Process 485

[Yayamaya, RN]

Am totally new to home health and the administrative area.

Can someone please explain to me when a SOC is submitted what is the process it goes thru?

What is the difference between a 485 and a OASIS?

Does the 485 go the doctor?

In Medicare what goes to CPOCC?

Thanks

[caliotter3]

Don't know all the specifics, but the 485 is the plan of care signed by the doctor. When established, it is the day to day "instructions" that the nurses use to provide care to the patient. The SOC Oasis provides the backbone of the case, resulting from the initial assessment by the intake nurse. Someone else can elaborate.

[nursearoo]

SOC is the date on the 485...basically the 1st day a nurse walks through the pt's door, even if it is only an orientation...... all the dates have to match .....the only date that doesn't matter is the "initial assessment " date...the date you go out to assess the pt for services ( such as private duty nrsing, home health aide services etc) The nurse case manager is the person who generates the 485/POT ...based on the pt specific information.....you look up all the diagnosis codes for all your pt's medical diagnoses and those go on the 485....usually if you don't have an exact date of diagnoses ( some pt's or pt's parents don't know the exact date) so you would just put the SOC date.

The OASIS is for any pt 18 or over 18 yrs old.......that is done for SOC, as well as if the pt goes in the hospital and when they come out, also every 60 days, and upon discharge and also if the pt dies or is transferred to a facility permanently. Oasis is done whether pt is on Madicare or not.....

[KelRN215, BSN, RN]

SOC is the date on the 485...basically the 1st day a nurse walks through the pt's door, even if it is only an orientation...... all the dates have to match .....the only date that doesn't matter is the "initial assessment " date...the date you go out to assess the pt for services ( such as private duty nrsing, home health aide services etc) The nurse case manager is the person who generates the 485/POT ...based on the pt specific information.....you look up all the diagnosis codes for all your pt's medical diagnoses and those go on the 485....usually if you don't have an exact date of diagnoses ( some pt's or pt's parents don't know the exact date) so you would just put the SOC date.

The OASIS is for any pt 18 or over 18 yrs old.......that is done for SOC, as well as if the pt goes in the hospital and when they come out, also every 60 days, and upon discharge and also if the pt dies or is transferred to a facility permanently. Oasis is done whether pt is on Madicare or not.....

OASIS is only REQUIRED by CMS for patients who have Medicare or adults with Medicaid as primary. It is not a universal requirement to do OASIS assessments on adult patients with private insurance. Your company may do OASIS assessments on all patients 18 and older, but that's your company's requirements alone.

OP, OASIS is your assessment of the patient that is done according to Medicare guidelines. The 485 is your home health plan of care. It goes to the MD for signature. The OASIS does not go to the MD but is submitted to CMS.

[nursearoo]

Well, I'm a case manager, and we do them for ALL pt's 18 & over......probably is my company's policy....have no idea, I just know we do them for ALL 18 y.o and over .....been doing them for as long as I have been at my company...