In today’s Question of the Week, Jennifer Osburn, Clinical Consultant answers a question related to nonbillable discharges.
Q: As I am new to this, I want to ensure I understood correctly: if we perform a nonbillable discharge on a patient, does that mean the entire episode is removed and not counted toward the calculation of our star rating? Same question but, if an episode ends with a transfer?
A: Non-billable discharges DO count toward quality measures. (This is why an in-home visit is required to assess unless the patient refuses or moves to a location the agency cannot service.)
Outcomes and Processes are measured in Quality Episodes. A quality episode begins when care begins and ends when care ends, as defined by OASIS type. SOC and ROC are the start point types and TIF, DC and DAH are end point types.
So, for example, if the patient has a SOC and then TIF, that is a quality episode. Same patient is a ROC and then DCs. That is a second quality episode. Outcomes would be assessed for both of these quality periods and would be included in your outcomes measures scores – such as improvement in oral medications, improvement in dyspnea and improvement with ADLs and Mobility measures.
Whether the DC is billable or not is not considered. However, if the patient discharges to hospice those episodes are excluded for some of the measures, like Discharge Function Score for example.
—
As a member of the HPS Alliance, you’ll have access to consulting support from HPS Staff via the member portal. For more info on how you can join the HPS Alliance, click here.
Subscribe now so you don’t miss future Questions of the Week, Monday Minutes with Melinda, and more. Click here to subscribe!