CMS Extends Compliance Date for New Home Health Conditions of Participation

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April 4, 2017

In February, we reported on revisions to the Conditions of Participation for Home Health Agencies (HHA) released by the Centers for Medicare & Medicaid Services (CMS).  CMS has now proposed the effective date of new Conditions of Participation (CoP) be delayed by six months.  The original effective date of the new regulations was July 13, 2017.  The recently proposed rule would delay the effective date of the new CoP until January 13, 2018.

The new CoP revisions published in January of this year were the first major revisions made to the rules in nearly 20 years.   The new rule reflects an increased focus on a patient-centered, data-driven, outcome-oriented process that continually promotes high quality patient care at all times.  The regulations represent a move away from regulatory focus on enforcement of prescriptive health and safety standards toward improving the quality of care for all patients.  Regulatory priorities are more focused on stimulating broad-based improvements in quality of care rather than expending resources on enforcing standards against marginal providers.

The new regulations purport to permit greater flexibility in how home health agencies are permitted to meet quality standards.  The new focus stresses interdisciplinary patient care and aims at creating broad-based measurable improvements in quality of care while streamlining procedural burdens that impede providers.

A few areas of change include new requirements for:

  • More continuous, integrated care process across all aspects of home health services based on a patient-centered assessment, care planning, service delivery, quality assessment, and performance improvement.
  • Use a patient-centered, interdisciplinary approach that recognizes contributions of various skilled professionals and their interactions with each other to meet the patient’s needs.
  • Emphasis on quality improvements by incorporating an outcome-oriented, data-driven, quality assessment and performance improvement program specific to each HHA.
  • Eliminate the focus on administrative process requirements that lack adequate consensus or evidence they are predictive of either achieving clinically relevant outcomes for patients or preventing harmful outcomes for patients.
  • A focus on safeguards on patient rights.

The extension of the effective date for the new regulations responds to concerns voiced by industry groups that there would be difficulties meeting the required timeline for implementing new quality assessment and improvement requirements

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