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MED-PASS:  The Fine Art of Document Design 25 years

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 20-49 for $33.95 each and save 19%
  • Buy 50 or more for $31.75 each and save 24%

CMS has posted the final version of the OASIS-C1/ICD-9 data sets. The MED-PASS OASIS-C1/ICD-9 version of this form is in production and projected to be available to ship early December to help ensure our customers have time to prepare for the January 1, 2015 implementation - click here to learn more.

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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.

Prices and Fax Order Form - click here

  • 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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