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Simplifying the Complex

OASIS Answers News

CMS Finalizes New Home Health Conditions of Participation

OASIS Answers - Tuesday, January 10, 2017

On January 9, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized the Home Health Conditions of Participation (COPs).  The new Conditions of Participation are the minimum health and safety standards a home health agency must meet to participate in the Medicare and Medicaid programs. The new COPs will be effective on July 13, 2017.

The update to the Medicare and Medicaid Conditions of Participation for home health agencies is the first update in many years, and reflects current best practices for in-home care, based on recommendations from stakeholders and medical evidence.  The changes are an integral part of CMS’ overall effort to improve quality of care furnished through Medicare and Medicaid programs and to streamline requirements for providers.

This 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 wellbeing.
  • 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.

Link to Final Rules on the Federal Register:

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