Home Health and Hospice Accreditation Consulting: CHAP and ACHC

Which accreditor should a home health agency or hospice choose: CHAP or ACHC?

Choose the accreditor your payers, state and own operations point to, because both can deem home health and hospice. CMS's list of approved accrediting organizations includes ACHC, CHAP and The Joint Commission among others. Home health agencies and hospices are among the program types CMS deems through accreditation, and CMS calls the accreditation pathway voluntary (CMS, Accrediting Organizations, page opened October 3, 2026). IHS prepares agencies for CHAP and ACHC.

CHAP, Community Health Accreditation Partner

CHAP's site lists accreditation for home health, hospice, home care, palliative care, HME and DMEPOS, home infusion therapy and pharmacy. It presents its accreditation as a deeming route to CMS compliance (CHAP, page opened October 4, 2026).

ACHC, Accreditation Commission for Health Care

ACHC's home health page says it holds deemed status for home health. Its hospice page says it has held CMS deeming authority since 2009 (ACHC, home health and ACHC, hospice, page opened October 4, 2026).

How does the ACHC process run?

ACHC describes five stages: get started, presurvey (information form, application and verification), survey (opening conference, onsite survey, closing conference and final report), post-survey (plan of correction review) and a decision. ACHC's hospice page says plans of correction are due within 30 days and the accreditation letter follows within five business days of the decision stage (ACHC, hospice, page opened October 4, 2026).

Can a new home health agency or hospice start now?

ACHC's home health page says that as of May 13, 2026, CMS implemented a nationwide moratorium on new Medicare enrollments for home health agencies and hospices, and that currently enrolled providers are not affected (ACHC, home health, page opened October 4, 2026). A startup agency or hospice should confirm its enrollment path before it plans an accreditation timeline.

What regulatory changes affect home health and hospice agencies in 2025-2026?

HOPE replaces the Hospice Item Set

CMS says HOPE, the Hospice Outcomes and Patient Evaluation, replaces the Hospice Item Set as the assessment instrument for hospice quality reporting, and that data collection under HOPE began October 1, 2025. CMS adds HOPE Update Visits in the first 30 days after a patient elects hospice care (CMS, HOPE, page opened October 4, 2026). For a hospice, that means retraining clinical staff, updating policies and documentation systems, and auditing HOPE data early.

CY 2026 home health payment change

CMS estimates that Medicare payments to home health agencies in CY 2026 will decrease in the aggregate by 1.3% compared to CY 2025 (CMS, CY 2026 Home Health PPS final rule fact sheet, CMS-1828-F, page opened October 4, 2026). When margins tighten, a failed survey or a lapse in accreditation costs more, so survey readiness matters.

Hospice Special Focus Program

CMS's Hospice Special Focus Program page says implementation for CY 2025 ceased effective February 14, 2025 while CMS evaluates the program (CMS, Hospice Special Focus Program, page opened October 4, 2026). Check that page for its current status.

Where does IHS look for gaps in home health and hospice documentation?

IHS looks at plan of care, medication review, physician orders and aide supervision for home health, and at care plan updates, aide reporting, infection control, volunteer records and bereavement assessments for hospice. The areas below are IHS's own review checklist for a mock survey. They are not accreditor finding statistics.

Home health review areas

1. Plan of care. IHS checks that goals are specific and measurable and that the plan reflects the comprehensive assessment.
2. Start-of-care information. IHS checks that written instructions, visit schedules, medication information and emergency contacts reach the patient on time.
3. Clinical documentation. IHS checks that visit notes are present and timely and support the need for skilled care.
4. Medication regimen review. IHS checks for complete medication details, PRN indicators and reconciliation of over-the-counter supplements.
5. Physician orders. IHS checks that care follows signed orders and ordered visit frequencies, and that physicians are told about changes in condition.
6. Aide supervision. IHS checks supervisory visit documentation against the supervision rules that apply to your state and program.

Hospice review areas

1. Plan of care updates. IHS checks that the plan changes after reassessments and reflects newly identified problems.
2. Aide reporting. IHS checks that aides report changes in a patient's medical or social status to the supervising nurse.
3. Infection control. IHS checks standard precautions and handling of medical bags entering the care setting.
4. Volunteer records. IHS checks that volunteer hours are tracked.
5. Bereavement assessments. IHS checks that initial assessments of family needs, including social, spiritual and cultural factors, are documented.

How does home health and hospice accreditation preparation work with IHS?

Step 1: Standards acquisition and readiness assessment

IHS obtains the standards for the accreditor you choose and assesses your agency against them. For a new agency, this step also lists the entity, licensure and Medicare enrollment items to confirm before survey planning begins.

Step 2: Policy and procedure manual development

IHS drafts state-specific policy and procedure manuals that cover patient rights, clinical protocols, QAPI, emergency management, human resources and credentialing, infection control and supervision. Each manual is written to the chosen accreditor's standards. Your clinicians review and approve every document.

Step 3: Operating under the new procedures

Your agency puts the new procedures into practice and builds the patient and record history a survey will review. Your named contact confirms the accreditor's eligibility requirements for your program.

Step 4: Mock survey

IHS runs a mock survey that follows the survey process: clinical record reviews, staff interviews and review of home visit documentation. IHS targets remediation at the gaps it finds.

Step 5: Survey support and plan of correction

IHS supports your team during survey preparation. If the survey cites findings, IHS drafts plan-of-correction text for your named contact to submit. A plan of correction works best when it fixes the cause across the agency, not only the cited record.

Step 6: Reaccreditation

Established agencies need a reaccreditation plan before the term ends. IHS builds a calendar of renewal tasks from your accreditor's schedule and offers readiness support between cycles.

What does home health and hospice accreditation cost?

The total has three parts: the accreditor's fees, consulting fees and your internal staff time. The accreditor sets the first, IHS sets the second and you control the third by how much of the document work your team carries.

CHAP says its costs are shaped by size, service mix, locations and readiness, and sends applicants to its pricing page (CHAP, page opened October 4, 2026). The ACHC pages we opened list no fee figures. Verify current fees with CHAP and with ACHC.

IHS sets a fixed fee for each engagement after a free discovery session, because scope, number of sites and gap severity change the work.

What this is not

• IHS is not an accrediting body and does not grant or influence a CHAP or ACHC decision.
• IHS drafts. Your organization's named contact handles every submission and all communication with the accreditor and with CMS.
• IHS's home health and hospice readiness work covers ACHC and CHAP. It does not cover Joint Commission accreditation.
• This page is not legal or billing advice, and preparation is not a guarantee of an accreditation outcome.

How does IHS help established agencies and new agencies?

IHS offers the following readiness work:

• HOPE readiness. Staff education and a documentation audit so HOPE data is accurate before the next survey.
• Multi-site and change-of-ownership programs. Policy frameworks that stay consistent across sites and adapt to each state.
• Aligned documentation. Documentation systems built to satisfy accreditor standards and payer audit requirements at once.
• Fee and timeline guidance. IHS points you to each accreditor's own fee information and builds a realistic plan around it.

Frequently asked questions

Does my agency need to be accredited to bill Medicare?

To participate in Medicare, home health agencies and hospices can be surveyed by the state survey agency on CMS's behalf or accredited by a CMS-approved accrediting organization, a route CMS calls voluntary (CMS, Accrediting Organizations, page opened October 3, 2026). Some states have additional licensure requirements beyond Medicare certification.

How do I choose between CHAP and ACHC?

Start with your payer contracts, your state's rules and the program types you operate, since CHAP and ACHC each accredit home health and hospice. IHS compares the two against those drivers and prepares you for the one you choose. See the comparison page.

What is HOPE and how should a hospice prepare?

HOPE is the CMS assessment tool that replaces the Hospice Item Set for quality reporting. Data collection began October 1, 2025 (CMS, HOPE, page opened October 4, 2026). A hospice should retrain clinicians, update its policies and documentation systems, and audit HOPE records early.

Can a new home health agency or hospice get accredited now?

ACHC's home health page says CMS implemented a nationwide moratorium on new Medicare enrollments for home health agencies and hospices as of May 13, 2026, and that currently enrolled providers are not affected (ACHC, home health, page opened October 4, 2026). A new agency or hospice should confirm its enrollment path first.

What does IHS do and not do?

IHS drafts policies and procedures, runs the mock survey and drafts plan-of-correction text. Your named contact handles every submission and all communication with the accreditor. IHS's home health and hospice readiness work does not include Joint Commission accreditation.

Does IHS prepare hospices as well as home health agencies?

Yes. IHS prepares hospices for ACHC and CHAP accreditation with the same process: standards acquisition, readiness assessment, document development, mock survey and survey support.

What does home health or hospice accreditation cost?

The accreditor sets its own fees, so verify current fees with CHAP or ACHC. IHS sets a fixed fee for each engagement after a free discovery session.

Who is this not for?

It is not for an organization that wants IHS to deal with the accreditor or CMS for it. It is also not for an agency or hospice that cannot yet enroll in Medicare and wants a survey date, until its enrollment path is clear.

Ready to prepare for home health or hospice accreditation?

We start with a readiness assessment that shows where your agency stands against the standards of the accreditor you choose.

Schedule a Free Discovery Session