CMS Home Health Conditions of Participation – Comprehensive Assessment

PUBLISHED: Mar 30, 2017
Relevant to: Home Health

Centers for Medicare and Medicaid Services (CMS) Conditions of Participation outlines the requirements Home Health Agencies have for the comprehensive assessment of patients. HHAs (section 484.55) are required to:

  • Conduct, document and update (within five days) a patient-specific comprehensive assessment.
  • Verify a patient’s eligibility for Medicare Home Health benefit
  • Include the following specific content for the comprehensive assessment:
    • Patient’s current health, psychosocial, functional and cognitive status
    • Strengths, goals and care preferences and patient progress toward goals
    • Patient’s continuing need for home care
    • Medical, nursing, rehabilitative, social and discharge planning needs
    • Review of all medications
    • Patient’s primary caregiver(s) and other available supports
    • Patient’s representative
    • Include items from the OASIS data set

Of particular note is that at section 484.55(c)(6)(i) and (ii) CMS now requires that the comprehensive assessment include information about caregiver willingness and ability to provide care and the caregiver's availability and schedule.

CMS’s final rule governing home health agencies was published earlier this year; see the StayAlert! Notice published on January 12, 2017 for an overview of that final rule. Included with today’s notice are example policies related to the comprehensive assessment.

For other relevant Home Health policies please see MCN Healthcare’s Home Health Policy and Procedure manual.

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