Home Health Interpretive Guidelines for the CoPs: What You Need to Know

On November 1, 2017, CMS released the draft Home Health Interpretive Guidelines for the final Home Health Conditions of Participation (CoPs), which took effect on January 13, 2018. The draft was released for review and comment to select industry groups. The Home Health Interpretive Guidelines are intended to clarify the CoPs for both providers and surveyors in instances where the regulation may be unclear.

Update: The Final Home Health Interpretive Guidelines were released on August 31, 2018. HEALTHCAREfirst is currently reviewing the content and will provide updates to our blog shortly.

On January 12, 2018, CMS released revised survey protocols to include new G Tags for each condition and standard for the new CoPs that surveyors will use to enter survey data into the system. Additionally, CMS revised Level I and Level II standards to determine whether a deficiency is standard level or condition level. The survey process was also revised to reduce pre-survey preparation time and refocus the use of CASPER reports in the HHA sample selection. Click here to view the CMS memo for detailed information on the new G tags.

Although there is a delay in finalizing the Home Health Interpretive Guidelines, there was no further delay in the effective date of the new CoPs and surveyors are receiving the guidance needed to start surveying, so you must be compliant or taking steps to be compliant.

Home health providers are expected to demonstrate a commitment to good faith efforts to achieve compliance with the CoPs. It is anticipated that surveyors will use the draft Home Health Interpretive Guidelines and guidance under the new G Tags to start surveys under the new CoPs, however the actual regulations, not the guidelines, will determine compliance decisions during surveys. Home health agencies must meet the regulation, not the Home Health Interpretive Guidelines. The guidelines assist surveyors to better understand CMS’s intent, but they are not the regulation by which compliance determinations will be made.

According to David Wright, Director of the Quality, Safety & Oversight Group for CMS, “CMS did agree, in an abundance of caution, to defer the imposition of CMPs (civil money penalties) for one year from January 13, 2018 to January 13, 2019. This would not apply in immediate jeopardy situations and all other HHA alternative sanctions will continue to be imposed.”

What does this mean to home health providers? While it is expected that CMS and surveyors will initially approach surveys with a broad perspective rather than a strict view, you should make every effort to ensure compliance with the CoPs NOW. Check out HEALTHCAREfirst’s Home Health CoPs Resource Hub filled with information to ensure your agency is in the best position possible.

Want to learn more about how HEALTHCAREfirst can help your agency succeed with the CoPs? Contact us to schedule a quick call with one of our regulatory experts today!