal Care Only Services And Vice Versa
Until collection of OASIS data on all patients receiving services from an agency goes into effect (skilled services and personal care only services), HCFA has given the following guidance to follow when patients go from receiving skilled services to personal care only services. When skilled services are no longer needed, the home health agency should do the following:
- Conduct a Discharge OASIS assessment with the Reason for Assessment in MO100 coded as a "9"- "Discharge from agency", even though the patient may not be "discharged" from your agency. The patient is "discharged" for OASIS purposes only;
- Code MO870 - Discharge Disposition, as a "1", patient remained in the community;
- Code M0880 which asks, what supportive services the patient is to receive after discharge as a "3", yes, assistance or services provided by other community resources.
When a patient has been receiving personal care only services from your agency and then requires a skilled component, at the point the patient begins receiving skilled services, a start of care assessment would need to be conducted.
Monitoring Activities By The Minnesota Department Of Health (MDH) Related To The Implementation Of The OASIS Requirements
On June 18, 1999, HCFA published a notice in the Federal Register re-establishing the effective dates for OASIS collection, encoding and transmission (64 FR 32984). Effective July 19, 1999, home health agencies were required to begin collecting and encoding OASIS data on all patients receiving skilled services as part of their comprehensive assessment process on admission and at specific time points during the period of home health care.
On August 24, 1999, home health agencies were required to begin electronically submitting this OASIS data to the Minnesota Department of Health for those patients that are Medicare and/or Medicaid.
For both collection and reporting of the OASIS data items, HCFA has encouraged State agencies to take a graduated approach to monitoring activities related to implementation during OASIS start-up. For the purposes of OASIS enforcement, HCFA has defined OASIS start-up as now until the end of 1999.
The graduated approach is outlined as follows:
On October 15, 1999, a letter was sent to all home health agencies that have not electronically submitted any OASIS production data to the MDH as of that date. This letter outlined the OASIS requirements and asked the agency to contact MDH regarding what problems they may be having related to these requirements.
On October 26, 1999, another letter was sent to home health agencies that still had not electronically submitted any OASIS production data. This letter requested that the agency submit in writing to the MDH their agency's plan to implement the OASIS requirements. This plan was to include the steps the agency will take to collect, encode, and transmit the data and the date of completion. If a response/plan was not received within 2 weeks from the date of this letter, the agency was informed that the MDH must proceed with our formal compliance process and issuance of deficiencies.
Automation Update And Upcoming Changes
To keep abreast of the changes over the past year, here is a recap of the current software and data specifications that you should be utilizing:
If you are utilizing the Home Assessment and Validation Entry software (HAVEN), this should be the HAVEN Version 2.0 (May, 1999), plus the HAVEN Patch Version 2.1 (August, 1999). The current data specifications are Version 1.03.
HCFA is not anticipating any changes to software, OASIS data items, the OASIS system itself or the correction policy, until the Spring of 2000.
During the period April through June, 2000, home health agencies in Minnesota will be required to convert to the Medicare Data Communications Network (MDCN) to access the state OASIS data system for submitting assessments. This system, which is administered by IBM Global Networks, provides for faster connections and fewer busy signals when dialing into the state system. No changes to computer systems, software, or the state data system will take place; only the procedure for dialing into the state system will be different. After March 15, 2000, home health agencies will be mailed a questionnaire which they will need to complete and return to IBM Global. After that, IBM Global will send complete instructions, along with login identifications and passwords, which will be needed for the MDCN system. The conversion is projected to be completed by June, 2000.
Who Can I Call If I Have Questions?
If you have questions regarding the jHAVEN software, please call:
- jHAVEN Help Desk: 1-800-339-9313
- Email: firstname.lastname@example.org (subject line - jHAVEN)
For technical questions please contact the OASIS Automation Coordinator:
For clinical questions about the OASIS assessment process, contact the OASIS Education Coordinator:
Please check the Centers for Medicare & Medicaid Services (CMS) website often for announcements and latest updates. CMS was previously known as the Health Care Financing Administration.