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CMS releases home health agency rules

January 9, 2017
by Pamela Tabar, Editor-in-Chief
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The Centers for Medicare and Medicaid Services (CMS) has issued a final rule of participation for home care agencies receiving reimbursement from Medicare or Medicaid. The rule is the latest in CMS’ momentum toward making all care settings responsible for documenting care quality against measurable health goals.

The 374-page rule defines the parameters of safety and details patient rights, including the right to submit complaints. The rule also outlines the items that should be part of a patient assessment—new additions to the list include psychosocial, functional and cognitive statuses, patient goals and measurable outcomes toward those goals, and identification of the patient’s caregivers and/or representatives.

The new rule also requires home health agencies to provide a written care plan, spelling out therapy parameters and frequencies and their measurable goals. The care plan must be reviewed by the responsible physician every 60 days or less, and updated if the goals are not being met.

Home health agencies also must document discharge or transfer summaries, just as hospitals and skilled nursing facilities do.

“Our priority is to ensure that Medicare and Medicaid beneficiaries who receive health services at home get the highest level of patient-centered care from home health agencies,” said Kate Goodrich, MD, CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality for CMS. “Today’s announcement is the first update in many years to Medicare and Medicaid home health agency rules and reflects current best practices for in-home care, based on recommendations from stakeholders and medical evidence.”

The final rule is expected to be published Jan. 13.

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