Recertification Assessment
The recertification assessment is the follow-up OASIS completed during the last 5 days of each 60-day certification period, days 56 through 60, when the patient will continue home health care into a new period. It updates the comprehensive assessment, supports the practitioner's recertification of eligibility, and informs the plan of care for the next 60 days.
How the recertification window works
Every home health certification period runs 60 days, and a patient who still needs care must be reassessed in the final 5 days of the period. The recertification OASIS documents current status: function, diagnoses, medications, risks, and progress against goals. It is deliberately narrower than a start of care assessment but still updates the full comprehensive assessment. Missing the window does not excuse the assessment; agencies complete it as soon as the omission is identified, document why it was late, and accept the survey exposure. Chronic window misses are a classic scheduling and caseload management failure.
Recertification and the practitioner
The OASIS is the agency's half of recertification. The other half belongs to the certifying practitioner, a physician or allowed practitioner (NP, PA, or CNS), who must recertify that the patient remains eligible: homebound, in need of intermittent skilled care, and under a plan of care. Recertification includes an estimate of how much longer skilled services will be required. No new face-to-face encounter is required for recertification of a continuing episode; the face-to-face requirement attaches to the start of care certification. The updated plan of care for the new period is built from the recertification assessment findings.
What recertification means under PDGM
Recertification does not reset payment mechanics, it continues them. Each new 60-day certification period contains two more 30-day PDGM payment periods, and every period after the first is classified as late timing, which generally carries lower case-mix weights than early periods. The recertification assessment refreshes the functional impairment level and supports the diagnoses carried on subsequent claims. That makes it a genuine revenue and compliance document: understated function or stale diagnoses at recert follow the episode for the next 60 days.
What good recert practice looks like
Strong agencies treat recertification as a deliberate clinical decision, not an autopilot event:
- Work from a rolling report of patients entering days 56 to 60
- Decide recert versus discharge at a case conference before the window opens
- Verify continued homebound status and skilled need with specific documentation
- Refresh medications, diagnoses, and goals rather than copying forward
- Confirm the practitioner signs the recertification and updated plan of care promptly
Frequently asked questions
When exactly must the recertification assessment be done?
During the last 5 days of the current 60-day certification period, meaning days 56 through 60 counting the start of care date as day 1 of the period. Each subsequent certification period has its own recert window at its end.
Is a new face-to-face encounter required at recertification?
No. The face-to-face encounter requirement applies to the initial certification tied to the start of care. Recertification requires the practitioner to recertify continued eligibility and estimate how much longer skilled care is needed, but not a new encounter.
What if the patient is in the hospital during the recert window?
If the patient is in an inpatient facility during days 56 to 60, the agency cannot complete a home visit assessment. Depending on the situation, the agency follows transfer and resumption of care processes or discharges the patient, and documents the circumstances. Policies should spell out this scenario so clinicians are not improvising.