QA Workflow and Corrections

OASIS data are used for multiple purposes, including production of quality reports for agencies, public reports on the Care Compare website, and to determine payment. Thus, it is imperative that the OASIS data that HHAs collect and submit be accurate and complete. [...] This language stipulates that the encoded OASIS data must accurately reflect the patient's status at the time the information is collected. The State survey process for HHAs may include review of OASIS data collected versus data encoded and transmitted to the CMS. [...] It follows that minimizing data errors that could affect accuracy of clinical data or outcome analyses is a necessary condition. This is the responsibility of the agency since, ultimately, agency-level quality reports reflect the data agencies input into the system.

For new admissions, review the start of care (SOC) OASIS items and compare them to other admission documentation and two or three subsequent visit notes, if they occur within the first week after SOC. [...] For example, if the SOC OASIS items indicate that the patient is fully independent in ambulation, but other documentation indicates that the patient needs assistance when walking, a data quality problem may exist. Assess for any discrepancies between sociodemographic items (for example, payment source or birth date) in addition to discrepancies in clinical assessments (ICD-10-CM codes, all clinical assessment OASIS items).

If clinical documentation must be amended, this is done according to agency policy. Any corrections to OASIS data in the clinical record must also be reflected in the OASIS database maintained by the agency, and if data submission has already occurred, a correction must be transmitted to CMS.

The following two processes have been established to correct records that have been accepted into iQIES: [...] A Modification record should be used when a record has been accepted into iQIES, but the information in the record contains clinical errors or errors to non-key fields. [...] An Inactivation record should be used when a record has been accepted into iQIES, but the corresponding event did not occur or information in ANY of the key fields is erroneous. Users are not allowed to change data in key fields. If data in the key fields in the current record are inaccurate, the current record must be inactivated, and a new replacement record should be submitted. Effective January 1, 2020, HHAs have 24 months from the assessment target date to submit, modify, or inactivate OASIS records.