The U.S. Centers for Medicare and Medicaid Services (CMS) has posted revisions to Home Health Agencies (HHA) – Appendix B of the State Operations Manual (SOM).
CMS states that it is releasing interpretive guidelines and updates to Appendix B of the SOM, because several final rules have amended the HHA Conditions of Participation (CoPs). It has made conforming revisions to the regulatory tags and interpretive guidelines. CMS is also combining the HHA survey protocol and interpretive guidelines into one document, updating Level 1 tags, and making clarifications and technical corrections to other guidance areas based on stakeholder feedback.
A summary of the changes follows:
- Retires CMS memos that are no longer applicable or have been incorporated into Appendix B.
- Adds the survey protocol for HHAs to Part I of Appendix B. Appendix B replaces older CMS memos that we are retiring and describes the requirements and procedures for conducting an HHA survey.
- Revises the Level 1 standards that surveyors must assess during a standard survey. Added three Emergency Preparedness tags to Level 1 standards. A partial extended survey is conducted when noncompliance is identified in any Level 1 Standard.
- CMS no longer identifies specific Level 2 standards; instead, when noncompliance with a Level 1 standard is identified, all remaining standards within the relevant CoP are evaluated, and a determination must be made as to the compliance with the condition.
- Revises tags to reflect updated regulatory language based on final rules and adds interpretive guidance where appropriate.
- Consolidates tags to remove redundancy.
- Adds survey procedures to multiple tags to assist surveyors in assessing compliance with the regulatory requirements.
- Adds a cross-reference to Appendix Z for the HHA emergency preparedness tags.
- Makes multiple technical and formatting revisions to fix regulatory citations, acronyms, and tag titles.
CMS is also updating the existing “Home Health Agency Basic Training” surveyor course on the Quality, Safety & Education Portal (QSEP). It anticipates that the revised surveyor training course will be available in early 2024. Currently, the training is available free of charge through the QSEP website here.
HCA will review the revisions and provide further information.