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Home Health 2018 CoPs: Summary of Changes to Patient Rights

Posted by Melissa Cott-Webber, RN on Oct 11, 2017

Medicare's new home health Conditions of Participation go into effect in January 2018. There are multiple changes to the language of the condition regarding patient rights §484.50.  Changes to the language include the following:

Changes to language at CoP at §484.50 Patient Rights

  • The patient’s legal representative must be informed of the patient rights information prior to the start of care.
  • An HHA must provide each patient with written notice regarding the HHA’s transfer and discharge policies. This requirement was originally proposed at 484.50(d).
  • Removed the requirement that HHA administrators are expected to receive patient questions.Download 2018  Patient Rights Form
  • Clarified that a signature confirming receipt of the notice of patient rights is only required from a patient or a patient’s legal representative.
  • The HHA must provide verbal notice of the patient’s rights no later than the completion of the second visit from a skilled professional.
  • The HHA provide written notice of the patient’s rights and the HHA’s discharge and transfer policies to a patient-selected representative within 4 business days after the initial evaluation visit.
  • Replaced the term “incompetence” wherever it appears with the more precise term “lack legal capacity to make health care decisions.”
  • Clarify that patients have the right to participate in and be informed about all assessments, rather than just the comprehensive assessment.
  • Removed the requirement regarding providing a copy of the plan of care to each patient.
    Require HHAs to provide contact information for a defined group of federally-funded and state-funded entities.
  • Remove the requirement for HHAs to provide patients with information regarding HHA admission policies and clarified that the “transfer and discharge policies” are those set forth in paragraphs (1) through (7) of this standard.
  • Clarified that HHAs are responsible for making arrangements for a safe and appropriate transfer.
  • Clarified that discharge is appropriate when the physician and the HHA both agree that the patient has achieved the measurable outcomes and goals established in the individualized plan of care.
  • Clarified that the subject matter about which patients may make complaints is not limited to those subjects specified in the regulation. HHAs must investigate all such complaints.
  • Specified that HHAs must take action to prevent retaliation while a patient complaint is being investigated.
  • Specified that that circumstances of mistreatment, neglect, abuse, or misappropriation of patient property must be reported in accordance with the requirements of state law.

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