Waivers for Home Health Care Providers: UPDATE

Home Health Agencies (HHAs)

CMS is revising its existing waiver that allows Occupational Therapists (OTs) to perform initial and comprehensive assessments beyond cases in which only therapy services are ordered by expanding it to permit Physical Therapists (PTs) and Speech Language Pathologists (SLPs) to do the same. The waiver thus permits OTs, PTs, or SLPs to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether or not the service establishes eligibility for the patient to be receiving home care.  Therapists must act within their state’s scope of practice laws when performing initial and comprehensive assessments, and access a registered nurse or other professional to complete sections of the assessment that are beyond their scope of practice.  CMS explains that the waiver is intended to provide HHAs with additional flexibility that may decrease patient wait times for the initiation of home health services.





Paid Feeding Assistants 

CMS is modifying the requirements at 42 C.F.R. §§ 483.60(h)(1)(i) and 483.160(a) regarding required training of paid feeding assistants. Specifically, CMS is allowing facilities to reduce training from a minimum of eight (8) hours to a minimum of one (1) hour.  CMS, however, is not waiving any other requirements with respect to paid feeding assistants, including the content of the required training or supervision requirements.  Given the range of topics to be covered during training, including infection control, providers should not expect to be able to fulfill the training requirements in one (1) hour and should plan accordingly.