Early vs Late no longer is determined from the OASIS. Under PDGM the first 30 day billing period is considered to be early. Every billing period after that for the chart is considered to be Late. There can be one exception to this case. If there is not a 60 day gap between the last charts discharge date and the next charts start of care then the first 30 day billing period is then considered to be Late. There are a couple of ways to handle this in the software. The first way is to edit the start of care status record and check the box that says that the admission is Late as seen in this image.
CMS does not pay based on the Early vs Late setting that the agency sends on the claim, they will determine the value as the patient may have been previously admitted at another home health agency. CMS will adjust the HIPPS code based on the Early vs Late setting that they determine to be correct. That is why we have the second way to let our software know and that is by using the Claim Amount Settings. This allows the user to adjust the Claim Amount to be the same based on the Early vs Late that CMS paid on as seen in this screenshot:
The user can also adjust this from within NetSmart using the following screen (also - the location of care you select will drive the admission source (community or institutional) in Synergy):