South West Texas Home Health Inc.

“Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This Standard is not met as evidenced by: Based on record review and interview the agency failed to code and electronically transmit each completed OASIS (data collected as part of the comprehensive assessment) assessment to the CMS system within thirty days of completing the assessment of the beneficiary for 213 of 275 assessments submitted from 05/07/24 to 05/07/25 (77.45%). This failure prevented the agency’s patient OASIS data from being made available to CMS for analysis of patient care performance. Findings included: Record review of an iQIES OASIS Error Summary Report dated 05/07/24 to 05/07/25 generated by the surveyor during pre-survey indicated the agency failed to code and electronically transmit 213 OASIS assessments data to the CMS system within thirty days of completing the assessment of the beneficiary. The iQIES OASIS Error Summary Report dated 05/07/24 to 05/07/25 indicated the assessments were for 64 patients and occurred in 5 of the 12 months. The iQIES OASIS Error Summary Report dated 05/07/24 to 05/07/25 indicated there were 147 assessments transmitted on 12/18/24 that were submitted after 30 days of completion, 21 assessments transmitted on 01/11/25 that were submitted after 30 days of completion, 16 assessments transmitted on 02/12/25 that were submitted after 30 days of completion, 25 assessments transmitted on 04/03/25 that were submitted after 30 days of completion, 3 assessments transmitted on 05/02/25 that were submitted after 30 days of completion, and 1 assessment transmitted on 05/06/25 that were submitted after 30 days of completion. Record review of an iQIES HHA Error Summary by Agency Report dated 05/07/24 to 05/07/25 indicated the agency transmitted a total number of 275 assessments of which 213 assessments were indicated as being transmitted later than 30 days after completion of the assessment. (77.45%) During an interview and record review on 5/21/25 at 1:45 p.m., the Alternate Administrator said he was responsible for transmitting OASIS assessments. The Alternate Administrator reviewed the iQIES OASIS Error Report which indicated the agency had 213 assessments transmitted late. The Alternate Administrator said OASIS assessments are usually transmitted twice monthly. The Alternate Administrator said he was aware the agency had some assessments that were transmitted late, but he was not aware it was to that extent. The Alternate Administrator said he knows the assessments should be transmitted within 30 days. The Alternate Administrator said he was not sure why the assessments were transmitted late. Attempted a telephone interview on 5/21/25 at 2:25 p.m. with the Administrator. Message left identifying surveyor and requested a return call. During a telephone interview on 5/21/25 at 2:34 p.m., the Alternate Supervising Nurse said she has never seen an error alert on her end that the assessments were late. The Alternate Supervising Nurse said the OASIS assessments should be submitted in a timely manner. The Alternate Supervising Nurse said she was unsure why the agency would have any late OASIS transmissions. During a telephone interview on 5/21/25 at 2:45 p.m., the Supervising Nurse said the agency then had 30 days to transmit the OASIS assessment. The Supervising Nurse said she had seen the OASIS Error Report and was aware the agency had late transmissions. The Supervising Nurse said the assessments have been late in the past due to a large volume of visits and corrections going back and forth. The Supervising Nurse said in the past the agency only had a couple of RN’s to complete the assessments for all the patients, but they have since hired additional RN’s to help. Record review of a “Timelines” policy dated 10/25/24 revealed, “… All completed and encoded OASIS data will be transmitted via electronic communication software that is available from CMS or software that conforms to CMS electronic record layout … from the Agency or the Agency contractor to the CMS collection site within 30 days of the M0900 date. …””