CMS Finalizes Revised Home Health Conditions of Participation

PUBLISHED: Jan 12, 2017
Source: Centers for Medicare and Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule governing home health agencies that will improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights. These Medicare and Medicaid Conditions of Participation are the minimum health and safety standards a home health agency must meet in order to participate in the Medicare and Medicaid programs.

These changes, effective July 13, 2017, are an integral part of CMS’ overall effort to improve the quality of care furnished through the Medicare and Medicaid programs, while streamlining requirements for providers. The final rule includes:

  • A comprehensive patient rights Condition of Participation that clearly enumerates the rights of home health agency patients and the steps that must be taken to assure those rights.
  • An expanded comprehensive patient assessment requirement that focuses on all aspects of patient well-being.
  • A requirement that assures 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.
  • A requirement for an integrated communication system that 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).
  • A requirement 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.
  • A new infection prevention and control requirement that focuses on the use of standard infection control practices, and patient/caregiver education and teaching.
  • A streamlined skilled professional services requirement that focuses on 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.
  • New personnel qualifications for home health agency administrators and clinical managers.

The final rule will be published in the Federal Register on January 13, 2017. Included with today’s StayAlert! is a link to the prepublication version of the final rule. StayAlert! is reviewing the final rule and will publish additional notices along with updated policies in upcoming weeks.

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