COPs go through first major revision
April 1, 1997 2 minutes read
COPs go through first major revision
The proposed revisions are the first major changes in Medicare’s home health Conditions of Participation (COPs) since the rules were originally issued in 1973.
According to the Washington, DC-based Department of Health and Human Services (DHHS), the proposal includes:
• requiring home health agencies that participate in the Medicare program to conduct criminal background checks on home health aides as a condition of employment (For more about criminal background checks, see p. 39.);
• expanding home health aide qualifications to include nurse aides who have completed appropriate nurse aide training or competency evaluation requirements;
• requiring agencies to discuss with patients the expected outcomes of care so the patients can be more involved in care planning;
• requiring agencies to coordinate all care that physicians prescribe for their patients, thus preventing the current practice of several agencies serving one patient without care coordination.
In another proposal, the DHHS says it would require home health agencies to implement OASIS (the Outcomes and Assessment Information Set), a standardized system for monitoring patient conditions and satisfaction.
The proposal would require home health agencies to perform a standardized patient assessment within 48 hours of a referral to determine the patient’s immediate care and support needs. To account for changes in the patient’s condition and measures of patient and family satisfaction, the initial assessment would have to be updated approximately every 60 days, after hospitalizations, and at discharge.
In addition, agencies would be required to evaluate their OASIS data and apply the results in their continuous quality improvement programs.
The Baltimore-based Health Care Financing Administration (HCFA) plans to implement OASIS in stages. The first stage begins when the proposal becomes the final rule. Agencies will then be required to to incorporate OASIS items into their present assessment program. HCFA later plans to publish another proposed rule requiring providers to report the OASIS data electronically.
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