This is Part 2 of a series on post-acute compliance
issues. Part 1 was published in the January 2018 issue of
Post-acute providers dealt with many changes in regulations that caused compliance challenges and burdens for
their operations. It became harder to operate
successfully and avoid citations and penalties in 2016 and 2017. The substantive changes
included finalizing the new home health
Conditions of Participation (CoPs), which are
the first significant revision to the home health
regulations in the last 20 years.
The home health industry prevailed in
Issues for home health agencies
getting the Centers for Medicare & Medicaid
Services (CMS) to delay the implementation
of a new payment model, called the Home
Health Groupings Model, for home health
providers. The private equity (PE)
investment in post-acute, home health,
and hospice care actively continued
in 2016 and 2017, bringing with it a
renewed interest in understanding the
multiple compliance issues to evaluate
ahead of any possible investment or
New home health CoPs take effect
January 13, 2018. CMS desired to
revise its CoPs, because “[e]nsuring
quality through the enforcement of
prescriptive health and safety standards, rather than improving the
quality of care for all patients, has
resulted in expending much of our resources
on dealing with marginal providers, rather
than on stimulating broad-based improvements in the quality of care delivered to
all patients.” Much like the long-term care
Requirements of Participation (RoPs), CMS‘s
by Todd J. Selby and Robert W. Markette, Jr.
Post-acute care compliance
issues, Part 2: Home health
» New Conditions of Participation (CoPs) require home health agencies (HHAs) to implement many changes to patient rights
and to use an objective, data-driven approach for the Quality Assurance and Performance Improvement (QAPI) requirement.
» Providers must prepare for the new CoPs based upon the wording of the regulations, but be prepared to adapt to the final
interpretive guidelines when issued.
» The Office of Inspector General (OIG) has identified vulnerabilities in payment, compliance, oversight, and quality of care
concerns, which can have significant consequences both for beneficiaries and the hospice program.
» Hospice providers are under increasing scrutiny, a world home health has known for many years.
» Private equity investors interested in investing in post-acute care businesses must understand that there are several
compliance issues to consider when evaluating any of these assets.
Todd J. Selby ( firstname.lastname@example.org) is an Attorney and Robert W.
Markette Jr. ( email@example.com) is Of Counsel at Hall, Render,
Killian, Heath & Lyman, PC in Indianapolis, IN.