September 21 2025
OASIS Answers
Categories: HHQRP

What’s Happening with the Home Health Falls Measure?

by Kerry Termine, DPT, HCS-D, COS-C

In this 2-part series, we’ll explore the Falls with Major Injury (FMI) quality measure, its heightened importance, and its pending changes.

Respecify a Quality Measure: Means to change the details of an existing measure that may include having a new purpose or data source. Respecification of a measure may include modifying the measure numerator, denomenator, target population, and/or data source to improve the measure’s accuracy, applicability, and/or understandability.

The Falls with Major Injury (FMI) quality measure is a cross-setting measure that aims to identify the percentage of home health quality episodes in which a patient has had a fall that resulted in a major injury. In 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) did a study and compared major injuries identified on Medicare hospital claims with falls identified on J1900 – Number of Falls since SOC/ROC on the corresponding OASIS assessment for that hospital admission.

The OIG study reported that 55% of the hospitalizations due to falls resulting in major injuries were not reported in the corresponding OASIS assessment.

This report raised concerns for home health related to overall compliance, accurate OASIS data collection, and the accuracy of the Falls with Major Injury quality measure calculated from this OASIS data. As a result, the OIG recommended that the Centers for Medicare and Medicaid Services (CMS) respecify the existing FMI quality measure to ensure that home health agencies were submitting OASIS assessments at the required timepoints and reporting falls with injuries with better accuracy.

Specifically, they recommended that additional data sources, beyond the OASIS assessments, be used to improve reporting of the quality measure. The recommendations from the OIG led to a CMS Technical Expert Panel (TEP) that provided clinical and technical guidance to CMS on re-specifying the FMI measure.

Read Part 2 of this series to learn about the FMI TEP!

Questions related to OASIS coding and documentation of the OASIS responses can be sent to the Home Health Quality Help Desk: homehealthqualityquestions@cms.hhs.gov.