OASIS Alert

Published on Tue Dec 03, 2013 PDF

Not all episodes are created equal.

Among the 16 general conventions for completing an OASIS assessment is this: “A care episode must have a beginning and a conclusion to be considered a complete care episode.” Chapter 1 of the OASIS Guidance Manual goes on to explain that a “care episode” is also called a “quality episode.”

So, what marks the beginning and end of a care episode? A care episode starts with a start of care (SOC) or resumption of care (ROC) assessment and ends with a transfer or discharge assessment.

Important: A “care episode” or “quality episode” differs from a “payment episode,” which is sometimes referred to simply as an “episode.”

A “payment episode” generally lasts 60 days but can be shorter, depending on events that occur during the time you are caring for the patient — such as the death of a patient.

As a result, a patient can have multiple “payment episodes” within a “care episode.” “Alternatively, if a patient is admitted to the hospital twice in the first six weeks after admission, you will have three episodes of care in one generic episode,” points out Julianne Haydel of Haydel Consulting Services in Baton Rouge, La.

When it comes to calculating outcomes from items like M1040 — Influenza Vaccine: Did the patient receive the influenza vaccine from your agency for this year’s influenza season (October 1 through March 31) during this episode of care?, your understanding of the difference between a “care episode” and a “payment episode” makes all the difference in your OASIS accuracy.