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Final Rule on Home Health Conditions of Participation

Friday, January 13, 2017   (0 Comments)
Posted by: Becky Carroll
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CMS Publishes Final Rule on Home Health Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) has published its final rule outlining the Medicare and Medicaid Conditions of Participation (CoP) for Home Health Agencies (HHA). This update is the first time the CoPs have been updated almost 20 years. The participation conditions govern how HHAs can qualify to participate in Medicare and Medicaid programs. The sprawling, almost 400 page document, includes a number of updates to existing polices and creates several new ones. Some highlights include:

  • The creation of a new Condition of Participation: “Care planning, coordination of services, and quality of care.” This section would specify that the HHA would have to provide the patient a plan of care that would set out the care and services necessary to meet the patient-specific needs identified in the comprehensive assessment, and the outcomes that the HHA anticipates would occur as a result of developing the individualized plan of care and subsequently implementing its elements.
  • The creation of a new Condition of Participation: “Infection prevention and control,” organized under the following three standards: (1) Prevention, (2) Control, and (3) Education. Requires that HHAs follow infection prevention and control best practices, which include the use of standard precautions, to curb the spread of disease. Under the new standard “Control,” CMS would expect the HHA to maintain a coordinated agency-wide program for the surveillance, identification, prevention, control, and investigation of infectious and communicable diseases. Additionally, under this proposal, the program would be expected to be an integral part of the agency’s QAPI program. CMS creates a new education standard within this CoP that requires HHAs provide education on “current best practices” to staff, patients, and caregivers. Creates new requirements for “skilled professional services.” Instead of specifically identifying tasks, CMS will broadly describe the expectations of the skilled professionals who participate in the interdisciplinary team approach to home health care delivery. Skilled professionals, within this context, would provide services to HHA patients directly as employees of the HHA or under a contractual agreement. Skilled professional services include physician services, skilled nursing services, physical therapy, speech-language pathology services, occupational therapy, and medical social work services.
  • Redefines the requirements, qualifications, and supervision of home health aides.

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