Home Health Agency (HHA) State Operations Manual (SOM) revisions:
Appendix B, HHA Enforcement Guidance and revisions to Chapter 2,
• Appendix B – Guidance to Surveyors: Home Health Agencies – Recent establishment of survey and enforcement regulations as
well as changes to other HHA policies have necessitated revisions to previously published survey guidance.
• HHA Survey and Enforcement regulations – The final rule on available alternative sanctions for HHAs with condition-level
deficiencies was published in 2012. Among other things, this rule allows for the imposition of civil money penalties (CMP),
directed in-service training, directed plan of correction, suspension of payment, and temporary management. The Centers for
Medicare & Medicaid Services (CMS) has developed a new SOM chapter 9 to guide State Agencies (SAs) and Regional Offices (ROs)
on imposing these sanctions, as well as on the procedures regarding an informal dispute resolution process (IDR). Office
of Strategic Operation and Regulatory Affairs (OSORA) has determined that the Chapter 9 designation is already in use. This
chapter has been renumbered as Chapter 10.
• SOM, Chapter 2, Certification, Sections 2180-2202.19 – Survey protocols, HHA enforcement regulations, changes to Outcome
and Assessment Information Set (OASIS) data transmission and other policy changes have resulted in the need to update the
HHA sections of Chapter 2. An error in section 2202.10 has resulted in 2 corrections.