Last updated: November 2026
CHAP home health and hospice accreditation readiness prepares an organization for review against the applicable CHAP standards and, for Medicare participation, federal Conditions of Participation. Integral Healthcare Solutions (IHS) maps client-supplied CHAP materials and applicable federal requirements to evidence, drafts missing documents for clinical approval, and runs mock surveys. This service focuses on organizations already pursuing CHAP accreditation for Medicare participation.
IHS works in three practice lines: accreditation consulting, compliance services and program development. This page is the accreditation line, for an agency that is already in the CHAP process. If you are still choosing an accreditor, start with our home health and hospice accreditation page.
What is CHAP home health and hospice accreditation?
Community Health Accreditation Partner (CHAP) offers Home Health and Hospice accreditation, including deemed and non-deemed options. See CHAP’s Home Health and Hospice program pages (pages opened 2026-11-05). Medicare deeming depends on the applicable CMS-approved program; accreditation outside that program does not establish deemed status.
For home health agencies and hospices, accreditation through the applicable CMS-approved program is a voluntary route for demonstrating compliance with Medicare health and safety conditions instead of a state certification survey. CMS evaluates the program’s standards and survey process. Deemed status covers the conditions recognized under the approval; it is not a blanket exemption from oversight.
The federal text is 42 CFR Part 484, Conditions of Participation: Home Health Agencies and 42 CFR Part 418, Hospice Care (checked against the official eCFR text, GPO build of November 4, 2026, Title 42 last amended October 8, 2026, on November 5, 2026). On CHAP’s education site (pages opened 2026-11-06), CHAP lists Home Health Standards of Excellence v.5.2.0 and Hospice Standards of Excellence v.3.2.0, each effective 03/23/2026. The Home Health page says those standards apply to agencies seeking or holding CMS deemed status through CHAP review. Editions can be superseded, so your agency should confirm with CHAP the edition in force for its survey.
Who needs it and what triggers it
IHS can help when an agency wants its files tested before a CHAP review. Examples include:
- The agency is in the last stretch of CHAP accreditation and wants its file tested.
- The policy manual was built from templates and never adapted to how the agency works.
- The administrator, clinical manager or medical director changed since the application.
- The agency serves home health and hospice patients and keeps two separate compliance files.
- A reaccreditation cycle is coming with stale QAPI data or an old emergency plan.
How IHS helps
IHS tests the agency against the timing rules in Parts 484 and 418. The method:
- Gap assessment against Parts 484 and 418, and against the CHAP materials your agency supplies.
- Condition-by-condition evidence index that ties each requirement to a policy, form, log or record element.
- Drafts of missing policies, patient notices, committee and QAPI documents, for your clinicians to approve.
- Mock survey with record tracers and a ranked findings list.
- A staff walk-through of the questions a surveyor is likely to ask.
Your agency supplies its policies and procedures, forms, organization chart, a de-identified or sanitized sample of clinical records, staff qualification files, QAPI and governing body minutes, the CHAP materials it has received, and the survey date.
The limit: IHS does not attend the survey, predict CHAP's findings or take part in CHAP's decision. IHS does not communicate with CHAP; your agency's named contact does. IHS markets its process and makes no claim about past work with this accreditor.
What to have ready
Have these twelve evidence groups ready. These are selected checks, not a complete standards inventory. Citations refer to the current eCFR, GPO build November 4, 2026, reviewed November 5, 2026.
| Evidence | Federal text | Evidence to check |
|---|---|---|
| Home health assessments | 42 CFR 484.55(a)–(b) | Initial visit by an RN within 48 hours of referral or return home, or on the physician- or allowed-practitioner-ordered start date. For rehabilitation-only orders, the appropriate skilled rehabilitation professional may perform it; for Medicare patients, OT must be ordered with qualifying PT or speech-language pathology. Complete the comprehensive assessment promptly according to immediate needs and within 5 calendar days after start of care. |
| OASIS submission | 42 CFR 484.45(a) | Encode and electronically transmit each completed OASIS assessment to CMS within 30 days of assessment completion for each patient whose data CMS requires. |
| Home health discharge and transfer summaries | 42 CFR 484.110(a)(6) | Send the discharge summary within 5 business days to the primary care practitioner or other health care professional responsible after discharge, if any. For planned transfers, send the transfer summary within 2 business days of transfer if facility care immediately continues. For unplanned transfers, the 2-business-day clock starts when the HHA learns of the transfer, provided the patient is still receiving facility care then. |
| Home health aide supervision | 42 CFR 484.80(h) | When the patient also receives skilled nursing, PT, OT or speech-language pathology, an RN or appropriate skilled professional familiar with the patient, care plan and written care instructions assesses aide services at least every 14 days. The aide need not attend. Assessments are onsite except for rare real-time two-way audio-video assessments, limited to one per patient per 60-day episode. Paragraph (h)(2) governs patients without those skilled services. |
| Hospice initial and comprehensive assessments | 42 CFR 418.54(a)–(b) | The hospice RN completes the initial assessment within 48 hours after election under section 418.24 is complete, unless the physician, patient or representative requests less time. The interdisciplinary group, consulting the attending physician if any, completes the comprehensive assessment within 5 calendar days after election under section 418.24. |
| Hospice assessment updates | 42 CFR 418.54(d) | The interdisciplinary group, collaborating with the attending physician if any, updates the assessment as often as the patient’s condition requires and at least every 15 days. Include changes since the initial assessment, progress toward outcomes and response to care. |
| Hospice care-plan reviews | 42 CFR 418.56(d) | The interdisciplinary group, collaborating with the attending physician if any, reviews, revises and documents the individualized plan as often as the patient’s condition requires and at least every 15 calendar days. Revisions incorporate the updated assessment and progress toward goals and outcomes. |
| Hospice aide supervision | 42 CFR 418.76(h)(1)(i) | An RN visits the patient’s home at least every 14 days to assess aide care and services and whether services ordered by the interdisciplinary group meet the patient’s needs. The aide need not be present. |
| Home health patient-rights notices | 42 CFR 484.50(a)(1)(i) | Give the patient and legal representative, if any, written notice of rights, responsibilities, and transfer and discharge policies during the initial evaluation visit before care. Make it understandable to people with limited English proficiency and accessible to people with disabilities. |
| Hospice volunteer records | 42 CFR 418.78(e) | Day-to-day administrative and/or direct patient-care volunteer service hours must equal at least 5 percent of total patient-care hours of all paid hospice employees and contract staff. Records identify service types and time worked. |
| QAPI evidence | 42 CFR 484.65; 42 CFR 418.58 | Bring program documents, service-wide data, improvement-project records and governing-body oversight evidence for the applicable home health or hospice QAPI requirements. Include contracted services in the program’s scope. |
| Emergency preparedness evidence | 42 CFR 484.102; 42 CFR 418.113 | Bring the applicable home health or hospice emergency plan, risk assessment, policies, communication plan and training/testing records. Both sections require review and updating of the emergency plan at least every 2 years. |
Also have your applicable CHAP materials and readiness timeline available. The introductory call can establish which files IHS will review.
How it compares
For Medicare certification, a state survey tests federal conditions, while the applicable CMS-approved accreditation program addresses its own standards as well as federal conditions. Compare program scope and the evidence each route requires.
Another approved organization on the CMS list is ACHC. IHS publishes pages on ACHC home health accreditation and ACHC hospice accreditation, and a comparison on the home health and hospice accreditation page. Use the program-specific standards and fee information when comparing CHAP with ACHC. IHS readiness support prepares evidence; it does not replace either organization’s accreditation review.
What it costs
CHAP does not publish a fee schedule on the pages we reviewed; fees depend on scope. See CHAP’s pricing FAQ (page opened 2026-11-05). Verify current fees with CHAP.
Budget separately for accreditation, consulting and staff time. IHS scopes each engagement after a free introductory call.
What this is not
IHS is not an accrediting body and does not grant accreditation or deemed status.
This page is not legal advice. IHS is a consulting firm, not a law firm.
IHS does not guarantee a survey result, does not write clinical content without your clinicians' approval, and does not file anything with CMS, a state agency or CHAP. Your agency submits.
Frequently asked questions
What is CHAP accreditation and how does it relate to Medicare deemed status?
CHAP offers Home Health and Hospice accreditation with deemed and non-deemed options, as described on its program pages (pages opened 2026-11-05). For Medicare participation, the applicable CMS-approved accreditation program matters; CHAP accreditation alone does not establish deemed status.
What is deemed status and what does section 1865(a) allow?
For home health agencies and hospices, deemed status concerns the Medicare conditions covered by CMS’s approval of an accreditation program. Section 1865(a) provides the statutory basis; CMS describes this accreditation route as voluntary.
Which federal rules does a CHAP survey line up with for home health and for hospice?
42 CFR Part 484 contains the home health Conditions of Participation; Part 418 governs hospice care. For Medicare deeming, CMS reviews the applicable accreditation program against federal requirements. CHAP standards must also be addressed using the materials applicable to your program.
How long before the survey should readiness work start?
Begin while there is time to review records, correct gaps and test the changes before your organization declares readiness. IHS can help plan that work; your organization confirms its CHAP process and timing using CHAP’s guidance.
What does a mock survey cover and what do I get at the end?
IHS follows sampled records against Parts 484 and 418, reviews policies and committee files, and walks staff through likely questions. You receive a ranked findings list and the condition-by-condition evidence index.
Which federal timing rules does a record review test?
The checklist above identifies selected timing checks and their conditions. For example, the home health comprehensive assessment must be completed promptly, consistent with immediate patient needs, and no later than 5 calendar days after start of care (42 CFR 484.55(b)(1)); hospice assessment updates must occur as often as the patient’s condition requires and at least every 15 days (42 CFR 418.54(d)).
What do I need in the emergency preparedness and QAPI files?
Bring QAPI program documents, data, improvement-project records and governing-body oversight evidence, plus the emergency plan, risk assessment, policies, communication plan and training/testing records. The applicable federal texts are 42 CFR 484.65 and 484.102 for home health, or 418.58 and 418.113 for hospice; the checklist links to each.
Does IHS speak with CHAP for us or submit anything?
No. IHS does not communicate with CHAP or submit anything to it. Your agency's named contact does, and IHS prepares the documents behind it.
Who approves clinical content in drafted policies?
Your organization’s designated clinical reviewers approve clinical content. IHS drafts policies, notices and committee documents for that review; your organization retains responsibility for clinical decisions and implementation.
Does readiness work guarantee accreditation, and what does CHAP accreditation cost?
No. IHS does not guarantee a survey result. CHAP does not publish a fee schedule on the pages we reviewed; fees depend on scope, so verify current fees with CHAP. IHS scopes each engagement after a free introductory call.