Home Health Agency Final Conditions of Participation Revisions Released by CMS

The Center for Medicare and Medicaid Services has issued a final rule that revises and modernizes the Conditions of Participation (COP) for Home Health Agencies.  The Final Rule can be found in its entirety at: Final Home Health Rule (CMS-3819-F).

The new rules describe the conditions that Home Health Agencies (HHA) must meet in order to participate in the Medicare and Medicaid programs. The new Final Rules reflect some significant changes in the rules that apply to Medicare HHAs and require HHAs to take a solid look at their policies and procedures and operations to be certain that they comply with the new requirements by the effective date of July 13, 2017.

The changes reflected in the new rules are intended by CMS to be an integral part of an overall effort to achieve broad-based, measurable improvements in the quality of care furnished through the Medicare and Medicaid programs, while at the same time eliminating unnecessary procedural burdens on providers.

The new rules generally focus on the care delivered to patients, reflect an interdisciplinary view of patient care, allow HHAs greater flexibility in meeting quality care standards, and eliminate unnecessary procedural requirements.  The primary coverage areas of the new rules include:

  • A focus on assuring the protection and promotion of patient rights.
  • Enhancement of the process for care planning, delivery, and coordination of services.
  • Building a foundation for ongoing, data-driven, agency-wide quality improvement.
  • Expansion of patient rights requirements that enumerate the rights of home health agency patients and the steps that must be taken to assure those rights.
  • Expansion of comprehensive patient assessment requirements that focuses on all aspects of patient wellbeing.
  • A focus on measures intended to assure that patients and caregivers have written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a home health agency clinical manager.
  • New requirements to promote an integrated communication system to help ensures that patient needs are identified and addressed, care is coordinated among all disciplines, and that there is active communication between the home health agency and the patient’s physician(s).
  • New standards for a data-driven, agency-wide quality assessment and performance improvement (QAPI) program that continually evaluates and improves agency care for all patients at all times.
  • Enhanced infection prevention and control requirements with a focuses on the use of standard infection control practices, and patient/caregiver education and teaching.
  • Streamlining of some of the requirements relating to skilled professional services which emphasize appropriate patient care activities and supervision across all disciplines.
  • An expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services, such as coordinating referrals and assuring that plans of care meet each patient’s needs at all times.
  • Revisions to simplify the organizational structure of home health agencies while continuing to allow parent agencies and their branches.
  • Revised personnel qualifications for home health agency administrators and clinical managers.



Comments are closed.