RFA Codes (01–09)

Identifies the "time point" – reason why the assessment data are being collected and reported. [...] Accurate recording of this response is important as the logic in the data reporting software will accept or reject certain data according to the specific response that has been entered for this item.

Code 1, Start of care, [...] For the start of care comprehensive assessment. A Plan of Care is being established, whether or not further visits will be provided after the start of care visit. This is the appropriate response anytime an initial HIPPS code (for a Home Health Resource Group) is required.

M0100. This Assessment is Currently Being Completed for the Following Reason [...]

1. Start of care — further visits planned

3. Resumption of Care (after inpatient stay) [...]

4. Recertification (follow-up) reassessment

5. Other follow-up [...]

6. Transferred to an inpatient facility — patient not discharged from agency

7. Transferred to an inpatient facility — patient discharged from agency [...]

8. Death at home

9. Discharge from agency

Code 3, Resumption of care, when the patient: [...] Resumes care following an inpatient stay of 24 hours or longer for reasons other than diagnostic tests. [...] Is discharged from an inpatient facility and care is resumed within the last 5 days of the 60-day certification period (that is, a recertification assessment is due). A ROC assessment, rather than a recertification assessment, is completed.

All patients who remain on service into a subsequent certification period require a follow-up comprehensive assessment (including OASIS) during the last 5 days of each 60-day period (days 56-60, counting from the start of care date) until discharged. [...] Unless the patient has been discharged, the due dates for Follow-Up (recertification) assessments are calculated from the original Start of Care date rather than from the Resumption of Care date.

The HH CoPs require a comprehensive assessment including OASIS when there is a significant change in the patient's condition. The Other Follow-up, RFA 5, is used when a patient experiences a major decline or improvement in their health status. CMS does not provide written requirements about what constitutes a significant decline or improvement. Each agency must determine its own policies regarding examples of major decline or improvement in health status and ensure that the clinical staff is adhering to these policies.

When a patient is transferred to the inpatient facility, it should be assessed if the agency anticipates the patient will be returning to service or not. If the HHA plans on the patient returning after their inpatient stay or if the patient's return to service is unsure, the reason for assessment (RFA) 6 should be completed. The patient should be discharged at the end of the current 60-day certification period if the patient has not returned to the HHA. [...] If you complete and transmit the RFA 6, Transfer to an inpatient facility - patient not discharged from agency, and the patient does not return to the care of the agency during the current 60-day certification period, no further OASIS is required. The quality episode ended with the Transfer (RFA 6) that was completed.

Code 7, Transferred to an Inpatient Facility- patient discharged from agency, if the patient is admitted to an inpatient facility for 24 hours or longer (for reasons other than diagnostic tests), and the agency does NOT anticipate the patient will be returning to care. The patient is discharged from the agency. [...] No additional OASIS discharge data are required.

Code 8, Death at home, when the patient dies:

• At home, while receiving home health services.
• Before being treated in the emergency department, or before being admitted to an inpatient facility.
• In the emergency department.
• Less than 24 hours after being admitted to an inpatient facility.
• In outpatient surgery, or, in the care of the recovery room after outpatient surgery.
• Do not use Code 8, Death at home, when the patient dies after being admitted for a qualifying inpatient facility stay.

Code 9, Discharge from agency, when the patient is discharged from the agency for any reason other than transfer to an inpatient facility or death at home. [...] This response includes transfer and discharge to another home health agency or an in-home hospice.