CMS SOM App. B, Tag G522

nurse must complete the comprehensive assessment and for Medicare patients,

determine eligibility for the Medicare home health benefit, including homebound

status.

Interpretive Guidelines §484.55(b)(2)

The requirements for conducting the initial assessment visit and the comprehensive

assessment for home health services are based on sections 1814(a)(2)(c) and

1835(a)(2)(A) of the Act regarding eligibility and payment for home health services. The

requirements for these assessments are based on the professional disciplines that will be

involved in, and coordinating, care for the patient. When nursing is assigned to the case,

it is likely the patient will have a greater need for nursing services than other services

and therefore skilled nurses should conduct the initial assessment visit and initiate the

comprehensive assessment (86 FR 62240, 62351 (Nov. 9, 2021)).

Survey Procedures §484.55(b)(2)

• Through clinical record review, verify the initial assessment was conducted by a

registered nurse unless the patient is receiving therapy services only.

• Through home visit observation, verify if the current comprehensive assessment

and plan of care were completed and accurately reflect the patient’s status.