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Home Health Providers Should Prepare for Increased Scrutiny Due to Nursing Home Sector Reforms

With the unveiling of the Biden administration’s nursing home reforms, which include increased health and safety inspections by the U.S. Centers for Medicare & Medicaid Services (CMS), home health providers will need to be prepared to navigate through additional oversight.

In February, the Biden administration released a full-scale set of proposed reforms. The reforms are meant to not only “protect vulnerable residents” and health care workers, but also to crack down on “bad actors” in the nursing home industry.

“The Biden administration wants to improve the safety and quality of nursing homes. They want to improve accountability for the provision of care, and they want to improve resident and family decision making,” Trish Richardson, director of post-acute care solutions at Relias, told Home Health Care News.

The Morrisville, North Carolina-based Relias is an analytics, assessments and education firm that serves providers across the continuum of care.

The proposed reforms include establishing minimum staffing requirements, examining the growing role of private equity in the nursing home sector, promoting single occupancy, strengthening the skilled nursing facility (SNF) value-based purchasing program and initiatives related to reducing unnecessary treatments and medications.

While the new requirements are focused on SNFs, it’s likely that the increased scrutiny will impact home health agencies and other long-term care providers.

The nationwide rollout of the Home Health Value-Based Purchasing (HHVBP) Model and the public health emergency play a role in this, according to Richardson.

“That’s a significant shift for [home health providers],” she said. “There are going to be specific areas of accountability, starting in the calendar year 2023. They’re also facing heightened scrutiny because of the pandemic. There’s been an incredible shift to recover at home, and along with it, you’ve got billions in federal funding following that.”

Possible increased scrutiny around infection control and prevention, care quality issues and staffing should be top of mind for providers.

“If you think about, in general, this sense of survey readiness — it’s about, ‘What can I do every day to make sure that our staff is prepared?’” Richardson said.

For providers moving forward, it will be important to take a step back and examine how compliance is managed in their organization, coming up with a plan of correction if needed.

“I call it a moment of self-reflection,” Richardson said. “What are your strengths? What and where are your vulnerabilities? What are your biggest areas of concern? That’s when you can have an intentional conversation with your team, to be able to say we’ve got these specific areas where you can make those improvements.”

Richardson also noted that it’s crucial for providers to be aware of what resources they’ll need in order to be successful.

In general, CMS has been concerned about all aspects of quality of life, quality of care and ensuring the health and safety of patients and residents when it comes to post-acute care.

“They did have several thousand surveys in the backlog,” Richardson said. “This is something CMS talked about back in November. They want to make sure they’re getting their surveyors out there. As of today, surveyors are out there conducting their surveys related to managing COVID, or infection control practices, as they come up. They’re continuing their recertification surveys as they need to be. CMS is continuing to work with states regarding clearing the backlog, but right now they’re focused on moving forward and getting back to that regular schedule.”


This article was written by Joyce Famakinwa on May 2nd, 2022 for Home Health Care News and can be found here. Please be sure to visit for more articles written by Joyce and other quality contributors.