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MED-PASS:  The Fine Art of Document Design

Outcome and Assessment Information Set - DISCHARGE FROM AGENCY & DISCHARGE Summary - 100/pack


Availability: In stock

Price: $41.50
  • Buy 5-9 for $38.00 each and save 9%
  • Buy 10-19 for $36.00 each and save 14%
  • Buy 20-39 for $36.00 each and save 14%
  • Buy 40 or more for $33.95 each and save 19%

The new OASIS-C1/ICD-9 Version item set becomes effective January 1, 2015.  Upon approval of the current draft version of the OASIS-C1/ICD-9 item set by CMS, MED-PASS will promptly complete production of the OASIS-C1/ICD-9 version of the Outcome and Assessment Information Set - DISCHARGE FROM AGENCY & DISCHARGE Summary.

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Custom Forms for Your Agency’s Custom Needs

·   Add your agency’s name

·   Tailor to specific agency needs  



This new addition to the OASIS line incorporates the exclusive MED-PASS two-forms-in-one color-coding to document Discharge from Agency and Discharge Summary. The form meets the new OASIS-C and the Medicare CoPs requirements for Discharge Summary.

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  • Pages 1-6 capture Discharge from Agency
  • Page 7 documents the Discharge Summary on a two-part carbonless form (original for the physician and a copy to remain attached to the Discharge from Agency)
  • Patient Tracking Sheet Update
  • Outcome Measures Indicator (marked with symbol)
  • Home Health Compare Quality Indicators (marked with symbol)
Size 8-5/8 x 11
Unit Package of 100
Number of Pages 7
Other Info Handwritten
Hole Punch 5 holes left, 5 holes top

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