Outcome and Assessment Information Set (OASIS) Vendors

he MDS Version 1.30 Data Specifications state that the NPI in the header record should match the NPI in the body records. If the two values are different such as, the header is blank and the body record contains the NPI then Warning Message -399 is generated. 

To avoid this warning in the future, verify that the NPI number is being entered into both the header in bytes 577-586 and each body record in bytes 1626-1635 when the assessments are exported and that the two are an exact match.

 

The OASIS Version 1.50 Data Specifications state that the NPI in the header record must match the NPI in the body records. If the two values are different such as, the header is blank and the body record contains the NPI then Warning Message +294 is generated. 

To avoid this error in the future, verify that the NPI number is being entered into both the header in bytes 575-584 and each body record in bytes 769-778 when the assessments are exported and that the two are an exact match.

Section W is included on all assessments with an assessment reference date (A3a) on or after October 1, 2005, all discharge tracking forms with a discharge date (R4) on or after October 1, 2005 and all reentry tracking forms with a reentry date (A4a) on or after October 1, 2005. However, not all Section W fields are required at all times. Below is a breakdown that explains what fields in Section W are required with each Reason for Assessment (RFA).

W1 : An Optional Data Item

Assessments (RFA 01, 02, 03, 04, 05, 10 and 00)

W1 is optional on all assessments with an assessment reference date (A3a) on or after October 1, 2005.

Discharge Tracking Forms (RFA 06, 07, 08)

W1 is optional on all discharge tracking forms with a discharge date (R4) on or after October 1, 2005.

Reentry Tracking Forms (RFA 09)

W1 is optional on all reentry tracking forms with a reentry date (A4a) on or after 10/1/2005.

W2

Assessments (RFA 01, 02, 03, 04, 05, 10 and 00)

W2 is required on all assessments with an assessment reference date (A3a) between October 1 and June 30.

Discharge Tracking Forms (RFA 06, 07, 08)

W2 is required on all discharge tracking forms with a discharge date (R4) between October 1 and June 30.

Reentry Tracking Forms (RFA 09)

W2 is inactive on Reentries.

Sections W2 can be submitted with a Reentry Tracking Form but the data will not be edited or stored in the state database. Therefore, the user will not receive any error messages due to including W2 on a reentry tracking form.

W3

Assessments (RFA 01, 02, 03, 04, 05, 10 and 00)

W3 is required on all assessments with an assessment reference date (A3a) on or after October 1, 2005.

Discharge Tracking Forms (RFA 06, 07, 08)

W3 is required on all discharge tracking forms with a discharge date (R4) on or after October 1, 2005.

Reentry Tracking Forms (RFA 09)

W3 is inactive on Reentries.

Sections W3 can be submitted with a Reentry Tracking Form but the data will not be edited or stored in the state database. Therefore, the user will not receive any error messages due to including W3 on a reentry tracking form.

 

Fatal record error message +138 deals with M0180 Inpatient Discharge date. This message reads; "Inconsistent M0180 values: If (M0180) Inpatient Discharge Date "UK" is checked, then (M0180) date field must be blank. If (M0180) Date is present, then (M0180) "UK" must be unchecked (zero)."

Beginning with the OASIS July 2002 Release, an additional edit was added for this error message. This is not a change to the data specifications. In the OASIS-B1 Data Specifications (Version 1.20), note #3 under item identifier M0180_INP_DSCHG_UNKNOWN states: "If date is present in M0180_INP_DISCHRGE_DT then M0180_INP_DSCHG_UNKNOWN must = 0." Previously, this particular version note was not included in the edit check. Beginning with the most current release, if the M0180 Inpatient Discharge Date is filled in, then M0180 Discharge Date Unknown (byte 351) must have a zero.

 

Although the MDS Face Sheet item AB1 (admission date) is not included on the new MPAF form, this should not pose any new problem for you in tracking the beneficiary's admission date. As has always been the case, the AB1 admission date is only required to be entered and submitted once for each new admission. AB1 is required either on the Initial Admission Assessment record (reason for assessment at AA8a = 01) or on a Discharge Tracking Form record for a discharge occurring before completion of the admission assessment (reason for assessment at AA8a = 08). The AB1 admission date is not required on any other assessment, discharge tracking form, or reentry tracking form. The requirements concerning AB1 have not changed and facilities can continue to use their existing method for tracking the beneficiary's admission date.

Prior to July 1, 2002, Medicare PPS assessments were required to use the Full Assessment Form. The new, shorter MPAF assessment form is being implemented on July 1, 2002 as an optional form that can be used instead of the Full Assessment Form for Medicare PPS assessments. Note that the AB1 admission date is not present on either form allowed for Medicare PPS assessments (Full Assessment Form or MPAF). The absence of AB1 on the MPAF form should not require any change in facility practice concerning the admission date.

It is important to make a few additional clarifications. First, the AB1 admission date is on the Background (Face Sheet) Form. The entire Face Sheet is required on an Initial Admission Assessment. However, the entire Face Sheet (including AB1) can also be optionally submitted by the facility on any non-admission assessment (including a Medicare PPS assessment using either the Full Assessment Form or the MPAF form). When the Face Sheet is optionally submitted on a non-admission assessment, then all Face Sheet items (all Section AB and Section AC items) must be completed and submitted. Optional submission of the Face Sheet must be in "all or none" fashion. If item AB1 is completed and submitted with a non-admission assessment, then all Face Sheet items must be completed and submitted.

A second clarification has to do with the AB5a through AB5f Face Sheet items. These 6 items involve prior institutional history and have been included on the MPAF form. In the future, these items may be used in Quality Measures being developed for Medicare SNF care. The items have been added to the MPAF form to allow use of these items on PPS, non-admission assessments without requiring the entire Face Sheet. With the July 1, 2002, implementation of the MPAF, the AB5 items are optional on PPS, non-admission assessments with plans to make them required in the future. Since they are optional, the AB5 items may be left blank on a PPS, non-admission assessment. Note that if the AB5a through AB5f items are optionally submitted on a PPS, non-admission assessment, then all 6 items must be submitted. Optional submission of the AB5 items must be in "all or none" fashion.

Submission of AB5a through AB5f is not optional on a PPS assessment coupled with an Initial Admission Assessment. The entire Face Sheet (all items in Sections AB and AC) is required on all Initial Admission Assessments, including combined PPS and Initial Admission assessments.

A second clarification involves PPS assessments that are combined with comprehensive assessments. On a PPS assessment coupled with any comprehensive assessment (admission with AA8a = 01, annual with AA8a = 02, significant change with AA8a = 03, and significant correction of prior full with AA8a = 04), the MPAF form is not allowed. All comprehensive assessments require use of the Full Assessment Form, as well as the RAP Summary Form (Section V).

A final clarification involves use of the AB1 admission date for calculating when Medicare PPS assessments are due. The Medicare PPS assessment schedule is actually based on the day that Medicare Part A coverage begins for the current covered stay and not the admission date. For instance, the PPS 5-day assessment window is Day 1 through Day 5 (with a grace period from Day 6 to Day 8), where Day 1 is the start of a covered stay rather than the admission date. There may be confusion about the starting point for the PPS assessment schedule, because the start of coverage and the admission date are the same for about 75% of all covered SNF stays.

While the admission to the facility and the start of coverage usually coincide, they are different for about 25% of SNF stays. Examples are:

An existing long-term care resident in the facility has a hospitalization and then a SNF covered stay. Admission to the facility may have been years before the start of coverage. A new Initial Admission Assessment is not appropriate and the AB1 admission date will predate the start of coverage (perhaps by years).

A new resident is admitted primarily to receive SNF care. On the advice of the resident's physician, the start of SNF coverage is delayed several days to allow the resident to stabilize before receiving rehabilitation therapy. The AB1 admission date may predate the start of coverage by a few days to a few weeks.

A new resident is admitted and SNF covered care begins immediately. The resident is then rehospitalized. The resident returns to the facility and resumes covered care with a new covered stay.

In this case, the PPS assessment schedule must be restarted based on the day that covered care is resumed. The AB1 admission date may predate the resumption of covered care by a few days to several months. In all of these cases, the AB1 admission date cannot be used for setting the PPS assessment schedule in this case. In general, the PPS assessment schedule must be based on the day that the current covered stay started, rather than the AB1 admission date.

A new grouper was created to accommodate the changes for the OASIS Data Specification Version 1.60. Agencies should review the HIPPS Code and the Version Code. If the Version Code is the only difference, then no further investigation is necessary. Once the agency upgrades their software which should include the OASIS Grouper Version 02.01 and calculate the HIPPS Code, this warning message should no longer be generated on the final validation report in reference to the Version Code. If the HIPPS Codes do not match, this will require further investigation by the Home Health Agency. Note: Any assessments already locked prior to upgrading your software that have not been submitted at the time of the upgrade will also receive this warning message as the HIPPS Code was calculated prior to the upgrade of the software.

HAVEN Users: HAVEN 8.0 will be available for download after December 21, 2007 from www.qtso.com/havendownload.html

Non-HAVEN Users: Please contact your software vendor for more information.

Once a branch is created on the state system and has been provided a 10 character Branch ID  M0016 must contain a P for Parent or the 10 character Branch ID in order for the record to be accepted.

The only exception to this rule is if all branch offices have been closed and the M0090 (Completion) Date of the assessment is greater than the Closed Date of the branch(s). In this instance M0016 should contain an N for freestanding.

The OASIS Version 1.50 Data Specifications state that the NPI in the header record must match the NPI in the body records. If the two values are different such as, the header is blank and the body record contains the NPI then Warning Message +294 is generated.

To avoid this error in the future, it is recommended that you contact your vendor to ensure that the NPI number is being entered into both the header in bytes 575-584 and each body record in bytes 769-778 when the assessments are exported.

It is possible that the "cookies" setting is set to disable. If this is the case, you will receive a blank login screen rather than gaining access to CASPER. This can be corrected by enabling the "cookies" settings.

In Internet Explorer, select: 

      Tools

      Internet Options

      Security

      Custom Level

      Under the Cookies heading - change all settings to "enable".

      Then select "OK" 

There is a two-month "lag time" between the current calendar month and the latest month for which data has been calculated. The primary purpose of this "lag time" is simply to provide for the most accurate data reporting possible by allowing for corrected assessments to be submitted. For example, if the current month is April 2002, the latest data available during this month will be from January 2002 (the two month "lag time" includes the complete calendar months of February and March). This does not mean, however, that the data for January will be available on April 1st. It simply means that January data will be available during the month of April, with the exact date varying from month to month depending on data processing. It will be expected that the calculations will be performed and the data available after the second Saturday of each month.

When attempting to log in, the User ID and Password fields may go blank or you may receive a message stating "Login Denied" regardless of whether the entries were correct. If this occurs, it is recommended that you close your browser and start over. After 3 unsuccessful attempts, the User ID may be locked out of the system. If this is the case, you must call the QTSO Help Desk at 1/800-339-9313 to have your User ID and Password reset.

Acronyms can be found by going to the QTSO Website (www.qtso.com) and clicking on the Help tab located on either the dark blue bar on the left side of the page displayed and also on the light blue bar near the top of the page.

The Assessment Internal ID is used in the State System to track assessments. Even when an assessment is rejected, it is assigned an ID number. This can track the order the assessments were processed in when they were submitted to the State System.

It is possible for an agency to have zero cases to report. In this event, the report will reflect zero.

If this is not a likely scenario for your particular agency, consider the following explanation.

After investigating a few agencies with reports reflecting zero cases, it has been found that some agencies have submitted their OASIS data in one of two manners:

The agency is set up as a test agency in the state database, thus no production data was stored on the state database.

The agency submitted their OASIS data as test data rather than production data.

Although this will create "unforeseen" work for both the agency and the data processing team, it can be corrected. If your agency is setup as a test agency, contact your state agency for this correction. If your agency has submitted its "production" OASIS data as "test" data, these submissions must be resubmitted for processing.

The following list makes up the 23 PPS Items: (M0175) Discharge in Past 14 Days; (M0230) Primary Diagnosis Code; (M0240) Other Diagnosis Codes; (M0250) Therapies; (M0390) Vision; (M0420) Pain; (M0440) Wound/Lesion; (M0450) Pressure Ulcers; (M0460) Most Problematic Pressure Ulcer; (M0476) Stasis Ulcer Status; (M0488) Surgical Wound Status; (M0490) Dyspnea; (M0530) Urinary Incontinence; (M0540) Bowel Incontinence; (M0550) Bowel Ostomy; (M0610) Behavioral Problems; (M0650) Dressing Upper Extremity; (M0660) Dressing Lower Extremity; (M0670) Bathing; (M0680) Toileting; (M0690) Transferring; (M0700) Locomotion; and (M0825) Therapy Projection.

This situation was probably due to an unintended consequence of your State law. Some States prohibit the collection of HIV and/or STD diagnosis codes. To comply, the OASIS State-system is programmed to reject an HIV or STD diagnosis code. If the State system was to accept blank fields, then all assessments with blank primary diagnosis fields would represent patients with a diagnosis of HIV or STD, essentially defeating the purpose of confidentiality. The current policy is that the HHAs must enter in (M0230) the next most appropriate diagnosis code that is related to the HIV or STD code (i.e., fatigue, malaise, pneumonia, ...).