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Home Health Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) have finalized new Conditions of Participation ("CoPs") for home health agencies ("HHAs") that will become effective on January 13, 2018. These CoPs represent the first major update to the rules governing HHAs in roughly 20 years.

CMS published proposed rules in October 2014. HHAs responded with numerous comments suggesting that a significant amount of time would be needed to adjust resource allocation, staffing, and infrastructure in order to implement the CoPs. Consequently, CMS agreed to delay the effective date for the CoPs first to July 13, 2017 and later to January 13, 2018.

Although the rules become effective on January 13, 2018, CMS will not impose Civil Monetary Penalties on not-yet-compliant HHAs between this date and January 13, 2019, absent an Immediate Jeopardy situation.

The finalized CoPs and draft Interpretative Guidelines ("IGs") comprise significant additions or reforms in four principal areas: Patient Rights, Care Planning, Quality Assessment and Performance Improvement ("QAPI"), and Infection Control and Prevention.

Among the more important updates are requirements that HHAs implement an integrated communication system, place a licensed clinician in charge of all patient care services, and provide patients or their representatives with a written notice of clearly stated comprehensive patient rights in a language the patient understands.

It will be critical for HHAs in the coming months to evaluate and retool their business practices in order to comply with these new CoPs. Please do not hesitate to reach out with any questions concerning the nature or effect of these regulations. 

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