26 Jun New Federal Regulations Passed Last Year Requiring Home Health Agencies to Provide More for Patients Have Become the Norm

May 31, 2018 

“The first major revision to federal regulations last year governing home health care agencies brought significant changes to an industry where great inconsistency was prevalent”

Last year a sweeping set of new requirements regarding patient care was put in to place. In these protocols, Home health agencies were required to become much more responsive to their patients and the caregivers they employed. This was the first significant revision of rules at the federal level governing home health care organizations in more than 25 years.

The crux of the regulations specify the conditions under which 12,600 home health agencies can participate in Medicaid and Medicare, affecting the care of over 5 million senior citizens as well as young adults with disabilities who participate in the government programs. The new rules place a focus on strengthening patient rights and making caregivers privy to more information and more involved in the patient plan of care. AARP stated that these regulations are real improvements and long overdue in an industry where there was very little oversight and consistency from agency to agency and state to state.

Another key part of the new rules require Home health agencies to coordinate all the services that patients receive and make certain that any approved treatment regimens are explained clearly and in a timely fashion to patients, caregivers, and all others affected by the services.

The rules officially went into effect in July, of 2017, and are subject to review since the administration changed, particularly given the fact that the Trump administration has reversed many Obama era regulations. The cost of implementation of these new polices falls on the backs of home health agencies, with projected cost falling somewhere between 250-300 million, a most unwelcome development to smaller agencies with tighter budgets.

While nearly a year has passed since their initial implementation, the administration is not expected to make any real changes to te policy, given there was substantial bi-partisan and industry wide consensus regarding their contents. Some have anticipated lobbyists could interfere and call for a new look at the rules, while others believe that delays in the full implementation could stretch beyond the end of 2018.

Some of the newer policies included the following:

1. Home Health services under Medicare, are available to seniors and young adults with disabilities who are confined to home and have a need, certified by a physician, for intermittent skilled nursing services or therapy, often after conditions such as a hip replacement, a heart attack or a stroke. Patients reach qualification when they have a need to improve functions (as an example, regaining the strength to walk across a room) or maintaining abilities (like having the capacity to get up from a chair), even when improvement is not considered possible. These services are not intended for patients who require full-time care because of serious illness or terminal conditions.
2. A greater focus on patient centered care. In the past, patients have been recipients of whatever services home health agencies determined were necessary, based on staff evaluations and physician opinion. Now, patients will be asked what they feel comfortable taking and being subjected to, as well as what they want to achieve, and care plans will be devised by agencies with their individual circumstances in mind.
3. More patient rights are now a focal point. Home health agencies will be under obligation to inform patients of all of their rights verbally and in writing. Additionally, the explanations must be communicated clearly, in the language that the patient can understand.
4. Greater patient awareness of rights and care decisions, notably, patients have a right to receive all the services considered necessary in their plans of care. These plans are created by agencies to address specific needs approved by a doctor, like speech therapy, occupational therapy, and the time frame of such services. Patients also have rights to lodge complaints about treatment and abuses by caregivers or doctors. The government will survey home health agencies every 3 years to ensure the rules are followed.

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