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MED-PASS - Forms
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| HC1305H | | | Outcome and Assessment Information Set – DISCHARGE FROM AGENCY & DISCHARGE Summary | | This form is currently being updated to reflect the Process Measures Indicators (P) based on the March 2010 CMS Process-Based Quality Improvement Manual and to add new features based on suggestions and comments from our customers and product development partners that will make the form more valuable and easier to use. To learn more, contact the MED-PASS Home Care Team at 800-438-8884.
Click here to learn more about the form enhancements.
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.
Easy Order Option - Print and Fax Order Form | | | Features: | - 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)
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| Specifications: | | 8-5/8 x 11, 7 pages, handwritten, 100 per package | | | Related Products: | | |
| Click for information about our custom forms service | |
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