It seems Medicare is giving us a “break” when it comes to changes to OASIS in January 2020. A couple of items have been added to the recertification assessment because they are needed for calculating the new functional score–M1800 (Grooming) and M1033 (Risk for Hospitalization).
The biggest change comes from the CMS instruction that MANY items on the recertification will be made optional. Since the recertification has traditionally only included payment items (with the exception of all those GG items added in 2019), it makes sense that those items no longer have a purpose. Before you start your celebration though, think about these things:
- The CoPs require a comprehensive assessment at the recertification assessment timepoint. That means you’ll need to keep answering those items OR you can include other clinical narrative, etc to comply with the comprehensive assessment requirement.
- Remember that your next PoC for the next 60 days (2–30 day payment periods) has to be based on that comprehensive assessment.
- People ask why those items were left as part of the OASIS? Not all payers will switch to PDGM, and those items, although obsolete for the purposes of PDGM, will still continue to be utilized for payers that use an HHRG to pay.
- OASIS accuracy will remain important to your outcomes! Some agencies have been reviewing OASIS accuracy only for payment purposes. Those Star Ratings are beginning to have an impact on your bottom line. Referral sources, especially those institutions that contribute to that portion of the PDGM payment, are paying attention to those ratings and choosing not to send patients to agencies with lower ratings.
So what is your action plan? We, as part of the Briggs Healthcare company are working on a simplified version of the recertification, so that the OASIS items can be “bypassed” on traditional Medicare patients.
Selman-Holman CoDR–Coding Done Right has always done a complete OASIS review, not just the payment items. A closer look at how information is passed on to billing at the 30-day mark for the new RAP is needed. Those DC OASIS need to be looked at carefully and QAPI Plans developed to improve those scores. Selman-Holman can assist with all of these items and more!