Medicare & Medicaid

CMS Compliance Consulting

Stay compliant with CMS Conditions of Participation. We help Medicare and Medicaid-certified agencies maintain full regulatory compliance.

What is CMS Compliance?

Understanding the Centers for Medicare & Medicaid Services Conditions of Participation

CMS (Centers for Medicare & Medicaid Services) sets the standards that healthcare agencies must meet to participate in Medicare and Medicaid programs. These Conditions of Participation (CoPs) cover:

Patient Rights

Rights to privacy, informed consent, and quality care

Quality of Care

Standards for clinical care, safety, and patient outcomes

State Operations

Licensing, certification, and relationships with state agencies

Medical Records

Documentation, confidentiality, and retention requirements

Who Needs CMS Compliance?

Medicare-Certified Home Health Agencies
Medicaid Waiver Service Providers
Hospice Providers
Durable Medical Equipment Suppliers
Comprehensive Outpatient Rehab Facilities

Non-medical home care agencies may not need CMS compliance, but accreditation demonstrates quality.

Our CMS Compliance Services

Comprehensive support to maintain your Medicare/Medicaid certification

Compliance Assessment

Comprehensive gap analysis of your current compliance status against CMS Conditions of Participation.

Mock Surveys

Simulated CMS surveys to identify deficiencies before the real survey and ensure survey readiness.

Policy Development

Custom policies and procedures aligned with CMS requirements and accreditation standards.

Staff Training

Ongoing education on CMS regulations, documentation requirements, and compliance best practices.

Corrective Action Plans

Strategic plans to address deficiencies identified during surveys and maintain compliance.

Ongoing Monitoring

Continuous compliance monitoring and regular updates as CMS regulations evolve.

CMS Conditions of Participation

Key areas of compliance for home health agencies

1

§418.100 - Condition of Participation: Compliance with Federal Regulations

Agencies must comply with all applicable federal, state, and local laws.

2

§418.102 - Governing Body

Requirements for leadership, administration, and organizational structure.

3

§418.104 - Provision of Services

Standards for types of services provided and quality of care.

4

§418.106 - Outpatient Physical Therapy

Requirements for therapy services and personnel qualifications.

5

§418.108 - Quality Assessment & Performance Improvement

QAPI program requirements and continuous improvement processes.

6

§418.110 - Infection Control

Policies for preventing and controlling infections in home health settings.

Stay CMS Compliant

Don't risk your Medicare certification. Let our experts help you maintain full compliance.