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Oakwood Home Care Services of Allen Park, MI, decided to give staff some quick reminders about documentation and Medicare assessment.
Each week, one-page educational sheets called "Education at a Glance" are sent to the staff and repeated in voice mail messages. Oakwood Home Care Services shares with Homecare Quality Management these three examples of the educational sheets:
1. Regulatory Compliance and Accreditation
Memo #16, November 29, 2000
DISCHARGE OASIS ASSESSMENTS
• Use this form when:
— your patient gets transferred to an inpatient facility without agency discharge (THIS OPTION IS FOR STRAIGHT MEDICARE PATIENTS ONLY).
Selection #6 on M0100 of the discharge OASIS form.
— your patient gets transferred to an inpatient facility with agency discharge.
Selection #7 on M0100 of the discharge OASIS form.
— your patient dies at home. Selection #8 on M0100 of the discharge OASIS form.
— your patient is discharged from agency. Selec-tion #9 on M0100 of the discharge OASIS form.
— your patient gets discharged from agency — no visits after start of care. Selection #10 on M0100 of the discharge OASIS form.
• Use the discharge summary (the one that goes to the doctor) when:
Your patient is discharged from the agency. (Selection #7, #8, #9, or #10 on M0100 of the discharge OASIS form.)
• Do not use the discharge summary (the one that goes to the doctor) when:
— your straight Medicare patient gets transferred to an inpatient facility without agency discharge. Selection #6 on M0100 of the discharge OASIS form.
REMEMBER THESE GUIDELINES BEFORE DISCHARGING
n Conference with all disciplines involved in the case.
n Check the patient’s insurance.
n Straight Medicare patients are not discharged when transferred to an inpatient facility within a current cert period.
n Check M0100. Read all the selections before you mark one. Mark only one.
n Fill in the discharge summary only when the patient is actually discharged from the agency.
2. Regulatory Compliance and Accreditation
December 21, 2000; Memo #17
Have you ever noticed OASIS question M0032?
Can you remember what it asks for?
You aren’t alone. Most people can’t.
OASIS question M0032 asks for the resumption date. If your patient has not been resumed this question must be answered "N/A." Remember the rule, "answer every OASIS question unless it is part of a skip pattern?" A date would only be marked for a straight Medicare patient that has been resumed following an inpatient stay. Once a patient has been resumed, this date should be reflected on every following OASIS assessment in the episode of care.
• Ima Hhrg’s start of care date is 11-23-2000.
• She was hospitalized on 11-30-2000. (Of course, we filled out a transfer to an inpatient facility without discharge OASIS.)
• Ms. Hhrg came out of the hospital and was resumed on 12-5-2000. (A ROC OASIS is required.)
• She had to go back into the hospital on 12-12-2000. (On that transfer to an inpatient facility OASIS form, M0032 would show 12-5-2000).
• When Ms. Hhrg was discharged from the hospital and resumed by her home care nurse on 12-15-2000 (again, a ROC OASIS is required), her new resumption date would be 12-15-2000.
• On her discharge OASIS, question M0032 would read 12-15-2000. (The start of care date M0030 remains unchanged throughout the entire episode of care.)
3. Regulatory Compliance and Accreditation
January 11, 2001, Memo #20
Do you know why OASIS questions M0190, M0210, and M0230/M0240 (on the admit) all ask for a medical diagnosis?
Well . . .
M0190 asks for the inpatient diagnosis; "The condition treated during an inpatient facility stay within the last 14 days."
M0210 asks for the "medical diagnosis for conditions requiring changed medical treatment regimen."
M0230/M0240 asks for the home care diagnosis. This is the reason we are providing home care.
Do you know where on the OASIS to write the diagnosis codes found on the insurance verification form? (The insurance verification form comes with the CPC when you receive the admit pack.)
Well . . .
They go under question M0190! Intake codes the inpatient diagnosis only. Remember that M0190, M0210, and M0230 can be all the same, or all different! We all know that sometimes the reason the patient was hospitalized is not necessarily the reason they need home care. Remember IMA Hhrg?
The diagnosis codes found on the insurance verification form are for the inpatient diagnosis. The home care diagnosis may be totally different!