Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
In April 2022, CMS will begin publicly reporting on the Care Compare website the percentage of patients in home health care who fell and endured major injuries for each home health agency (HHA). HHAs report falls in patient assessments using the standardized Outcome and Assessment Information Set (OASIS), and CMS reports the agency fall rates calculated from these assessments. In this study, we will assess the accuracy of HHAs’ reporting of falls in OASIS. Specifically, we will use Medicare claims to identify hospitalizations due to falls with major injuries among Medicare beneficiaries in home health care. We will then assess the extent to which those falls were reported in OASIS assessments. We will describe the characteristics of beneficiaries who did not have their falls reported. Finally, we will describe the characteristics of HHAs that have particularly low reporting rates.
This addition to the OIG Work Plan can be found here.