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Home Health Quality Initiatives

OASIS User Manual

Part I - Implementation Manual - Revised Oct 2007

CMS recommends that HHAs, state agencies, and regional offices download the October, 2007 revision of Part 1 - Implementation Manual of the OASIS User's Manual. We recommend that each new chapter be printed so agencies can be assured that their manual is complete and accurate. The manual reflects changes from the Final Regulation, effective January 1, 2008. These zip files contain the revised chapters: Chapter 2, 3, 4, 11 and Chapter 8 and appendices.

Chapter 8 - Appendix D with coding examples will be posted at a later date.


  • Portions of the manual have been revised to reflect the changes effective 1/2008. We apologize for any inconvenience. The corrected Chapter 8 and a crosswalk table showing the final changes are available in the Downloads section.
  • The information in the revised manual is effective immediately.

Pressure Ulcer Stages Revised by NPUAP

In February 2007, the National Pressure Ulcer Advisory Panel released updated definitions of pressure ulcers and the stages of pressure ulcers, available at www.npuap.org. Effective immediately, home health agencies and clinicians may begin to utilize the 2/2007 NPUAP Pressure Ulcer Definitions and Stages in the assessment and reporting of pressure ulcers while completing the patient comprehensive assessment, and to the extent possible in reporting pressure ulcer-related OASIS items. Due to inconsistent language between the new NPUAP definitions and the current OASIS item language (e.g., a "suspected deep tissue injury" referenced in the NPUAP criteria is not currently present as a response option in the OASIS items) it will not be possible to exactly report the new pressure ulcer stages in OASIS 2008.

The updated approach to pressure ulcers will be tested in the OASIS C instrument in 2008. CMS expects that the most recent instruction provided, usually in the form of released CMS Q&As, will be followed when completing the OASIS items, therefore providers are encouraged to review and follow the Q&As posted at https://www.qtso.com/hhadownload.html

CMS Policy Change for Accurate Coding of Surgical Wounds

Based on the current advances in wound care research, CMS will follow the recently revised guidance on the Wound Ostomy Continence Nurses Society (WOCN) Guidance Document on "OASIS Skin and Wound Status M0 Items" (revised July 2006) regarding the lack of scientific evidence supporting the finding of the healing ridge in the assessment of surgical wounds closed by primary intention.

CMS encourages clinicians to follow the guidance suggested in the WOCN Guidance Document on "OASIS Skin and Wound Status M0 Items" (revised July 2006) in the assessment of surgical wounds, specifically in the assessment of M0488 Status of Most Problematic (Observable) Surgical Wound. This document is found at: http://www.wocn.org.


  • The revision date of 07/2006 is found in the document's footer.
  • This policy guidance for accurate coding of surgical wounds becomes effective 07/27/2006.
  • The zip files are common WinZip files, but do require WinZip software. Using similar software other than WinZip may not open the zip files accurately.

Part 2 - HHA System User's Guide Version 4.5 (December 2007)

This manual covers the data submission process for home health agencies, including how to access the state system that will be used for electronic data submission, procedures for submitting data (including corrections of previously submitted data), and interpretation of feedback reports from the state system. It is recommended that you download all revised zips files because Appendix A (CASPER Reporting Section) was removed from the manual.

OASIS Validation Report Messages and Description Guide

We have updated the HHA Error Message Guide to provide you with a manual which describes the types of reports and messages you can expect to see in response to your electronic submission of OASIS data. This guide is updated to reflect the OASIS-B1(01/2008) version. This manual is based on version 1.60 data specifications, available in HAVEN 8.0. This manual is designed to help you interpret your feedback reports.

Part 3 - HAVEN System Reference Manual (December 2007)

This manual covers the use of HAVEN 8.0 software, which has been developed to provide home health agencies with software for data entry, editing, and validation of OASIS data. This software uses the Version 1.60 data specifications contingent upon the reason for assessment. All assessments with a reason for assessment of 04 or 05 effective on or after December 27, 2007 and assessments with a reason for assessment of 01, 03, 06, 07, 08 or 09 effective on or after January 1, 2008 must conform to Version 1.60 specifications. This manual includes information on setting up the software, defining agency and employee information, entering patient and assessment data, and data management functions.

HHA System Users Guide (2008) [ZIP 1.5 MB]

Part I Implementation (OASIS) Manual Updates (2008) [ZIP 1MB]

OASIS Appendices (10/2007)  [ZIP 1.2 MB]

Part I Chapters (2006)  [ZIP 1.2 MB]

OASIS Appendices (2006) [ZIP 1.6 MB]

Part 2 - Error Guide (2008) [ZIP 409 KB]

Part 3 - HAVEN (2008) [ZIP 1 MB]
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