HOME HEALTH INTERPRETIVE GUIDELINES
home health
HOME HEALTH INTERPRETIVE
GUIDELINES:
Understanding the Expectations for Compliance
1
1
OBJECTIVES
To gain an understanding of the expectation for compliance for the Medicare
Conditions of Participation
Identify how to reduce your risk for a condition level deficiency
Identify the Level 1 and Level 2 G tags
2
STANDARD- AND CONDITION-LEVEL DEFICIENCIES
Standard-level deficiencies are ACHC-only deficiencies and individual G/L tags
?
?
Not as severe
Individual, random issue vs. a systemic issue
Condition-level deficiencies result when either an entire condition is out of
compliance, multiple G tags under a single condition are out of compliance, or the
deficiency is severe
Home Healthutilize the Home Health Protocols
? Level 1 G tags
? Level 2 G tags
3
THE NEW CONDITIONS
Subpart A - General Provisions
484.1 Basis and scope
484.2 Definitions
Subpart B - Patient Care
484.40 Condition of Participation: Release of patient-identifiable OASIS information
484.45 Condition of Participation: Reporting OASIS information
484.50 Condition of Participation: Patient rights
484.55 Condition of Participation: Comprehensive assessment of patients
484.60 Condition of Participation: Care planning, coordination of services, and quality of care
484.65 Condition of Participation: Quality Assessment and Performance Improvement (QAPI)
484.70 Condition of Participation: Infection prevention and control
484.75 Condition of Participation: Skilled professional services
484.80 Condition of Participation: Home Health Aide services
4
THE NEW CONDITIONS
Subpart C - Organizational Environment
484.100 Condition of Participation: Compliance with federal, state, and local laws and regulations related to
health and safety of patients
484.102 Condition of Participation: Emergency preparedness
484.105 Condition of Participation: Organization and administration of services
484.110 Condition of Participation: Clinical records
484.115 Condition of Participation: Personnel qualifications
5
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