A single, accurate medication list can prevent harm, yet it’s often the messiest part of home visits. We unpack how to turn a kitchen-table pile of bottles into a clear, living record that protects patients, reduces polypharmacy, and keeps agencies compliant. Drawing on decades at the bedside and in surveys, we walk through the moments where discrepancies hide—transitions between providers, “as needed” meds, herbals and supplements, dose tweaks after a clinic visit—and show how to bring everything into alignment with orders and what’s actually in the home.

View CHAP's new resource: Medication Reconciliation in Home-Based Care

We get specific about what good medication reconciliation looks like in home health and hospice: verify at every visit, include non-covered and OTC products, and escalate discrepancies to the prescriber right away. You’ll hear why misalignment across the home list, the medication profile, and facility records is a top CMS deficiency and how it can escalate to immediate jeopardy when safety is at risk. We also dig into the April 2024 Home Health CoP interpretive update that lets agencies define who performs medication reviews based on scope and policy, while underscoring the nonnegotiable goal: a timely, accurate, and complete list.

Education and tools make the difference. We share practical strategies for teach-back, multilingual materials, and adapting for hearing or vision limits. We cover the Beers Criteria for older adults, ISMP resources, safe storage and disposal, and tech that improves adherence—delivery services, synchronized refills, pre-filled packs, and smart dispensers. Expect actionable checklists, questions to ask on every visit, and a reminder to have patients carry a current list to appointments and during any transition of care.

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The FY2026 Hospice Final Rule brings positive changes with a 2.6% payment increase and significant regulatory clarifications that reduce administrative burden for providers nationwide. Jennifer Kennedy and Kim Skehan discuss critical updates affecting hospice operations, with special focus on the imminent HOPE assessment implementation.

• 2.6% national payment increase for hospices with cap amount set at $34,465.34
• Regulatory clarification allowing any physician member of the IDG to complete certification of terminal illness
• Face-to-face attestation requirements simplified, eliminating need for separate documentation
• HOPE implementation confirmed for October 1st with data submission through iQIEs system
• 90% compliance threshold remains in effect with potential 4% payment reduction for non-compliance
• Final date for HIS corrections is February 5, 2026
• CMS holding on decisions regarding interoperability and deregulation requests

Providers should evaluate the financial impact of wage index changes, update policies to align with regulatory modifications, and ensure readiness for HOPE implementation through comprehensive staff training.

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CMS has proposed significant DME regulation changes in the 2026 Home Health Payment Update Rule that focus on combating fraud, improving supplier compliance, and enhancing efficiency through increased oversight and expanded requirements. The proposed changes would dramatically impact DME operations through annual accreditation surveys, expanded competitive bidding, and enhanced data reporting requirements.

• Annual accreditation surveys instead of the current three-year cycle would increase costs and operational burden
• Expanded competitive bidding to include continuous glucose monitors, insulin pumps, and certain medical supplies
• Prior authorization exemption process for providers with 90% or higher claim approval rates
• Enhanced oversight requirements and increased data submission for both providers and accrediting organizations
• Significant financial impact through decreased reimbursement rates paired with increased costs
• Comments are due by August 29, 11:59 PM

We strongly encourage DME providers to review the proposed rule and submit comments with data, beneficiary stories, and constructive suggestions. Visit the CHAP website for a summary of DME provisions or contact your state and national associations for guidance in developing your comment letter.

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A massive regulatory overhaul looms on the horizon for home health agencies. The proposed Calendar Year 2026 Home Health Payment Update rule spans nearly 600 pages, packed with changes that extend far beyond payment adjustments.

• Proposed expansion of face-to-face encounter policy to allow not just physicians but also NPs, CNSs, and PAs to perform encounters regardless of prior patient relationship
• CMS plans to remove COVID-19 vaccine reporting measure and four social determinants of health assessment items from OASIS data collection
• Proposed shorter HHCAHPS survey implementation beginning April 2026 with fewer questions
• Potential reduction in data submission timeframes from 4.5 months to 45 days to improve measure timeliness
• Updates to Home Health Value-Based Purchasing including measurement changes and reweighting of components
• Technical updates to Conditions of Participation text to accommodate all-payer OASIS data submission
• Multiple requests for information on interoperability, wellness measures, and falls reporting

Comments on these proposed changes must be submitted to CMS by August 29th. The final rule is expected to be published in late October or early November.

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Case management represents the invisible thread that weaves together all aspects of patient care in home health and hospice settings—yet many clinicians receive minimal training in this critical skill. 

The conversation between Jennifer Kennedy and Kim Skehan dives deep into what effective case management looks like and why it matters so profoundly for both patient outcomes and regulatory compliance. As Kim notes, "Case management is a next level skill" that requires dedicated training and support beyond what most clinicians receive in their professional education. Organizations must invest in developing these capabilities, recognizing that quality case management takes months—not days—to cultivate.

Beyond simply making visits, case management involves comprehensive assessment, holistic care planning, and coordination across disciplines to address all patient needs. When done well, it improves patient outcomes, prevents complications, and creates seamless care transitions. When it falters, the consequences can be severe, with many survey findings at the condition level or immediate jeopardy stemming directly from coordination failures. This reality highlights the intersection where compliance meets quality—where doing right by patients simultaneously protects organizations from regulatory challenges.

With increasing patient acuity in home-based care, case management has become more complex and demanding. Today's case managers must effectively coordinate multidisciplinary teams, manage high-complexity patients, and ensure comprehensive documentation of all care activities. While technology and AI provide increasingly valuable support tools, the human elements of assessment, coordination, and communication remain irreplaceable. The most successful organizations combine robust training programs with clear processes and adequate time allowances for this vital function.

Ready to strengthen your organization's case management practices? Explore CHAP's Center for Excellence for resources, educational offerings, and disease program certifications that can enhance your team's ability to deliver truly coordinated, patient-centered care.

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The fiscal year 2026 proposed hospice rule brings cautious optimism to providers with a projected 2.4% payment increase, though experienced hospices know to factor in the ongoing 2% sequestration when calculating their bottom line. For those who've long struggled with regulatory inconsistencies, this rule delivers welcome clarification on who can certify hospice eligibility, aligning payment regulations with Conditions of Participation after years of confusion.

Most significantly, CMS confirms the HOPE assessment tool will launch on October 1, 2025, as scheduled. Despite earlier speculation about potential delays, hospices should maintain implementation momentum, with CMS planning one final training session this summer. Face-to-face attestation requirements also receive much-needed clarification, potentially reducing one of the top reasons for claim denials.

Beyond operational updates, CMS seeks provider input through several Requests for Information. They're exploring digital quality measurement using FHIR-based reporting, considering new quality measures around well-being and nutrition, and looking for opportunities to streamline regulations and reduce administrative burden. This represents a genuine opportunity for hospice providers to shape future requirements.

The relatively slim 62-page rule contains consequential changes that demand attention. Providers should thoroughly review the complete document, evaluate potential financial impacts, coordinate with state and national associations on comments, and ensure staff education aligns with the clarified regulations. With the comment period closing June 10 and the final rule expected in early August, the time to prepare is now. Let your voice be heard on these important changes that will influence hospice care delivery and reimbursement for years to come.

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The episode examines the top 10 home health survey deficiencies of 2024, underscoring the importance of compliance and effective care planning. Jennifer and Kim provide actionable strategies for home health agencies to enhance their survey readiness and improve quality care. 
• Identifying and understanding the top 10 deficiencies for compliance 
• Importance of comprehensive assessments in care planning 
• Challenges faced in interdisciplinary care coordination 
• Significance of infection prevention during home health visits 
• Technical requirements regarding patient rights documentation 
• Strategies for ongoing survey readiness and case management best practices 
• Utilizing CHAP resources for enhanced compliance strategies 
• Importance of ongoing education and staff training in home health settings

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Understanding the top 10 hospice deficiencies for 2024 is crucial for providers committed to compliance and quality care. This episode explores key themes like survey readiness, comprehensive assessments, case management roles, and the importance of continuous improvement strategies.

• Importance of recognizing key hospice deficiencies 
• Challenges in today's survey environment 
• Trends focusing on care planning and assessments 
• Case management as an essential component of patient care 
• Emphasis on interdisciplinary teamwork and communication 
• Necessity of mock surveys for ongoing readiness 
• Strategies for maintaining compliance and enhancing care quality

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Join Jennifer Kennedy and Kim Skehan for an unfiltered conversation about the CMS Hospice Special Focus Program (SFP), launched on January 1, 2025. This transformative program is reshaping hospice care—and Jennifer and Kim are here to ensure you’re prepared to adapt and thrive.

In this episode, they simplify the complexities of SFP, exploring how it works, who it impacts, and most importantly, how your hospice can stay ahead. Learn how to interpret the program’s data-driven selection process, evaluate your organization’s readiness, and build the strategies you need to mitigate risks while maintaining top-quality care.

From the critical role of QAPI programs to the importance of strong policies during times of change, Jennifer and Kim provide actionable tools for leaders determined to deliver excellence in every aspect of hospice care. Whether you're navigating SFP or aiming to prevent future challenges, this episode is packed with insights that matter.

Don’t miss this essential guide to staying compliant, proactive, and focused on what truly counts—your patients.

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For over 60 years, CHAP has been leading the way in home and community-based care, and now CHAPcast is leveling up! With a dynamic new format, co-hosts Jennifer Kennedy and Kim Skehan bring their expertise, passion, and a touch of personality to every episode.

Get ready for deeper dives into the issues that matter—breaking down policy updates, exploring cutting-edge trends, and sharing practical tools to help you thrive. Fresh perspectives and actionable insights you can use right away.

Whether on a commute, in the office, or just catching a moment to yourself, CHAPcast is here to keep you informed, inspired, and ahead of the curve.

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