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Frequently Asked Questions
“I have no special talents. I’m only passionately curious.”
– Albert Einstein
Does my home health agency need to be certified?
Most home health agencies providing skilled services to homebound patients have obtained Medicare Certification. This enables agencies to provide care to Medicare recipients and receive reimbursement for services through that program. Agencies are required to follow CMS Conditions of Participation (CoP’s).
Many agencies will also seek the certification of the State Medicaid program, although Medicaid reimbursement is lower than Medicare.
Does my home health agency need to be accredited?
Accreditation is not required – it is in addition to certification. Accreditation requires compliance with additional higher standards and processes for the agency to follow.
Accrediting agencies, through “deeming authority” by CMS, have the regulatory authority to survey agencies providing home health and hospice services to determine if they meet Medicare Conditions of Participation and CMS Quality Standards.
What are the accrediting agencies for home health and hospice agencies?
The three main accrediting agencies are the Joint Commission (TJC), the Community Health Accreditation Program (CHAP), and the Accreditation Commission for Health Care (ACHC). The Joint Commission services are provided directly or through a contracted individual or program. CHAP is an accrediting body for community-based health care organizations and is not-for-profit. ACHC is an accrediting body for home health and hospice organizations and is not-for-profit.
5 Star Consultants is a Certified Consultant for ACHC.
What is ICD-10?
This acronym stands for “International Classification of Diseases”, and has been effective since October 1, 2015 in the United States. When assigning diagnosis codes, everyone in the medical community covered by HIPAA now uses ICD-10 instead of ICD-9. The greatest difference between the two versions is that, because of increased specificity, the number of codes in ICD-10 is 69,099 versus 14,315 in ICD-9.
What is HHCAHPS?
This program sends standardized surveys to home health patients to evaluate their experience. It is called the Home Health Consumer Assessment of Healthcare Provider Systems Survey. The survey consists of 32-34 questions that ask the recipient to rate their experience with a particular home health agency.
Participation in the HHCAHPS program is a requirement of Medicare certification for home health agencies. Since 2015, CMS has been rating home health agencies using a 5-star rating system. To see how 5 Star Consultants can help you improve your rating, contact us about our Quality Improvement services.
What kind of education is offered for home health and hospice agencies?
There are many opportunities for home health and hospice education. Most national and state home health associations offer home health and hospice education through conferences, training and online learning. Additionally, 5 Star Consultants holds frequent webinars as well as presentations through private education companies. In addition, Sharon Litwin is scheduled to speak at various state conferences, and the annual NAHC conference. See our “Events” page for further information.
Are there any industry associations my agency can join?
Many agencies choose to become members of home health and hospice associations in order to participate in conferences, networking events and other learning opportunities. Most states have associations dedicated to home health, hospice or both. In addition, agencies might consider joining the National Association for Home Care and Hospice or the National Hospice and Palliative Care Organization. Both of these associations offer a wealth of information regarding professional development, regulatory changes and advocacy.
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