Discharge Assessment
The discharge assessment is the OASIS completed when a patient is discharged from home health care, other than by death or transfer to an inpatient facility. It must be completed within 2 calendar days of the discharge date, and it captures the patient's end-of-care status that CMS compares against admission to calculate outcome measures.
Where discharge fits among OASIS time points
Discharge (reason for assessment 09) closes the OASIS record for the episode. It applies when the patient reaches goals, declines further care, moves out of the service area, or otherwise ends services while still in the community. It is not used when the patient dies at home, which has its own time point, or when the patient is admitted to an inpatient facility, which is documented with a transfer OASIS instead. The assessment must be based on an actual patient encounter and completed within 2 calendar days of the discharge date.
Why the discharge OASIS determines your outcomes
Most OASIS-based outcome measures are change scores: CMS compares start of care or resumption of care responses with discharge responses to determine whether the patient improved in areas like ambulation, self-care, and dyspnea, with risk adjustment applied. Discharge function items in Section GG feed quality reporting as well. That means the discharge assessment is half of every improvement calculation. An accurate admission assessment paired with a careless discharge assessment will erase real clinical gains from your star ratings, HHVBP performance, and Care Compare results.
Common discharge assessment pitfalls
The same errors show up in audit after audit:
- Completing the discharge OASIS from memory or chart review instead of an in-person assessment
- Understating discharge function out of caution, wiping out measured improvement
- Answers that contradict the final visit note or therapy discharge summary
- Missing the 2-calendar-day completion window after an unplanned discharge
- Failing to complete discharge planning items, medication teaching, and physician notification alongside the OASIS
Running a disciplined discharge process
Treat discharge as a planned clinical event that starts weeks earlier. Case conferences should project a discharge date, confirm goal progress, and assign who performs the final visit and assessment. The discharging clinician should score function based on observed performance at that visit, then QA should compare admission and discharge responses side by side before submission, questioning both implausible improvement and implausible flatness. Discharged-to-community and follow-up instructions deserve the same rigor, since post-discharge outcomes now flow into claims-based measures that follow the agency.
Frequently asked questions
Is a discharge OASIS required when the patient goes to the hospital?
No. An inpatient admission of 24 hours or more for other than diagnostic tests is documented with a transfer OASIS, not a discharge assessment. If the agency also ends care at that point, the transfer with discharge option applies.
How soon must the discharge assessment be completed?
Within 2 calendar days of the discharge date. It must reflect an actual assessment of the patient, typically at the final visit, not a retrospective chart review.
Do discharge OASIS answers really affect star ratings?
Yes. Improvement measures compare admission and discharge responses, so the discharge assessment directly sets measured outcomes that flow into the Quality of Patient Care Star Rating and HHVBP scoring. Systematic understatement at discharge suppresses your measured improvement.