HCFA Letter on HHAs
Parent, Branches, Subunits
Introduction | Rules_&_Regulations
| Providers | Contacts | What's_Happening | Publications | Related Sites
Return
to BQA memo 99-075
HEALTH CARE FINANCING ADMINISTRATION
Chicago Regional Office, Midwest Consortium
Electronic Regional Program Letter 2000-3
DATE: January 12, 2000
FROM: HCFA, Chicago Regional Office, Division of Survey and Certification
SUBJECT: HCFA Policy on HHA Branches and Subunits - INFORMATION
TO: State Survey Agency Directors
The purpose of this memorandum is to address our national policy on approving HHA
branch offices as stated in our State Operations Manual and program
memorandum Transmittal No. 99-1 Policy Clarification: Home Health Agency Parent, Branch,
and Subunit Criteria. We are not providing any new policy on this issue, as we remain
confident that our current policy is consistent with regulatory and statutory requirements
and serves to promote quality patient care.
As you are probably aware, we received complaints from the National Association for
Home Care (NAHC) and others concerning the inconsistent application of the guidelines in
some areas of the country, as well as the imposition of prescriptive guidelines not
contained in the national policy. As a result, we were able to work on our current policy
and on the need for consistent implementation in the States. We have attached a copy of our letter to NAHC.
We became aware that there was also a need for consistency in the guidelines concerning
reciprocal agreements between State agencies when a parent requests to operate a branch
across State lines. As stated in section 2184 of the State Operations Manual, a branch
office may be located in a neighboring State if it is near enough to the parent agency to
share administration, supervision, and services on a daily basis and if the State agencies
responsible for certification in each State approve the operation.
Please continue to implement the required reciprocal agreements to assure that at least
one of the State agencies assumes responsibility for any necessary surveys of the branch.
If both State agencies are unable to come to a reciprocal agreement on assuring any
necessary surveys of the branch, the branch will not be approved.
As the regional office reviews each HHA’s request for a branch office, we’ll
consider all the national guidelines, and communicate our final decision in writing to the
parent, along with a copy to your office. If our decision is to deny the request for a
branch office, we’ll include a full range of the reasons supporting the denial, using
the model letter listed as an exhibit.
Thank you for your cooperation in promoting national consistency in our program
administration of HHAs. If you have any questions concerning this memorandum, please
contact me or your Principal Program Representative.
/s/ Charles Bennett, Branch Manager
Survey and Certification Program
Coordination and Improvement
EXHIBIT A: Model Denial Letter
Dear HHA Administrator:
This is to inform you of the Health Care Financing Administration’s decision to
deny your request to establish a branch office in (City, County, State.)
In order to be approved as a branch office of a parent HHA, an entity must meet the
regulatory requirements for a branch. These requirements are found at 42 CFR 484.2. The
branch must also meet applicable licensing or certification requirements for a branch in
the State in which it is located and the State in which the parent is located if
different. The branch office is a location or site from which an HHA provides services
within a portion of the total geographic area served by the parent agency. The regulations
require that a branch be "sufficiently close" to the parent to share
administration, supervision, and services in a manner that makes it unnecessary for the
branch to meet the conditions of participation on its own. To accomplish this, the parent
agency must be physically located so that sharing of administration, supervision, and
services with the branch can occur on a daily basis.
After a careful review, HCFA has determined that the location that you proposed as a
branch does not meet the regulatory requirements. This is because:
____The proposed location provides services in a different geographic area from the
parent HHA.
____The proposed location is not sufficiently close to the parent to share
administration, supervision and services on a daily basis.
____The proposed location does not meet State licensure or certification requirements
for a branch.
____The involved State agencies were unable to come to reciprocal agreement concerning
surveys of the branch office.
If you wish to request that this location be considered as a subunit, please
contact......
|
