Spotlight

Latest News:

• 07/25/12: The existing OASIS-C instrument, OMB #0938-0760, has an expiration date of July 31, 2012.  A Paperwork Reduction (PRA) package requesting approval to renew the document, with no changes, was published in the Federal Register on December 16, 2012 [Volume 76, Number 242]. On March 13, 2012 the PRA package was submitted to the Office of Management and Budget (OMB) for their statutory 60 day review period.  

  Once OMB receives a PRA package, the document is considered “Under Review” and the approval of the current document does not expire. Therefore, the expiration date for the OASIS-C instrument is automatically extended until OMB formally approves the current PRA package.  
  Home Health Agencies may continue to use the current OASIS-C instrument as is until further notice.

• 5/31/2012: It is the intent of CMS to publish errata documents for OASIS-C and related manuals twice each year, in June and in December.  Updated manual sections are made available with the December errata.  However, since the  December 2011 errata and manual updates, we have only identified minor issues affecting the OASIS-C and related manuals.  Thus, we will not publish an errata in June 2012.  Instead, all identified manual updates will be included in a December 2012 errata along with the relevant updated manual sections.

• 1/6/2012: The annual revision of the OASIS-C Guidance manual for CY2011 is completed. The revised manual and updated errata list are available under downloads on the OASIS User Manual section in the list to the left on this page. A revision of the PBQI Manual for CY2011 is also completed. The revised PBQI Manual and errata list are available under downloads on the OASIS PBQI/Process Measures section in the list to the left on this page.
  
• 1/6/2012: Revisions to Logistic Regression Models for Risk Adjustment are now available as a download on the Quality Measures section which can be accessed from the list on the left side of this page.
  
• 10/6/2011: Revisions to Technical Documentation of OASIS-C outcome, potentially avoidable event and process measures are now available as a download on the Quality Measures section which can be accessed from the list on the left side of this page.
  
• 5/27/2011: Technical Documentation of OASIS-C outcome, potentially avoidable event and process measures is now available as a download on the Quality Measures section which can be accessed from the list on the left side of this page.
  
• 1/13/2011: The revised OASIS-C Guidance Manual and errata sheet posted on 1/5/2011 contain a typographical but significant error. That error is on page F-18 in the last sentence of the last RSI bullet (#9) for Item M1340. In that sentence, M1340 should read M1350.
  
  The corrected (and updated for CY2010) manual and the corrected errata list are available under downloads on the OASIS User Manual page in the list to the left on this page. The single corrected page F-18 can also be printed individually from the zip file on the User Manual page.

• 1/5/2011: The annual revision of the OASIS-C Guidance manual for CY2010 is completed. The revised manual and updated errata list are available under downloads on the OASIS User Manual page in the list to the left on this page.
  The OASIS-B1 to OASIS-C Transition Matrix has also been updated and can be found under downloads on the Quality Measures page in the list to the left on this page.
  

• CMS has created four training videos related to OASIS-C and process measure items. They are available on YouTube as follows:
  
  The Process Based Quality Improvement (PBQI) process.
  http://www.youtube.com/watch?v=hNno1GIVAPA

  Accurately Responding to Process Items: Intervention Synopsis (M2400)
  http://www.youtube.com/watch?v=XrPJ85GQJVg

  Accurately Responding to Process Items: Plan of Care Synopsis (M2250)
  http://www.youtube.com/watch?v=H7mdobdIXr4

  Accurately Responding to Process Items: Fall Risk Assessment (M1910)
  http://www.youtube.com/watch?v=gUFeQZWQycY
   

• As of September 1, 2010 the OASIS-C Process Measure Reports are available in CASPER and QIES Workbench. A user's guide is available to providers on the OASIS State Welcome Pages and to State Agencies on the QIES to Success page under Training and Education. Please contact the QTSO Help Desk at help@qtso.com or 1 (888) 477-7876 if you have any questions concerning this information.
  
• The OBQI Manual has been revised and posted. Go to the OASIS OBQI link in the link list on the left side of this page. This page briefly describes the reports that can be used by agencies as part of their Outcome-Based Quality Improvement (OBQI) efforts - the Outcome Report, the Agency Patient-Related Characteristics Report, and the Patient Tally Report. It also holds the Outcome-Based Quality Improvement (OBQI) Manual (under Downloads below) which explains the reports in detail, discusses their use for quality improvement purposes, and provides step-by-step guidance on implementing the OBQI process.
  
• The OBQM Manual has been revised and posted. Go to the OASIS OBQM link in the link list on the left side of this page. This page briefly describes the OBQM Potentially Avoidable Event Reports and Agency Patient-Related Characteristics Reports. It also holds the Outcome-Based Quality Management (OBQM) Manual (under Downloads below) which explains these two reports in detail and discusses their use for quality monitoring purposes.
  
• The PBQI (Process Measure) Manual has been posted. Go to OASIS PBQI/Process Measures link in the link list on the left side of this page. This page holds the Process-Based Quality Improvement Manual (under Downloads) which describes the Process Quality Measure Report in detail and discusses its use for quality monitoring purposes.
  
• Home Health CAHPS Survey: For all Medicare-Certified Home Health Agencies
  Have you heard about HHCAHPS but need to know more about how to start it? Go to www.homehealthcahps.org to learn all about it. If you are a very small HHA with less than 60 HHCAHPS eligible patients annually, by June 16, 2010, you will need to submit the Exemption Form on www.homehealthcahps.org with your patient count. If you have 60 or more HHCAHPS eligible patients annually, then you will need to do a dry run in the third quarter 2010 (July, August, and/or September), and you need to contract with an HHCAHPS survey vendor listed on www.homehealthcahps.org. All Aboard for the HHCAHPS Survey in 2010!
  
• Exploration of OASIS-C Training Needs: The Centers for Medicare & Medicaid Services (CMS) welcomes feedback from the public regarding areas of education and training that would be beneficial for ongoing use of the OASIS-C instrument. Though providing this feedback is optional, information received will furnish CMS with valuable insight that will assist with the planning of future training. Please feel free to comment at OASISCTrainingFeedback@cms.hhs.gov. Though CMS welcomes feedback on an ongoing basis, receipt of this OASIS-C training information by March 22, 2010 would be greatly appreciated.
  
• The OASIS-C Guidance Manual has been posted. Go go OASIS User Manuals link in the link list on the left side. This document includes item-by-item guidance for completing OASIS-C (required for all Medicare and Medicaid home health patient assessments as of January 1, 2010) as well as other useful information.
  
• OMB approved OASIS-C on 7/27/09. The final versions of the OASIS-C data sets have been posted (9/11/2009). Go to OASIS Data Set link in the link list on the left side.

Attachment D was posted in December 2008 on the "manual" page for coding guidance associated with the Grouper Revision in January 2008.

Patient Experience: The National Implementation of the Home Health Care CAHPS Survey with Medicare-certified home health care agencies will begin in the Spring of 2009 with home health agencies that wish to voluntarily participate in the survey. See Related Links Outside CMS below.

Pay for Performance Demonstration began in 2008-2010 using 10 OASIS-Based Quality Measures (see links below - inside CMS )

CASPER Report Update: HHA Trend Analysis is available to all agencies which includes all 41 measures tracked over time and provides a breakdown on "reasons for hospitalization" as a follow up to the 8th SOW project.

Helpful Information:

Home Health Compare (HHC) - in both English and Spanish - is available at www.medicare.gov. 

New quality data are posted quarterly. Generally, the update occurs around the 3rd week of the 3rd month of each quarter. The data is usually reflective of 6 months prior.

On a monthly basis, administrative information is updated on the website. Home health agencies are responsible for ensuring that their address, phone numbers, and types of services offered are kept up to date. The last refresh for 2008 is December 18.

To verify you have the most recent data, the correct date of the update is shown under the measure on the Quality Graphs tab/page when a home health agency is selected. You will see the following statement: This information comes from the Home Health Outcome and Assessment Information Set (OASIS) during the time period.

The dates shown on the Overview and Find Criteria pages reflect changes to the formatting of those pages and not data reporting period.

Because quality measures are updated quarterly to reflect more recent data, a new workbook containing national and state outcome rates is released to coincide with each quarterly update. The workbook and instructions to use can be found in the Downloads section at http://www.cms.hhs.gov/HomeHealthQualityInits/11_HHQIOBQIMeasureCalculation.asp

Agency reports for OBQI/M calculations are ran the 2nd Saturday of each month and is available on the following Monday. For example: Current OBQI/M data is available through the month of January. On May 10 calculations will be ran to include data through the month of February. These calculations will be available to the user on May 12.

Home Health Compare quality measures

All measures are part of the larger set of data, Outcome Assessment Information Set (OASIS), collected by Medicare-certified home health agencies.

• Improvement in Ambulation/Locomotion
• Improvement in Bathing
• Improvement in Transferring
• Improvement in Management of Oral Medication
• Improvement in Pain Interring with Activity
• Acute Care Hospitalization
• Emergent Care
• Discharge to Community
• Improvement in Dyspnea
• Improvement in Urinary incontinence 
• Percentage of patients whose wounds improved or healed after an operation
• Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected

As part of home care, the nurse must assess and instruct the patient or caregiver on the signs of normal wound healing, signs and symptoms of wound infection, wounds that are getting worse, or new wounds, and the importance of calling the home health agency first with concerns about the wound. The home health agency also has a responsibility to visit the patient frequently enough to assess the wound, assist in care for the wound according to the doctor's orders, and look for any preventable problems such as pressure relief and proper nutrition.

Reporting Home Health Quality Data for Annual Payment Update - We have posted a page to describe the requirements of the Deficit Reduction Act (DRA) of 2005 for home health agencies and the tools CMS developed to support this effort.