CMS SOM App. B, Tag G570

quality of care.

Patients are accepted for treatment on the reasonable expectation that an HHA can

meet the patient's medical, nursing, rehabilitative, and social needs in his or her

place of residence. Each patient must receive an individualized written plan of care,

including any revisions or additions. The individualized plan of care must specify

the care and services necessary to meet the patient-specific needs as identified in the

comprehensive assessment, including identification of the responsible discipline(s),

and the measurable outcomes that the HHA anticipates will occur as a result of

implementing and coordinating the plan of care. The individualized plan of care

must also specify the patient and caregiver education and training. Services must be

furnished in accordance with accepted standards of practice.

Interpretive Guidelines §484.60

“Reasonable expectation that an HHA can meet the patient’s medical, nursing,

rehabilitative, and social needs in his or her place of residence” means that, in

consideration of the patient’s level of acuity, the HHA can effectively and safely provide

the patient with the skilled services that the patient needs within the patient’s home.

“Accepted standards of practice” include guidelines and recommendations issued by

nationally recognized organizations with expertise in the relevant field. The Agency for

Healthcare Research and Quality (AHRQ) maintains a National Guideline Clearinghouse

as a public resource for summaries of evidence-based clinical practice guidelines.

See §484.60(e) for written information that must be provided to the patient.