OASIS Alert

A correction a day keeps angry surveyors away and the Iowa Foundation for Medical Care has made a list of the 10 most frequent errors home health agencies make.

The West Des Moines-based foundation's technical support division contracts with the Centers for Medicare & Medicaid Services to collect and process OASIS data, and has compiled a list of the most common errors in the last five quarters, ending with Sept. 30, 2001.

The top 10 errors remain remarkably consistent throughout the five time periods, so agencies' OASIS compliance efforts should start here, experts recommend.

Many of the errors that made the list result from delays in assessing and submitting OASIS data which violate Medicare home health conditions of participation requirements.

Four of the top 10 errors codes (+102, +129, +234 and +262) indicate a late assessment. "A consistent pattern in these codes could result in a deficiency during a certification survey," warns Chapel Hill, NC-based consultant Judy Adams with the Larson Allen Health Group.

If the assessment was timely, the HHA may not have locked it within the required seven days (+102), either because of a software problem or because of a backlog if it is entered manually, Adams says.

Another potential certification deficiency, says Adams, is error code +234 (OASIS not submitted for more than a month). This is less of a problem than in the early days of OASIS, she says, so if an agency is receiving this error code it should review the workflow and correct the underlying problem.

The most common error (+81) indicates a change in patient information from that previously submitted. It could result from a Medicare patient becoming newly eligible for Medicaid and thus having a new number, or from a change in HHAs.

But it also could result from typos or entering the patient's name inconsistently, Adams explains. Be as accurate as possible when first obtaining and entering patient information, and if you're unsure of the way the name is entered, compare it with a hard copy of the previous entry, she says.

Two of the errors (+1002 and +1003) indicate that the agency submitted the data in the wrong sequence. Agencies can avoid these errors by having an effective monitoring system to track OASIS submissions, experts agree.

Only three of the top 10 errors cause the system to reject the OASIS (+1000, +213 and +258), Adams says. In these situations, look at the internal systems and perhaps consult with your software vendor to track down the reasons for these delays to your cash flow, she recommends.

Agencies "that run a very tight ship" are more likely to be able to comply with assessment and submission requirements, says consultant Sherill Garvey with KPMG.

It's important for agencies to focus on the "flow of the work product" and monitoring. "Somebody needs to have the responsibility for staying on top of that aspect of the revenue cycle," Garvey reminds providers.

Editor's Note: To see the error list go to www.qtso.com/download/hha/Top10_072001.pdf.