A home-health patient’s care plan can involve several professional disciplines, but responsibility for coordinating them needs an owner. CMS’s final rule published January 13, 2017 assigns clinical managers oversight of patient services and personnel in participating home-health agencies. This January 15 weekend account examines Friday’s publication, not a new Sunday decision. [2017-00283]

The final duties include making patient and personnel assignments, coordinating care and referrals, ensuring continuing assessment of needs, and ensuring that individualized care plans are developed, implemented and updated. These are agency responsibilities rather than tasks the rule leaves for patients to assemble themselves. They describe a system of oversight, not evidence that every handoff has already improved. [2017-00283]

The October 2014 proposal had put the clinical-manager role at the center of this coordination effort, including services delivered under arrangement. It would have limited the role to a qualified licensed physician or registered nurse. The final qualification list is broader: it also includes physical therapists, speech-language pathologists, occupational therapists, audiologists and social workers. That change matters when describing who can carry the responsibility. [2017-00283][2014-23895]

CMS scheduled general effectiveness for July 13, 2017, while the performance-improvement-project requirement begins January 13, 2018. These participation conditions concern Medicare and Medicaid home-health agencies, not every provider of help at home. Proposal and final rule trace one proceeding. Their immediate contribution is a clearer location for coordination duties; whether patients experience better continuity requires evidence beyond the rule itself. [2017-00283][2014-23895]

Source documents

  1. Medicare and Medicaid Program: Conditions of Participation for Home Health Agencieshttps://www.govinfo.gov/content/pkg/FR-2017-01-13/html/2017-00283.htm
  2. Medicare and Medicaid Program: Conditions of Participation for Home Health Agencieshttps://www.govinfo.gov/content/pkg/FR-2014-10-09/html/2014-23895.htm