Good morning, this is Leah, Vice President for Quality Compliance and Informatics at Northern Light Home Care and Hospice. I am here today to provide updates on the home health conditions of participation, which went into effect in January 2018. However, due to our busy schedule, we are just now starting to implement some of these new processes required by the conditions of participation. If you have any questions, please feel free to email me at WrightL@northernlight.org or speak with your manager. We will do our best to answer your questions. Let's begin with the first area of focus: risk for hospitalization. It is now a requirement to document the patient's risk for emergency care or hospitalization, as well as any interventions to address those risks, on the plan of care or the 485 in home health. Starting February 1st, 2019, we will be implementing this requirement. Please watch this video to learn about all the changes before February 1st. To determine the risk for follow-up care after a hospitalization, Northern Light Health has adopted a tool called LACE. LACE stands for Length of stay, Acuity, Comorbidities, and Emergency room visits. Based on the LACE score, you will receive a recommendation on when the patient should have their physician follow-up. Intake will start receiving this information as part of the referral process from any Northern Light Health facility. This information will also be included in the assessment. When you receive a referral, you can quickly assess whether the person is at high risk for emergency department visits or rehospitalization. In our EMR system, whenever you conduct an Oasis assessment, the predictive modeling will run. This is provided by the company Ability, which analyzes the answers to your Oasis questions to determine the patient's risk. However, please note that the accuracy of the tool depends...
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Cms maintains an extensive list of conditions of participation (cop). what are these? Form: What You Should Know
Medicare and Medicaid Programs; Conditions of Participation. Mar 6, 2025 — Rural Emergency Health Care (REC) providers and rural health care consumers will have access to new ways to connect through a new consumer portal to the Medicare and Medicaid Programs: Medicare and Medicaid Dec 13, 2025 — CMS finalizes requirements for health care organizations to meet requirements of Conditions of Participation (CoPs) and Provides information on the CMS website about conditions of participation. Provides information on the CMS website about conditions of participation. Jan 9, 2025 — HHS releases a letter (PDF) explaining how the Medicare and Medicaid programs are affected by the ACA and a public comment period for this rule begins on Feb 20, 2018. HHS Release: Letter explaining conditions of participation for rural Medicare providers (7) An individual who receives services under this Subtitle from a rural Medicare provider must have (as of January 13, 2017) one of the following: (1) A certificate of eligibility from a rural medical assistance provider. (2) A Certificate of Eligibility from their state's Health Insurance Marketplace (HIP). (3) A Certificate of State Eligibility (CSE). (h) State Operations Manual: Appendix A — Survey Protocol — CMS Public Comment Period on CMS Proposed Rules Maine Medicaid Program; Medicaid Expansion Jun 8, 2025 — For a proposed rule that would modify the Maine Medicaid program, CMS released a Letter explaining the proposed requirements and inviting public comments. The Letter is available on the CMS website. Apr 24, 2025 — An application for funding under Part C of Medicaid has been filed with the CMS to expand Maine's Medicaid program, which was first implemented in 2011. If the state adopts the rules contained in the application, Maine would be able to expand Medicaid coverage to residents with incomes up to 138% of the Federal Poverty Level (GPL), subject to the requirements of the Affordable Care Act. The rule requires that the Maine Health Connect (MEMO) system include an option for the application process, but does not require that the state plan undergo a state-wide evaluation or that the state's application have any significant changes. It also prohibits Maine from using a private contracting authority or its own assessment.
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