We break down the top 10 DME survey deficiencies for 2025 and why annual CMS oversight raises the bar for safety, compliance, and documentation. Practical steps show how to turn policies into proof, strengthen QuAPI, and align multi‑site operations.

• CMS’s increased oversight and annual DME surveys
• the role of survey readiness and mock surveys
• building an effective compliance program using OIG’s seven elements
• quality assurance and performance improvement as a monitoring engine
• safety program gaps including tank storage, transport, cleaning and PPE
• TB screening requirements and aligning policy with state and CDC
• documentation errors that mask compliant practice
• training versus competency and observed skill assessment
• leadership accountability and consistency across multiple locations

After you listen to this podcast, click on some of the links to our resources: our top 10 DME survey deficiency list, which includes our three-year comparison.

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We break down the top 10 hospice deficiencies for 2025, why citations shifted toward aide compliance and volunteers, and how to align care plans with assessments to satisfy CMS and improve patient care. We also share new CHAP tools and practical steps to tighten supervision, documentation, and QuAPI.

• plan of care as the central compliance document
• comprehensive assessment driving timely care plan updates
• documentation beyond point and click to show necessity
• hospice aide scope, competency, and 14‑day supervision
• reporting status changes from aide to RN promptly
• state rules shaping permitted aide tasks
• volunteer 5% utilization tracking and recruitment evidence
• root cause analysis and data‑driven QuAPI
• RN case management and IDG accountability between meetings
• continuous survey readiness through mock surveys and policy reviews

After you listen to this podcast, click on some of the links to our resources: our top 10 hospice survey deficiency list, which includes our three-year comparison, and the medication reconciliation blog.  

Check out our course: Charting the Course: A Guide to Effective Care Planning in Home Health & Hospice

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We share the most-cited CHAP home health deficiencies and turn them into practical fixes you can implement now. From individualized care plans to med reconciliation, aide supervision, infection control, and transition timelines, we outline simple workflows that hold up on survey day.

• why care plan content remains the top citation
• how to individualize documentation beyond point and click
• full medication reconciliation on every primary visit
• written visit schedules and real patient notification
• patient rights forms and proof of delivery
• infection control habits, bag technique, and equipment cleaning
• aide supervision every 14 days and virtual limits
• transfer and discharge timelines with proof of sending
• using CHAP’s new tools, and three-year trends
• building QAPI projects from deficiency data

After you listen to this podcast, click on some of the links to our resources: our top 10 home health survey deficiency list, which includes our three-year comparison, and the medication reconciliation blog.  

Check out our course: Charting the Course: A Guide to Effective Care Planning in Home Health & Hospice

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We unpack the 2026 CMS DME final rule with an eye on what changes first, what it costs, and how suppliers can adapt without disrupting patient care. Annual surveys, stricter accreditation oversight, and targeted incentives reshape strategy, budgets, and daily operations.

• Annual surveys begin at next initial or reaccreditation after 1 January 2026
• Elimination of temporary accreditation before surveying new service locations
• CHOW events may trigger initial surveys and start annual cadence
• Prior authorization exemption for suppliers maintaining 90% approval
• Added products and remote item delivery in competitive bidding
• Increased CMS validation, AO reapproval, and continued sampling
• Faster complaint reporting and more granular data submission
• Clear rationale required when accepting corrective action plans
• Address changes and warehouse functions require survey planning
• Practical steps for budgeting, staffing, and strategic footprint decisions

Read the final rule. Listen to industry webinars and review our resources to understand the key elements and direct impact on suppliers.

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We break down the 2026 home health final rule, from the 1.3 percent cut and sequestration impact to face-to-face, OASIS, HHCAHPS, and value-based purchasing changes. We share concrete steps to shore up documentation, data, and budgets before January 1, 2026.

• Why the final rule timing compresses preparation
• Payment impact of the 1.3 percent cut plus sequestration
• What changes in face-to-face encounter responsibility and proof
• Aligning COPs with the all-payer OASIS requirement
• How HHCAHPS and OASIS items are being revised
• What new and removed VBP measures mean operationally
• Anti-fraud signals in enrollment and oversight
• Practical actions to update policies, analytics, and training
• Resources to read and where to find deeper summaries

We did present and post two very detailed summaries with the highlights of the home health content as well as the DME content on our website

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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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