Software updates related to documentation enhancements supporting comprehensive assessment collaboration are available with Main Office Software version 6446 and Clinical Point of Care Software version 2778.
The OASIS Guidance manual states in Chapter 1 under the heading Comprehensive Assessment and Plan of Care: “Agencies may have the comprehensive assessment completed by one clinician. If collaboration with other health care personnel and/or agency staff is utilized, the agency is responsible for establishing policies and practices related to collaborative efforts, including how assessment information from multiple clinicians will be documented within the clinical record, ensuring compliance with applicable requirements, and accepted standards of practice.”…“For items requiring patient assessment, the collaborating healthcare providers must have had direct contact with the patient.”

Software enhancements include adding the new GG items to the Therapy Assessments and Progress notes allowing Therapists and the individual completing the comprehensive assessment the opportunity to collaborate. The GG items available in the Therapy Assessments and Progress notes will not populate the items in the Comprehensive OASIS assessment.
All documented responses are available in the Print Form and View screens for the records.
The Print form of Comprehensive OASIS Start of Care and Resumption of Care will include a list at the top of all of the Visits with Employee and Discipline that occurred from the SOC or ROC date up to and including the M0090 date. The Recertification OASIS print form will contain a list of visits for the 7 days prior to the M0090 date.
The Trend button (represented as a peach colored button with a picture of a white piece of paper) available at the top of comprehensive documents in the Clinical Point of Care software will contain a new option GG items. The Discharge Goals established in the GG items will be available for evaluation of patient progress in meeting the discharge goal established in the Comprehensive OASIS.

As stated in the Guidance manual Agencies are responsible for specific policies and procedures to reflect collaboration practices. These software Enhancements are meant to assist agencies in meeting collaboration practices but do not establish or endorse specific policies or procedures.

Main Office Software version 6420 dated 01/16/19 and Clinical Point of Care software version 2760 dated 01/16/19 will contain enhancements to Advanced Directives. Additional Fields have been added to the data entry fields in the Comprehensive OASIS Assessments for POA, DPOAHC, and Living Will. If documentation is present indicating a patient Emergency Contact is a POA or DPOAHC the data will automatically be indicated in the Advanced Directive documentation section.
Advanced Directive will now have a distinct section in the Plan of Care/485 data entry fields in the Risk/Support tab.
A separate distinct Advanced Directive section print below the Patient Diagnosis on the Plan of Care Print Form.

A new Communication note type, Falls, has been added to the Communication note types with Main Office software version 6381 and Clinical Point of Care software version 2731 both dated 11/12/18.
A Falls Communication note generated when a patient has a fall can be tracked in the Main office software through the Control Board or the Communication note Listing. Clinicians utilizing the Clinical Point of Care Software can count and review any entered details utilizing the Document log in order to respond to the New OASIS D item J1800 and J1900 related to any Patient falls since SOC/ROC with the corresponding number for Falls with No injury, Injury and Major Injury.

Agencies will need Main Office Software Version 6362 dated 10-01-18 prior to submitting any OASIS XML files to CMS for OASIS Assessments with a M0090 date of 10-01-18 or later to ensure the updated HIPPS Version is applied.

Agencies must ensure they are using Main Office Software Update Version 6359 or later and Clinical Point of Care Software Users must have Version 2728 to receive the updated ICD 10-CM code set that will be effective as of October 1, 2018.
The stated version updates will also include the new Grouper Version for OASIS due to the ICD 10-CM code set update.

The Print forms for Comprehensive OASIS Assessments in the Clinical Point of Care Software have been restored and are now available with version 2713 dated 07/11/18.

Beginning with Clinical Point of Care software version 2712 dated 07/10/2018 OASIS Comprehensive Assessments PRINT FORMS will not be available in the Clinical Point of Care software. This is a temporary change due to some initial programming required to be ready for OASIS D January 2019.
All OASIS Comprehensive Assessments should be Printed from the Main Office software until further notice.
A message will be posted in Allegheny Messages when the Print form has been restored for OASIS Comprehensive Assessments in the Clinical Point of Care Software.

HHC 3000 Main Office software version 6336 dated 07/03/18 will update the Physician Certification language on the Home Health Plan of care print form. Allegheny Software Publishers has been notified by some agencies that Medicare Medical Record Targeted Auditors are refusing payment due to a lack of wording on the Home Health Plan of Care indicating the Physician does not have a direct or indirect financial relationship/ownership, investment or compensation agreement with the agency. Allegheny Software Publishers has added additional wording to the certification language of the Home Health Plan of Care. Allegheny Software Publishers is aware this additional wording in not part of the five content requirements detailed for the Certification language in 42 CFR 424.22 (a)(1)(i-v). Allegheny Software Publishers does not feel this additional wording will cause any issues as it continues to ensure the five content requirements are present, but will assist agencies with positive payment determinations during targeted probes or medical record reviews.
As per regulation 42 CFR 424.22 (d) Limitation of Performance of Physician Certification and Plan of Care functions, a physician who has a financial relationship as defined by 42 CFR 411.354 with a Home health agency may not certify, recertify, conduct a Face to Face encounter or establish a patient Plan of Care.
Agencies still need to comply with regulation 42 CFR 411.354 in Subpart J relating to Financial Relationship between Physicians and Entities furnishing designated health Services, Financial relationship, compensation and ownership or investment interest.

A new Security Report is now available in the Main Office software. The new Report can be found in Set Up/ System Security/ Security Reports. The Report is called Document in/Out Date and Time. The report provides an audit trail for every time an employee edits and closes a Comprehensive Visit or Assessment in the software. The report will also total the amount of time spend on each record. The report may be run by Data range and for a specific Employee.

Enhancements to the Progress Summary Document to include accommodation with DC Medicaid 60 day Progress Summary requirements are available with Main Office software version 6316 and Clinical software version 2693 dated 05/09/18. The enhancements will utilize Dc Medicaid specific PCA Assessment and DC Medicaid Plan of Care to import data into the Summary tab, Hospitalizations and Professional Visits. The Clinical tab contains a new button to import POC will pull DC Medicaid Plan of Care orders for DC Medicaid skilled nursing and PCA service, 24 Hour Management plan and Goals.
The Prior Orders Goals and Notes will continue to allow Import of Physician orders Missed visits and Progress Notes. Items not specific to DC Medicaid services can be removed to maintain functionality for other State or agency specific requirements for Progress Summary documents.
The Summary Progress and Plan will allow the import of Narrative documentation from the last comprehensive assessment or visit for DC Medicaid, other state or agency specific requirements.
The patients current Medications will continue to be imported in the Current Medications tab.
The Progress Summary document in the Clinical Point of Care software will now have access to the Document Log, Trend button to access historical information such as vital signs, orders, medications, and Access to the patient medical information screens such as Physicians is now available from inside of the Progress Summary Document.

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