If your home health agency relies on Medicaid and Medicare payments via the Centers for Medicare and Medicaid Services, or CMS, you already know the importance of COPs, or Conditions of Participation. While the regulations and guidance surrounding Conditions of Participation in a home health agency have not been updated for more than three decades, a few changes over the past few years have made a difference in daily operations.
Here’s what you need to know about COPs if you rely on Medicare and Medicaid payments.
It Starts with the Assessment
Prior to changes to the Conditions of Participation, most home health agencies had their staff nurse develop a plan of care. The care plan is crucial for overall patient care, as it provides the road map to caregivers and other staff who provide assistance to the client. However, new COP requirements dictate that the care plan must be based on a comprehensive patient assessment. The assessment must be completed when a client begins to receive services as well as when there is a significant change, like a hospital stay. Regular re-assessments will ensure the care plan is built on a foundation of current data about the patient.
If your agency does not have a thorough assessment policy and timeline, now is the time to adjust it accordingly. Remember, your care plans will become much better when you are re-evaluating the patient regularly and upon significant change.
Quality Assessment Is Crucial
Quality assessment and performance improvement should be a part of any healthcare organization, but the new CMS guidelines made it imperative for home health agencies. All home health agencies should have a formal QAPI plan and policy in place. This can include a way to track trends in order to anticipate potential changes to policy, as well as report certain quality measures.
If your home health agency does not have a formal QAPI plan in place, it’s time to do it. Designate a clinician in your agency to take over this task and begin reporting immediately.
Communication is Key
Finally, one of the cornerstones of the Conditions of Participation is reliable and timely communication regarding care plan changes or updates. Caregivers must have a reliable way to find updated care plan information while in the client’s home. Further, family members and other relevant parties must be informed of any change to the care plan in a timely manner as well.
How is communication in your home health agency? You might need to make some tweaks to your current practices in order to ensure everyone is in the loop about patient care. Perhaps using technology, like a caregiving app that can give real-time updates, is a wise investment at this time.
Keeping up with CMS guidance and COPs is an important part of your leadership role. Learn more about how to develop policies based on best practices by downloading our Guide to Mastering Home Care Management.
Article written by Haley Burress.
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