Home Health Agencies: 2018 Language Access Compliance

Improving communication with limited-English-proficient patients is a high priority for healthcare organizations and insurance agencies in 2018. For Home Health Agencies participating in Medicare, there are new language access requirements to understand this year for Home Health Agencies New Medicare CoPs in 2018compliance.  

On January 13, 2017, Centers for Medicare and Medicaid Services (CMS) published the final rule which revised the Medicare and Medicaid Program: Conditions of Participation (CoP) for home health agencies. The new standard for the development of performance improvement projects has an implementation date beginning January 13, 2018.


CoPs and Home Health Agencies

As the number of Medicare home health agencies has grown significantly, so have the standards of care, which include language access requirements. In order to improve the rights and quality of care for Medicare and Medicaid beneficiaries who rely on home health agencies, minimum standards, known as CoPs, must be met by home health agencies to participate in Medicare. Failing to comply CoPs can lead to program termination for sanctions from Medicare.
Number of Medicare Home Health Agencies U.S. Statista

Language Access Requirements for Home Health Agencies

Home Healthcare Providers must provide a “Notice of Rights” to patients and their representatives during the initial evaluation visit, and before the HHA can provide care. LEP Patients and those with disabilities must be provided notices that are understandable to them. In addition, Home Health Agencies must verbally provide these notices in the patient’s primary or preferred language. If an interpreter is needed, they must be provided at no cost to the patient.

“At § 484.50, we proposed revised patient rights provisions under six standards: (1) Notice of rights; (2) Exercise of rights; (3) Rights of the patient; (4) Transfer and discharge; (5) Investigation of complaints; and (6) Accessibility. In proposed § 484.50(a), we stated that each patient and patient representative (if the patient has one), would have the right to be informed of his or her rights in a language and manner the individual understands.”

“More specifically, under § 484.50(a)(1), we proposed that the HHA provide the patient and patient’s representative with verbal notice of the patient’s rights in the primary or preferred language of the patient or representative, and in a manner that the individual can understand, during the initial evaluation visit, and in advance of care being furnished by the HHA. We also proposed to require that the patient be provided a written copy of the patient rights information. The written information would be required to be provided in alternate formats free of charge for persons with disabilities, when necessary, to ensure effective communication. In addition, written notice would be required to be understandable to persons who had limited English proficiency. Furthermore, HHAs would be required to inform patients of the availability of the services and instruct patients how to access those services.”


Home Health Agencies must provide information in a way that is both timely and accessible to the patient, and must be provided instructions for how to access services. For patients with limited-English proficiency, this means access to translated materials and interpreters (via Phone, Video Remote or On-site), and for deaf or hard-of-hearing patients, access to auxiliary aids and services like qualified interpreters (via VRI or On-site).

“To address effective communication with patients who are limited English proficiency (LEP) or have disabilities, we proposed a new standard at § 484.50(f), “Accessibility.” We proposed that information that is provided to patients would have to be provided to the individual in plain language, and in a manner that is both accessible and timely.”

“§ 484.50(c)(12) that patients have the right to be informed of their right to access auxiliary aids and language services, and to be provided instruction on how to access these services.”


The final rule revising the conditions of participation (CoPs) that home health agencies (HHAs) must meet in order to participate in the Medicare and Medicaid programs can be found on the Federal Register website
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