January 11, 2017

CMS finalizes home health standards to improve care quality, bolster patient rights

Daily Briefing

    CMS on Monday announced that it has finalized a rule that sets new standards for home health agencies (HHAs).

    Final rules details

    The final rule affects the 12,600 HHAs that participate in Medicare and Medicaid and provide care to roughly five million beneficiaries. The final rule details new training requirements, competencies, and patient rights criteria HHAs must follow to participate in the program.

    According to Modern Healthcare, the final rule aims to improve care quality and bolster patient rights. CMS in writing the final rule said it sought to remove administrative measures that the agency determined did not benefit beneficiaries.

    Under the final rule, HHAs will be required to provide patients and caregivers written information detailing their clinical managers' contact information, treatments administered by the HHA, and instructions for care and medications.

    How to identify high-performing home health partners

    The final rule also outlines several new requirements HHAs must follow that aim to improve care integration and coordination. For instance, HHAs must:

    • Appoint a licensed clinician to oversee all patient care services;
    • Establish an integrated communication system that ensures care is coordinated across disciplines and between the HHA and the beneficiary's doctors; and
    • Streamline skilled professional services to ensure appropriate patient care activities and supervision.

    The final rule also includes new patient and quality assessment requirements, including:

    • An agency-wide "data-driven" quality assessment and performance improvement program; and
    • An expanded comprehensive patient assessment that focuses on the patient's wellbeing.

    In addition, the final rule details:

    • A "comprehensive" condition of participation regarding patient rights and what HHAs must do to assure those rights;
    • New HHA administrator and clinical manager qualifications; and
    • Standard infection control practices, as well as patient and caregiver education and teaching.

    The final version of the rule will be published in the Federal Register on Friday. The rule goes into effect July 13 (Whitman, Modern Healthcare, 1/9; CMS release, 1/9; Federal Register, accessed 1/10).

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