Effective April 30, 2018, The Joint Commission will no longer score deemed home health organizations that fail to give their patients a written plan of care. This change is in response to recent communications from the Centers for Medicare & Medicaid Services (CMS) stating that it no longer requires the following in Condition of Participation (CoP) 484.60: “Each patient must receive an individualized written plan of care, including any revisions or additions.”
Since January 2018, The Joint Commission has been surveying home health organizations pursuing deemed status according to the language in the CoPs, as well as relevant Joint Commission requirements approved by CMS. Due to the recent communication from CMS, organizations are no longer required to provide a written individualized plan of care to each patient as currently required at PC.01.03.01, element of performance (EP) 10:
PC.01.03.01 — The organization plans the patient’s care.
EP 10: For home health agencies that elect to use The Joint Commission deemed status option: The organization provides the patient with a written individualized plan of care. The plan of care specifies the care and services necessary to meet the needs identified in the comprehensive assessment and addresses the following:
- All pertinent diagnoses
- Mental, psychosocial, and cognitive status
- Types of services, supplies, and equipment required
- The frequency and duration of visits
- The patient’s prognosis
- The patient’s potential for rehabilitation
- The patient’s functional limitations
- The patient’s permitted activities
- The patient’s nutritional requirements
- All medications and treatments
- Safety measures to protect against injury
- A description of the patient's risk for emergency department visits and hospital readmission, and all necessary interventions to address the underlying risk factors
- Patient-specific interventions and education
- Patient and caregiver education and training to facilitate timely discharge
- Goals and measurable outcomes that the organization anticipates will occur as a result of implementing and coordinating the plan of care
- Information related to any advance directives
- Identification of the disciplines involved in providing care
- Any other relevant items, including additions, revisions and deletions.
Based on the recent communication with CMS, The Joint Commission has submitted the above EP revision to CMS. Pending their review and approval, this revision will be reflected in the January 2019 Comprehensive Accreditation Manual for Home Care and the January 2019 E-dition update. (Contact: Kathy Clark, kclark@jointcommission.org)