Migration
How to switch EHRs without losing a single claim
The number one reason agencies stay on an EHR they hate is fear of the switch — lost claims, dropped OASIS history, clinicians staring at a blank system mid-episode. It doesn't have to go that way. Here's the parallel-run playbook that keeps every claim moving while you change platforms.
The principle: never cut over mid-episode
The mistake that loses claims is a hard switch — turning off the old system on Friday and turning on the new one Monday, mid-episode. The safe approach is the opposite: let existing episodes finish where they started, and start only new admissions in the new system. Nothing in flight is ever interrupted.
A Business Associate Agreement must be in place before any PHI moves. With a modern vendor this is a short web form, and a sandbox tenant is provisioned within a day so your team can start training immediately on real-looking data.
Export your patient list, clinician credentials, schedules, and care plans (usually CSV) and import them. Historical OASIS records should be archived for the 7-year retention requirement — they don't need to be re-keyed, just preserved and accessible. Reconcile counts so nothing is silently dropped.
Document the first start-of-care in both systems and confirm the OASIS answers and the resulting HIPPS code match. This is your proof that the new system scores correctly before you trust it with billing.
From here, every new admission starts in the new EHR. Existing patients keep finishing their current episode in the legacy system. Two systems run side by side, but no single patient or claim is ever split across them.
Once the last legacy episodes close, cancel the old EHR. Your cost savings begin and your first invoice on the new platform runs at the agreed rate. Nothing was lost because nothing was ever interrupted.
The five things to verify before you commit
- Who does the import? The vendor should handle the patient and clinician load — not your office staff after hours.
- Does OASIS/HIPPS match in parallel? Don't move billing until you've confirmed the grouping is identical on a real assessment.
- Is historical OASIS retained? You need 7-year access for surveys and audits even after the legacy system is gone.
- Are claims ever interrupted? Confirm the new-admissions-only bridge so no episode is split.
- What does it cost to run both systems briefly? A vendor confident in the switch will often cover the overlap — Sothcare runs the first 5 skilled-HH agencies 90 days free in parallel.
A switch done this way is boring — which is exactly the goal. That's how Sothcare migrations are run: we handle the import, prove the HIPPS match in parallel, bridge on new admissions, and cut over only when the last legacy episode closes.
This guide is general educational information, not legal or compliance advice. Confirm retention and migration requirements with your accrediting body and state agency.
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