Fraud or not?

Specialties Home Health

Published

Specializes in Home care, case management.

I am being asked to complete a non-visit discharge oasis from last december that was never done. The nurse is no longer here, and it was before my hire to this company. Is this ok? I really dont think so.

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Specializes in psychiatric home care.

That is illegal

do not do it!!!

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Specializes in Functional Medicine, Holistic Nutrition.

No, this is not okay. It is considered fraud because they are asking you to back-date the discharge and you were not even working at the agency during that time. If I were you, I would be re-evaluating my employment with that agency.

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Agree with what the previous post said. If they were going to try this they should at least use an employee who was with them at the time. That would make more sense.

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Specializes in COS-C, Risk Management.

No, this is not illegal--it is perfectly fine and expected. Non-visit discharges should be completed with all questions answered exactly the same as the last OASIS, whether a SOC or a recert. Medicare REQUIRES a discharge OASIS unless the patient was transferred to an inpatient facility or died at home. Any RN can complete a non-visit discharge OASIS. The date of last visit should be the last date any clinician saw the patient and will also be the date of discharge. The only things that you will have to look up and answer is if the patient has a dx of CHF, you will need to look through the chart to find out if s/he had any symptoms during the time s/he was being seen (M1500); and if the patient had any emergent care (M2300). Everything else should be exactly the same as the last OASIS.

I know there's a Q&A to address this, I'll look for it.

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Specializes in COS-C, Risk Management.

I've tried several times to post the applicable OCCB Q&A but can't get it to post from here. I will try again when I get home, but if you need it quickly, it's in Q&A #37, situation 2.

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I would only add one thing to KateRN1's excellent response - if the last OASIS-qualified clinician who saw the patient was still employed there (RN, PT, OT), they would be responsible for the DC OASIS, and would base their responses on the condition of the patient at the time of that clinician's last visit.

She is correct that the situation as decribed is perfectly legal and in fact the only way it can be managed, assuming you are the supervisor or case manager.

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