Home Health & Hospice Week

Sixty-day summary change should please while discharge proposal is impossible.

The newly proposed revisions to the Conditions of Participation will bring some relief in addition to the new burdens for home health agencies.

On the plus side, the Centers for Medicare & Medicaid Services wants to get rid of the confusing “subunit” designation for HHAs, cheers attorney Robert Markette Jr. with Hall Render in Indianapolis.

“We propose to delete the term ‘subunit’ because the distinction between the requirements that the parent HHA and a subunit must meet are minor,” CMS says in the rule published in the Oct. 9 Federal Register. “Currently, a subunit must be able, independently, to meet the CoPs. The distinction between a ‘subunit’ of a HHA and an independent HHA is that a ‘subunit’ may share the same governing body, administrator, and group of professional personnel with its parent HHA. In practice, the requirement that a ‘subunit’ must independently meet the CoPs renders this distinction moot, and we believe that an entity operating for all intents and purposes as a distinct HHA should be treated as such.”

“Most agencies had done away with the subunit concept, because nobody really understood what it was,” Markette tells Eli.

Another good change is elimination of the 60-day summary, Markette says.

“In the revised CoPs, we propose to retain and/or include process-oriented requirements that are predictive of ensuring desired outcomes,” CMS notes. “We propose to eliminate many of the process details from the current requirements where they do not achieve this goal” — including the 60-day summary.

“From a survey standpoint, I like this change, because the 60-day summary was a source of many survey headaches, as no two surveyors ever agreed on what a 60-day summary was,” Markette says.

Overall, consultant Lynda Laff with Laff Associates in Hilton Head Island, S.C. thinks “the organizational and numbering changes make the CoPs more easily ‘found,’” she says. They also “seem more logical than the way they were categorized and numbered originally,” Laff praises.