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Revision of Standard Survey Definitions for Home Health Agencies

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Date: October 16, 2000 DSL-BQA-00-070

To: Home Health Agencies HHA 29

From: Otis Woods, Chief, Health Services Section

Via: Sue Schroeder, Director, Bureau of Quality Assurance

The Bureau of Quality Assurance (BQA) received the attached Electronic Regional Program Letter (ERPL) #2000-22 [below] from the federal Health Care Financing Administration, Division of Survey and Certification, Chicago Regional Office. The letter explains the federal Health Care Finance Administration’s revisions of the definition of the standard certification survey for home health agencies. The ERPL #2000-22 references two attachments (OASISMEMO (PDF, 8 KB) and HHAGUIDE (PDF, 232 KB). However, only a copy of EPRL #2000-22 is being sent with this memorandum. Copies of the two attachments are available on the BQA website at:

The document titled OASISMEMO is an April 18, 2000 HCFA cover memo to the draft Appendix B, Interpretive Guidelines for home health agencies. The document titled HHAGUIDE is an informational draft of Appendix B, Interpretive Guidelines incorporating the OASIS regulations. This draft is currently under review for final clearance and publication. We will notify all home health agencies when this information is published as final.

Please direct any questions you may have regarding OASIS data collection to Andrea Henrich, OASIS Education Coordinator, at (608) 267-3807 or Barbara Woodford, Nurse Consultant, at (715) 855-7310 (replaced by Marianne Missfeldt, (715) 836-4036). Questions related to automation may be directed to Chris Benesh, OASIS Automation Coordinator, at (608) 266-1718 or to Cindy Symons, OASIS Technical Analyst, at (608) 266-9675 [no longer available, contact Chris Benesh]. Questions related to onsite monitoring issues should be directed to Jane Walters, Supervisor Northern Unit, at (608) 267-7389 (replaced by Jan Heimbruch, (608) 243-2086), or to Juan Flores, Supervisor Southern Unit, (608) 261-7824 (replaced by Cremear Mims, (414) 227-4556).

Chicago Regional Office, Midwest Consortium
 Electronic Regional Program Letter #2000-22

DATE: August 4, 2000

FROM: HCFA, Chicago Regional Office, Division of Survey and Certification

SUBJECT: Revision of Standard Survey Definition for HHAs - ACTION

TO: State Survey Agency Directors

The purpose of this memorandum is to inform you that HCFA is changing the definition of the Medicare standard survey for home health agencies (HHAs) to include a review of the HHA’s compliance with the Outcome and Assessment Information Set (OASIS) regulations that were published in final on January 25, 1999.

Section 1891(c)(2)(C)(i)(II) of the Act requires that the standard survey include "a survey of the quality of care and services furnished by the agency as measured by indicators of medical, nursing, and rehabilitative care." Therefore, it is essential that the surveyor review the HHA’s compliance with the new comprehensive assessment regulation (which incorporates the OASIS data elements) as well as identify how the HHA defines, plans for, delivers and measures anticipated outcomes for patients. The OASIS educational coordinators will continue to check for compliance with the OASIS data transmission regulation (which requires electronic submission of OASIS information to the State) and report any concerns to the State agency surveyors. Effective immediately, the standard survey will consist of a review of the following regulations:

  • Patient rights (42 CFR 484.10);

  • Release of Patient Identifiable OASIS Information (42 CFR 484.11);

  • Federal, State, and local laws and regulations, the disclosure of ownership and management information, and accepted professional standards and principles (42 CFR 484.12);

  • Coordination of patient services (42 CFR 484.14(g));

  • Acceptance of patients, plan of care, and medical supervision (42 CFR 484.18);

  • Home health aide services (42 CFR Part 484.36);

  • Clinical records (42 CFR 484.48); and

  • Comprehensive assessment of patients (42 CFR 484.55)

Surveyors may use the working draft of the home health guidelines provided as part of a memo dated April 18, 2000, to assist them with conducting the standard survey, until the guidelines are published in final. A copy of the memo (PDF, 8 KB) and guidelines (PDF, 232 KB) are attached.

If you have any questions about these instructions, please contact your Branch Manager or the Principal Program Representative for your State.

/s/ Charles Bennett, Branch Manager, Survey and Certification Program, Coordination and Improvement

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