Home Health & Hospice Week

Keep working on compliance with new CoPs.

You could risk a survey deficiency if you don’t get the reporting relationship nailed down between your administrator and governing body, a recent Frequently Asked Questions set from Medicare indicates.

Home health agencies’ confusion about the administrator’s roles and duties under the new and revised CoPs that took effect in January 2018 is clear, since the Centers for Medicare & Medicaid Services addresses the topic in seven of its 48 questions in the recent FAQs.

One welcome clarification regards sharing an administrator and governing body, points out attorney Robert Markette Jr. with Hall Render in Indianapolis.

Question: “Can HHAs share an adminis­trator and/or a governing body?” a home health agency asks in the Jan. 23 letter to State Survey Agency Directors that lays out the FAQs.

Answer: “The CoPs do not prohibit an administrator or governing body from working at more than one home health agency,” CMS responds. “However, an HHA must ensure that the responsi­bilities of the governing body, administrator, and clinical manager (for the day-to-day operation of the HHA) are not relinquished to another person or organization on an on-going basis and must ensure the HHA maintains compliance with all Conditions of Participation. See §484.105.”

Another FAQs also clarifies that “the Administrator is appointed by the governing body but is not required to be directly supervised by the governing body.”

But another FAQ about the administrator is “an important point for providers,” Markette emphasizes

Question: “Can the Administrator report to a person appointed by the Governing Board, such as the hospital CEO?”

Answer: “The administrator must report directly to the governing body with no interme­diaries,” CMS says. “Although the HHA may have additional management and organization structures, the relationship between the administrator and governing body is a direct reporting structure. See §484.105(b).”

“Not all organizations do that,” Markette cautions of the direct reporting relationship. “They felt reporting to the board through an officer would suffice, but the FAQ specifically states no interme­diaries.” CMS said in the same in its Interpretive Guidelines as well (see story, p. 108).

Note: The FAQs letter is at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/AdminInfo19-07-HHA.pdf.