CMS Establishing Star Rating System for Home Health Care

In an effort to be consistent with quality reporting measures for various health care providers, the Centers for Medicare and Medicaid Services (CMS) are reportedly beginning to bring home health care, hospitals and dialysis facilities into the five-star rating system used for other sectors.

Already, nursing homes, Medicare health plans with Part B coverage, Medicare Advantage plans, physician group practices, and accountable care organizations use the star rating system. According to Visiting Nurse Associations of America (VNAA), CMS hopes to transition home health care to the five star rating by the end of 2014, or at latest, the beginning of 2015. However, the Home Health Quality Improvement Campaign (HHQI) reports that hospitals will be the next provider group to get the star rating system and home health will come online in 2016.

Nursing homes are rated on staffing, health inspections and a set of 9 quality measures on the Nursing Home Compare website. Home health agencies and other providers each have their own range of quality criteria. Currently, there are no details on how CMS plans to determine the star ratings for home health agencies.

More information on this topic will be reported as it becomes available.

Return to

Alliance Presents Comments on DLS Proposal to Drop Private Home Care Agencies

A gap in the state’s oversight of private pay home care agencies will result from regulatory changes proposed by the Massachusetts Division of Labor Standards (DLS), a division within the Executive Office of Labor and Workforce Development.

Currently, DLS registers private pay home care agencies and has been falsely classifying them with employment and staffing agencies. After years of advocacy, DLS recognizes the misrepresentation and makes the appropriate change in their proposed regulatory changes.

The Home Care Alliance offered written and verbal comments at a public hearing in Boston held by DLS, which is making changes sparked by a mandate to update regulations relative to the “Temporary Workers Right-to-Know” Law, which became effective more than a year ago.

In addition to incorporating provisions of the new law into the Staffing Agency regulations, DLS is updating all of their regulations and proposing to drop home care agencies from their definition of “Employment Agencies” and to redefine “Domestic Employee” as a worker paid directly by a household or a family, among other changes.

The Alliance’s Private Care Advisory Committee reviewed the implications of this change for member agencies an approved comments on behalf of the association. These comments include the following:

The proposed changes from the Department of Labor Standards (DLS) recognize that home care agencies do not belong in the same oversight structure as employment, staffing and placement agencies. As much as this shift is welcomed, we must also acknowledge that Massachusetts lacks any other licensure or state oversight for home care agencies. The certified sector is subject to oversight from the Department of Public Health in their role as a federal quality and compliance agent. With an aging population, private-pay home care is a rapidly-growing sector with a rapidly growing workforce. In fact, the federal Bureau of Labor Statistics places home care aides as one of the fastest growing occupations over the next decade.

With these significant factors in mind, and the gap in state oversight, we urge a commitment from and partnership with DLS and the Executive Office of Labor and Workforce Development (EOLWD) to collaborate with the Home Care Alliance, its private pay agency membership, and other organizations to help transition away from DLS registration.

As part of the partnership and collaboration proposed by the Alliance with DLS is joint education and outreach to agencies regarding current state rules and regulations, information for agencies about the Alliance’s Home Care Accreditation Program, helpful information for consumers, and assistance in advocating other state offices and the legislature on the need for agency oversight.

The proposed regulations and a summary are available on the DLS website. Any home care agency interested in commenting can request the Alliance’s full comments and send a supporting letter to James Fuccione at the Alliance who will collect and submit any comments received. If agencies wish to submit comments directly, they can be mailed to Heather Rowe, Director, Department of Labor Standards, 19 Staniford Street, 2nd floor, Boston, MA 02114.

Return to