Compliance & Regulatory

For agency owners and managers: home health compliance, CoP, OASIS, HIPAA, surveys, UPIC audits, and audit defense

In this section

• Medicare Conditions of Participation (CoPs)

  For managers: what home health CoPs are and how to stay on the right side of them.

• OASIS-E Documentation Guide for Home Health

  For clinical managers: OASIS-E key items, timing, and common slip-ups for home health compliance.

• HIPAA Compliance Checklist for Home Health

  For owners and managers: privacy, security, and what auditors look for.

• Home Health Survey Preparedness

  For agency leaders: before, during, and after the survey.

• PDGM Home Health: Payment, Documentation & Clinical Grouping

  For owners and billing: PDGM home health explained, payment, clinical grouping, what to document, and LUPA.

• HHVBP and Star Ratings: How They Affect Referrals and Payment

  For owners and managers: what’s measured, how to read your score, and where to improve.

• Documentation Best Practices That Hold Up in Audits

  What managers need: what to document, when, and how to avoid takebacks.

• Home Health Audit Defense: ADRs and Plan of Correction

  For agency leaders: how to respond to ADRs and surveys without making it worse.

• Medicare UPIC and ZPIC Audits for Home Health: What They Are and How to Respond

  For owners and compliance leads: program integrity reviews, ADR deadlines, extrapolation risk, and a response process that protects the claim.

• ICD-10 Coding for Home Health: What Drives Payment and Denials

  For owners and billing: ICD-10 impact on PDGM and how to prevent billing denials.

• OASIS QA Before Lock: What to Review and Who Should Own It

  For clinical managers: pre-lock QA steps so one bad OASIS doesn’t hit home health payment or star rating.

• Visit Note QA That Prevents Denials: Skilled Need, Homebound, and Triggers

  For managers: what payers and auditors look for in visit notes and how to fix before billing.