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Home Health Quality Reporting Program - Data Specifications

Guidance for explaining all the recent updates to the data specification requirements under the Home Health Quality Reporting Program.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 05, 2020

Updates

March 7, 2024

OASIS Data Specifications V3.01.0

The Outcome and Assessment Information Set Version E1 (OASIS-E1) Data Submission Specifications Version 3.01.0 are now available in the Downloads section below. This DRAFT version applies to the OASIS-E1 item set, which is scheduled for implementation on January 1, 2025. Note that the Section GG Goal items, as well as items M0110 and M2200, will be removed. Also, a new COVID-19 item, O0350, will be added. Review the OASIS-E1 Guidance manual for additional information and the Item Change and Edit Change reports within the data specifications.

August 25, 2022

OASIS V3.00.2 Errata

Errata V3.00.2 for the forthcoming version of OASIS (V3.00.1) is now available in the Downloads section below. Seven issues have been identified. These changes will be applied in the January 1, 2023 release. Please note the addition of subedit c to edit -6020, which addresses the handling of the dash [-] in the N0415 items. Also, note that the dash has been removed as an allowed value for items D0160 and A1110B.

July 06, 2022

OASIS Data Specifications V3.00.1

The Outcome and Assessment Information Set Version E (OASIS-E) Data Submission Specifications Version 3.00.1 are now available in the Downloads section below. This FINAL version applies to the OASIS-E item set, which is scheduled for implementation on January 1, 2023. There have been significant revisions to the edits for items in Sections A, D, and N. Also, several items in Section A (as well as one item in Section B and one item in Section D) now have a new response option: patient declines to respond. Review the OASIS-E Guidance manual for additional information and the Item Change and Edit Change reports within the data specifications.

November 19, 2021

OASIS V2.31.1 Errata

Errata V2.31.1 for the current production version of OASIS (V2.31.0) is now available in the Downloads section below. Four issues have been identified. It has been decided that item M1242 will now be voluntary for all RFAs. Three edits (-3891, -5123, and -5421) contained typos in the edit text and have been corrected. These changes will be applied to upcoming iQIES production releases.

June 05, 2020

OASIS Data Specifications V3.00.0

The Outcome and Assessment Information Set (OASIS) Data Submission Specifications Version 3.00.0 are now available in the Downloads section below. This DRAFT version applies to the OASIS-E item set which is scheduled for implementation on January 1, one full year following the end of the Public Health Emergency (PHE).

Note: The implementation date for ITM_SET_VRSN_CD for OASIS E and SPEC_VRSN_CD Version 3.00.0 both reflect a value of TBD within the specs. At the end of the PHE, an Errata will be issued that provides the implementation date.

Release Details

Users will have the ability to upload patient assessments in XML format and will have the ability to view their final validation report, in addition to their other reports, directly in the Internet Quality Improvement and Evaluation System (iQIES). It is important to note that the submission date and time are stored in Coordinated Universal Time or Universal Time Coordinated (UTC)., which is five hours ahead of Eastern Time (ET). The reports will display the UTC. However, prior to evaluating the submission timeliness of OASIS records for the Home Health QRP, iQIES will convert the UTC to Eastern Time.

OASIS V2.31.0 Details

The specification changes include updates to accommodate the new Functional Impairment Level Case-Mix Adjustment under the Patient-Driven Groupings Model, or PDGM, as items that were previously inactive for Reason for Assessment 04 and 05 will now be active assessments with a M0090 Completion Date of January 1, 2020, or greater. These two items are M1800 Current Grooming and M1033 Hospital Risk Items History of Falls through None of the Above. Also taken into account is the transition to PDGM for payment calculation; as a result, the Health Insurance Prospective Payment System (HIPPS) Group Code and HIPPS Version Code are no longer required for submission for assessments with a M0090 date of January 1, 2020, or greater. It is important to note that the transition period for accepting the Health Insurance Claim Number (HICN) or Railroad Retirement Board (RRB) number will end on December 31, 2019. After January 1, 2020, only the Medicare Beneficiary Identifier (MBI) will be accepted, and providers can no longer submit a HICN on assessment submissions or claims.

Please note that at this time, only certified Home Health Agencies will be onboarded to iQIES. For technical assistance, please contact our service desk at: iqies@cms.hhs.gov or by phone at: 800-339-9313.

Home Health Quality Reporting Archives

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.