• Recertification – No earlier than five days prior to end of certification (56 th through the 60 th day). If an ROC occurs in this time frame, then only an ROC assessment is required, along with the recertification documents such as the new POC, aide care plan, medication profile, etc. • Other Follow-Up – Defined by agency policy. CMS defines it as a change in the patient’s/client’s condition that requires a change in the plan of care and was not expected in the original plan of care. The assessment is completed within 48 hours. • Transfer to Inpatient Facility (24 hours or longer) – Patient/client is not discharged but is placed on agency “hold”. Complete OASIS transfer assessment within 48 hours of transfer or agency notification. If the patient/client remains in the hospital at the end of the episode, the patient/client must be discharged from the Agency. However, no additional OASIS assessment is required, simply a discharge summary. • Transfer to Inpatient Facility and Agency Discharges – Complete OASIS transfer form and an agency Discharge Summary within 48 hours of transfer or agency notification. • Discharge from the Agency – Complete OASIS Discharge Assessment form and an agency Discharge Summary within 48 hours of discharge. • Death at Home – Complete the OASIS Death at Home Assessment if a patient/client dies at home or en route to the hospital. Complete the assessment within 48 hours of the death or agency notification. OASIS Data Collection and Documentation Responsibilities • OASIS data items are considered “discipline neutral” which means data may be collected by an RN, PT, or ST/SLP. There are forms that include discipline specific assessment items available. The Agency may prefer that the RN complete all the OASIS assessments. • OT may collect the OASIS data when there is a continued need for OT after all other services have discharged, and OT is the qualifying service. Administrative Staff Responsibilities • Develop tracking mechanism to ensure documentation is submitted in required time frames. • OASIS assessments should be reviewed to ensure that the data is complete and timely. If it is incorrect, clinician will be contacted to correct it as soon as possible due to the time constraints on OASIS submission. It is critical that assessments be submitted timely. • OASIS transmission must follow the same sequence as the OASIS data collection. If a patient/client is transferred to an inpatient facility and returns to the Agency, the transfer OASIS must be transmitted prior to the resumption of care OASIS.
