Information Bulletin 99-12
Outcome and Assessment Information Set (OASIS)
Collection, Encoding And Transmission Resumes
This bulletin contains information for certified home health agencies regarding: new effective dates for the mandatory use, collection, encoding and transmission of OASIS data, the need to incorporate into your admission policies a notice of patient privacy rights and the changes in the application of the OASIS requirements.
In a Federal Register notice published June 18, 1999, HCFA announced new effective dates for the mandatory use, collection, encoding, and transmission of OASIS data for all Medicare/Medicaid patients receiving skilled services. The Federal Register notice which pertains to the use of OASIS begins on page 32984 of the June 18, 1999 publication and the System of Records (SOR) notice begins on page 32992.
The use of OASIS notice and the System of Records notice can be found on the HCFA OASIS website at http://www.cms.gov/oasis/.
What Are The Major Changes to OASIS?
- A standard notification to patients of their privacy rights on admission to the HHA. (These standard notifications are attached to this information bulletin)
- The addition of language in the System of Records notice explaining limitations on "routine uses" of data under the Privacy Act so that personally identifiable data will only be used where statistical information is not sufficient.
- Limiting the "routine uses" of data to other Federal and State agencies.
- Major changes to the application of OASIS to private-pay patients. Information on non-Medicare and non-Medicaid patients will not be transmitted to the State or HCFA in personally identifiable form.
- All questions on the OASIS data set will remain and be collected as indicated on the OASIS B-1 data set. One item, M0160 which was identified as a sensitive question on patient financial circumstances will not be reported to HCFA or the State.
- Acceleration of efforts to encrypt data during transmission, will provide yet another level of protection. HCFA expects to complete these efforts within a year.
- The requirement to collect, encode, and transmit OASIS data on patients receiving personal care only service, regardless of payor source is delayed until further notice.
Who Does The OASIS Requirement Apply To?
Mandatory use, collection, encoding and transmission of OASIS data applies to all Medicare/Medicaid patients receiving skilled services with the exclusion of patients under the age of 18, patients receiving pre and post partum maternity services; and patients receiving only chore and housekeeping services.
For non-Medicare/non-Medicaid patients receiving skilled services, there will be no requirement for encoding and transmission of the OASIS data until further notice, but HHAs must conduct comprehensive assessments and updates using the OASIS data items at the required time points on these patients.
For patients receiving personal care only services, regardless of payor source, HCFA is delaying the requirements regarding OASIS until further notice.
What Is The Timing Schedule For Implementation?
HCFA has announced a new schedule for OASIS data collection, encoding and transmission.
- June 18, 1999 - Federal Register publication date.
- July 19, 1999 - OASIS data collection is required on ALL patients receiving skilled care. For new patients receiving skilled care admitted on or after July, 19, 1999 a Start of Care Assessment is required; for existing patients on service with an HHA, the comprehensive assessment, including the OASIS data set, is required at the next assessment time point.
- July 19, 1999 - Encoding of the OASIS data collection is required for Medicare or Medicaid patients receiving skilled care, beginning with the first required assessment conducted on or after this date.
- Through August 18, 1999 - HHAs must send at least one "TEST" file submission to the State Agency.
- August 19, 1999 through August 23, 1999 - All data that has been submitted will be purged from the States' data management system.
- August 24, 1999 through August 31, 1999 - All "production" files must be submitted
for all data collected, encoded, and locked July 19,1999 through July 31, 1999.
NOTE: Any required assessments conducted on or after July 19, 1999 that are sent to the State prior to the transmission effective date will be purged from the database.
HHAs are advised to begin submitting production OASIS data on or after August 24, 1999 to avoid having to re-transmit required production files.
- Monthly beginning September, 1999 - On a monthly basis, all data encoded and locked through the last day of the preceding month must be transmitted to the State system by the last day of the current month. Example: All assessments encoded and locked through August 31, 1999 must be sent to the State no later than September 30, 1999.
Has Chapter 8 Of The OASIS User's Manual Been Updated?
HCFA has made some changes to the OASIS User's Manual with regard to the conventions involved in collecting and recording OASIS data in the context of the comprehensive assessment process, in particular for mental health assessments. The purpose of these changes it to clarify the definitions, instructions, and assessment strategies for selected OASIS items as follows:
- Pages 8.2 and 8.3 of the OASIS User's Manual have been modified to clarify the means of administering the OASIS items in the context of the comprehensive assessment.
- An introductory page (8.82) has been inserted into the Item-by Item Tips section regarding the assessment of mental and emotional status, to provide further clarification concerning observational and interview techniques that are effective in eliciting the needed information while minimizing burden and intrusion to the patient.
- Item-by-item tips have been changed for item M0540 and items M0560 through M0620. The purpose of these changes is to emphasize observational techniques and to provide further guidance for clinicians in assessing these characteristics especially in situations where patients refuse to answer direct questions.
The entire revised Chapter 8 of the OASIS User's Manual is available for downloading (148 pages) from the HCFA OASIS website or you may download only those pages that have changed. The HCFA OASIS website that you may access this information is at: http://www.cms.gov/oasis/
What Is The Latest Version Of The HAVEN Software That Is Available?
The Home Assessment Validation Entry (HAVEN) Version 5.0 software is now available. This software provides home health agencies with a no-cost vehicle to encode the OASIS data set, create an export file and manage a patient tracking system.
HAVEN 5.0 is the latest production version and must be used by HAVEN users to collect OASIS data. HAVEN 5.0 is fully compliant with the OASIS version 1.10 data specifications. HAVEN 5.0 has enhanced the system setup, the data entry screens, the import/export function, and the report capabilities.
You may download the software from the OASIS website, or register your request to receive a CD containing the software on the OASIS website at: http://www.cms.gov/oasis/
If you have received HAVEN as a CD-ROM, you are automatically on the mailing list to receive subsequent versions of HAVEN as a CD-ROM.
What Is The Patient Notification Of Privacy Rights?
Existing regulations at 42 CFR 484.10, Conditions of Participation: Home Health Agencies, specify that the patient has the right to be informed of his or her rights with respect to care provided by the Home Health Agency. Home Health Agency patients whose data will be collected and used by HCFA must receive a notice of their privacy rights. The privacy rights include:
- the right to be informed that OASIS information will be collected and the purpose of collection;
- the right to have the information kept confidential and secure;
- the right to be informed that OASIS information will not be disclosed except for legitimate purposes allowed by the Federal Privacy Act;
- the right to refuse to answer questions;
- the right to see, review, and request changes on their assessment.
HCFA has developed 3 separate notices to patients regarding these rights. They are titled attachments A, B & C and are included in this Information Bulletin. These notices may also be accessed on the HCFA OASIS website at: http://www.cms.gov/oasis/
Scroll down to "Please click here to view the Patient Privacy Notices."
Attachment A is the Statement of Patient Privacy Right.
Attachment B is the Privacy Act Statement - Health Care Records, and
Attachment C is the Notice About Privacy for Patients Who Do Not Have Medicare or Medicaid Coverage.
For your Medicare/Medicaid patients that you will be collecting OASIS information on, you will be required to utilize the notices in Attachments A and B. These patients are to receive this notice on admission. For those patients you have on service as of July 19, 1999 that you will be collecting OASIS information on, you will be required to give them these notices at the first required assessment that will come due for them.
For your Non-Medicare/Non-Medicaid patients that you will be collecting OASIS information on, you will be required to utilize the notice in Attachment C. These patients are to receive this notice on admission. For those patients that you have on service as of July 19, 1999 that you will be collecting OASIS information on, you will be required to give them this notice at the first required assessment that will come due for them.
The privacy statements in these notices cannot be changed. You may copy them and put them on your own stationary etc, if you wish, but the statements may not be altered.
Who Can I Call If I Have Questions?
If you have questions regarding the HAVEN software, please call the HAVEN Help Desk at:
For technical questions please call Rich Kooyer at the OASIS Help Desk.
The phone number is: (651) 201-3818 in the Twin Cities metro dialing area, or 1-800-657-3879
in other areas of the state.
E-mail address: firstname.lastname@example.org
For clinical questions about the OASIS assessment process contact the OASIS Education Coordinator at: (651) 201-4314 or please e-mail your questions to the following e-mail address: health.OASIS@state.mn.us.
We will respond to your calls and e-mails as soon as possible.
To provide clarification for all providers, as common themes of questions become evident, these questions and responses will be posted on the Minnesota Department of Health website at: http://www.health.state.mn.us/divs/fpc/profinfo.html.
Please check the HCFA OASIS website frequently for announcements, latest updates and other technical information. The website address is: http://www.cms.gov/oasis/