Home Health Patient Tracking Sheet
Gregg Moore
Western Governors University

Home Health Patient Tracking Sheet Field Name | Field Type(OASIS-C Data, n.d.) | Field Size(OASIS-C Data, n.d.) | Definition(OASIS-C Data, n.d.) | Allowable Values/ Edits(OASIS-C Data, n.d.) | CMS Certification # | Number | 6 | Specifies the agency’s Centers for Medicare and Medicaid Services (CMS) certification number (CCN/Medicare provider number). | | If the HHA has a CMS Certification number, it must be entered in this field. Otherwise enter spaces. | Branch State | Text | 2 | Specifies the State where the agency branch office is located. | | Branch ID # | Text | 10 | Specifies the branch identification code, as assigned by CMS. The identifier consists of 10 digits – the State code as the first two digits, followed by Q (upper case), followed by the last four digits of the current Medicare provider number, ending with the three-digit CMS-assigned branch number. | If the assessment was performed by an HHA which has no branches or by a subunit which has no branches, then M0016_BRANCH_ID must contain the following: "N " (N followed by 9 spaces). This indicates that the assessment was completed by an HHA or subunit which has no branches. | National Provider Identifier | Number | 10 | Identifies the physician who will sign the Plan of Care | Leave blank (spaces) if a referring physician National Provider ID (NPI) is not applicable. | Patient ID # | Number | 20 | Specifies the agency-specific patient identifier. | | Start of Care Date | Date | 8 | Specifies the start of care date, which is the date that the first reimbursable service is delivered. | *1. This field must contain a valid date and cannot be blank. | Resumption of Care Date | Date | 8 | Specifies the date of the first visit following an inpatient stay by a patient receiving service from