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Medicare Home Health Conditions of Participation

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What are the Medicare Conditions of Participation?

For the first time since 1997, CMS has updated the Medicare Conditions of Participation for Home Health organizations (HH CoPs). The Home Health Conditions of Participation are required standards for organizations to participate in Medicare and Medicaid programs. These standards establish initial compliance and ongoing re-assessment during federal and state surveys and organizations with deeming authority.

Medicare’s Quality Improvement Timeline

2018

Jan 13, 2018

Implementation of the updated HH CoPs

Jul 13, 2018

Start of Quality Assurance and Performance Improvement (QAPI) CoPs

2018

2019

Jan 1, 2019

Medicare begins fines for CoPs non-compliance

Jan 2020

Anticipated start date of Home Health Groupings Model (HHGM)

2020

2022

Jan 2022

Anticipated rollout of value-based purchasing to all organizations

2018

Jan 13, 2018

Implementation of the updated HH CoPs

2018

Jul 13, 2018

Start of Quality Assurance and Performance Improvement (QAPI) CoPs

2019

Jan 1, 2019

Medicare begins fines for CoPs non-compliance

2020

Jan 2020

Anticipated start date of Home Health Groupings Model (HHGM)

2022

Jan 2022

Anticipated rollout of value-based purchasing to all organizations

What are the goals of the Medicare Conditions of Participation?

The revised Conditions of Participation emphasize organizational structure and staff oversight to ensure patients are safely and effectively receiving healthcare services. The new requirements focus on using an interdisciplinary approach to care delivery, improving the quality of patient care and utilizing organization self‑assessments.

The Three Areas Affected by the Medicare Conditions of Participation

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Care Delivery

Delivering timely services and improving patient care at the point‑of‑care

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Communication of Care

Enhancing patient, provider and cross-functional communications

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Organizational Functions

Streamlining organizational operations and increasing compliance

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