ACHC Home Health Accreditation — Frequently Asked Questions
What is ACHC Home Health Accreditation?
ACHC Home Health Accreditation is a CMS-approved accreditation program that grants Medicare-certified home health agencies deemed status under the Medicare Conditions of Participation (42 CFR Part 484). An accredited agency is deemed compliant with the Medicare CoPs and does not require a separate routine CMS survey. ACHC has held CMS deeming authority for home health since 2008.
Is ACHC Home Health Accreditation required?
ACHC accreditation is not required to operate a Medicare-certified home health agency — agencies can remain subject to standard CMS state agency surveys without accreditation. However, many agencies pursue accreditation to obtain CMS deemed status, satisfy payer credentialing requirements, and signal quality to referral sources. In some states, accreditation may influence licensure requirements or managed care contracting.
How long does ACHC Home Health Accreditation take?
For agencies starting from a low baseline, expect 9-15 months from initial preparation to accreditation award. Agencies with existing quality infrastructure can often achieve accreditation in 6-9 months. The key constraint is operationalizing policies and generating audit evidence over a sufficient look-back period before the survey date.
What does CMS deeming authority mean for home health agencies?
CMS deeming authority means that ACHC accreditation substitutes for the routine CMS survey under the Medicare Conditions of Participation. Instead of being subject to periodic state agency surveys on behalf of CMS, an accredited agency is surveyed by ACHC under its accreditation standards — which meet or exceed the CoPs. CMS retains authority for complaint investigations and for-cause surveys regardless of accreditation status.
What are the Medicare Conditions of Participation for Home Health?
The Medicare Conditions of Participation for Home Health Services (42 CFR Part 484) set minimum federal requirements for Medicare-certified agencies. Key domains include patient rights, comprehensive patient assessment (OASIS), care planning and coordination, skilled nursing and therapy services, home health aide services, infection prevention and control, emergency preparedness, and QAPI. The CoPs were substantially revised effective January 2018.
What is the ACHC Home Health survey process?
ACHC conducts unannounced surveys for initial accreditation and recertification. The survey includes a document review (policies, personnel files), clinical record audit, staff interviews across all roles, and a physical environment assessment. Surveyors evaluate whether operations match written policies — not just whether policies exist.
How much does ACHC Home Health Accreditation cost?
ACHC application and survey fees are based on agency size and are not publicly published — contact ACHC directly for current fee schedules. IHS consulting engagement fees are scoped to each agency's specific situation and readiness level — contact IHS for a tailored proposal.
How long is ACHC Home Health Accreditation valid?
ACHC Home Health Accreditation is awarded for a three-year period. Agencies must submit to a recertification survey before the end of the accreditation period to maintain continuous accreditation and deemed status.
What are the most common ACHC Home Health survey deficiencies?
The most common deficiencies include: incomplete or untimely OASIS assessments, care plans that do not reflect the comprehensive assessment, inadequate aide supervision documentation, insufficient infection control program documentation, emergency preparedness plans that have not been tested, nominal QAPI programs without genuine trend analysis, incomplete personnel files, and clinical record gaps that do not support billed services.
What happens if deficiencies are found during an ACHC survey?
ACHC issues a Request for Information (RFI) requiring a corrective action plan with supporting documentation. Most RFIs result in accreditation being awarded after the corrective action is accepted. In cases of serious or widespread deficiencies, ACHC may issue a Preliminary Denial of Accreditation. IHS provides RFI response support for both standard deficiencies and Preliminary Denial situations.
Can a home health agency have ACHC accreditation and CMS certification simultaneously?
Yes. ACHC accreditation provides deemed status under CMS certification — the agency retains its Medicare Provider Number and billing privileges. Accreditation does not replace CMS certification; it satisfies the survey requirement associated with maintaining that certification.
How does IHS help home health agencies prepare for ACHC accreditation?
IHS provides end-to-end consulting: standard-by-standard gap analysis, policy and procedure development, operational alignment support, clinical record audit, mock survey, day-of survey support, and post-survey RFI response. Every engagement is led by senior consulting staff with deep regulatory expertise. IHS is led by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC.
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