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That’s a 1040!

Have you ever, you know, just for fun, went perusing the outcomes of your competitors online? Maybe trying to see if they had an advantage over you? Did you notice anything strange about the OASIS questions regarding flu vaccine?

I always do. Like just now, I went to and put in my zip code and pulled an agency beginning with A, B and C. This is what I found:

How often the home health team determined whether patients received a flu shot for the current flu season?

So, the blue bars are for agencies A, B and C. The first yellow bar is the Louisiana average and the second bar is the National Average.

What on earth is wrong with Agency C, you ask? Would it inconvenience them so very much to inquire about a flu shot?

Chances are they did. Remember, these were the first three that I pulled up. The problem lies in the OASIS question that determines this data.


The word, ‘Episode’ may not have been the best choice to describe the period of time under consideration in this question. It is a vastly overused word and maybe someone at the Head OASIS Office should have considered the likelihood of people confusing the ‘episode of care’ with an ‘episode’.

Don’t let this happen to you. Prove to the world that you care about your patients by learning the difference between an episode and an episode of care.

Episode – A 60 day period of time sometimes called a cert period. It can be cut short by death, partial episode payments and a couple of other things.

Episode of Care – an unknown period of time which begins at admission and continues until discharge unless the patient goes into the hospital. If the patient goes into the hospital, the episode of care ends at transfer and a new episode of care begins upon resumption of care.

In the example below which serves as proof that I have no graphics designer on staff, you see two plain old generic episodes separated by a pale blue line on Day 60 if the admit episode. The episodes of care are in the blue boxes. In this case, the first episode of care goes from admit until day ten of the second episode when the patient is transferred to the hospital (70 days). A second episode of care begins on resumption and ends on discharge (45 days). This means that the episode of care could be 180 days if the patient is on service for 3 episodes and has no intervening hospitalization. Alternatively, if a patient is admitted to the hospital twice in the first 6 six weeks after admission, you will have three episodes of care in one generic episode.

episode jpeg

Is that clear as mud?

Patients who were admitted to services after March 30 and discharged before October 1, should have NA checked. If your answer is, ‘No’, it will not figure into the outcomes if the patient received the flu shot from your agency in another episode or received the vaccine from another healthcare provider (Walgreen’s, their MD, etc.) which will be reflected in M1045.

Don’t shoot the messenger. I serve as the translator and obviously nobody asked me before naming the ‘episode of care’ because I would have come up with a different word to describe that period of time that took over a hundred words and a poorly constructed graphic to fully describe.

Remember, nobody likes the flu. Don’t be known as the agency who can’t be bothered to ask about flu shots. This isn’t nearly as hard as it seems but much more confusing than it has to be. Just saying. If you have any questions, please feel free to call the OASIS help desk.




2 Comments Post a comment
  1. Carol Parks #

    Thanks, Julianne. This explanation helped me understand episode/episode of care when requesting “unduplicated annual census” from an HHA for CAHPS surveying.
    -Carol Parks, Deyta

    November 18, 2013

    • Carol, when they speak of duplicated census, I always think of cloning.

      I love excel. I never use it for determining a duplicated census but if you were to sort all the names in the agency for the given time period and eliminate any patient who was there twice, you would have a unduped census. If you count every admission as one patient, you will have a duplicated census if any one patient were admitted twice.

      For the purposes you described and others, I really do not understand the value compared to the trouble it takes to find the number or even agree on how the number should be found.

      November 19, 2013

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