Volume 6-2025 | December 2025 | |
You're receiving this email because of your relationship with the Office of Inspector General, Division of Health Care. Thank you for your continued commitment to serving the citizens of our Commonwealth!
Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
| | |
Home Health Agency Newsletter
December 2025
| | |
2025 Kentucky Annual Home Health Utilization Survey
The 2025 Kentucky Annual Home Health Utilization Surveys will be available in January 2026. Please take a moment to make sure that the administrator and survey contact is correct by logging in to the survey database at https://prd.webapps.chfs.ky.gov/oigpublic/. If you require assistance, please contact Michele Bushong at michele.bushong@ky.gov or (502) 564-5798.
| | |
NOW AVAILABLE
The Outcome and Assessment Information Set Version E2 (OASIS-E2) Data Submission Specifications Version 3.02.0 are now available in the Downloads section of the OASIS Data Sets page at https://www.cms.gov/medicare/quality/home-health/data-specifications
This FINAL version applies to the OASIS-E2 item set, which is scheduled for implementation on April 1, 2026. Note that item A0810 replaces M0069_PAT_GENDER, item A1255 replaces the A1250 items, several items were added to RFA 03, and the dash (-) is now an allowed value for the item D0150 frequency items. These item changes resulted in several edit changes.
Review the OASIS-E2 Guidance manual for additional information and the Item Change and Edit Change reports within the data specifications. The draft Guidance Manual for the OASIS-E2 version of the OASIS data set, effective April 1, 2026, is available in the Downloads section of the OASIS User Manuals | CMS page, https://www.cms.gov/medicare/quality/home-health/oasis-user-manuals.
| | |
Home Health Quality Reporting Program: Non-Compliance Notifications
The Centers for Medicare & Medicaid Services (CMS) is providing notifications to home health agencies that were determined to be out of compliance with the Home Health Quality Reporting Program (HHQRP) requirements for calendar year (CY) 2026 Annual Payment Update (APU). Non-compliance notifications will be placed into Home Health Agencies (HHA) My Reports folders in iQIES on November 26, 2025. Additionally, the Medicare Administrative Contractors (MACs) will distribute a letter by email or regular mail to non-compliant HHA’s in their service area. HHAs that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, January 6, 2026. If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notification and on the Home Health Quality Reporting Reconsideration and Exception & Extension webpage.
Please note: Any reconsideration request emails greater than 20 MB in size or containing protected health information (PHI) will not be processed. All PHI must be removed in order for a reconsideration to be reviewed.
| | |
Posting of the Calendar Year 2026 Home Health Prospective
Payment System Final Rule
The Calendar Year 2026 Home Health Prospective Payment System Final Rule was published on November 21, 2025. The following are the Home Health Quality Reporting Program proposals that are being finalized: CMS is finalizing the proposal to remove the COVID-19 Vaccine: Percent of Patients Who Are Up to Date Measure and the corresponding OASIS data element. CMS is also finalizing the proposal to remove four assessment items: one Living Situation item, two Food items, and one Utilities item. CMS is also finalizing the proposal to revise the policy to allow for providers to submit a request for reconsideration of an initial determination of noncompliance if they can demonstrate full compliance. In very limited circumstances, HHAs can request an extension to file a reconsideration request if the HHA was affected by an extraordinary circumstance beyond the control of the HHA (that is, a natural or man-made disaster such as a cyber-attack, hurricane, tornado, or earthquake) during the 30-day reconsideration period. CMS is also finalizing the proposal to implement a revised Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey beginning with the April 2026 sample month. This rule would also update regulatory text to account for all-payer data submission of OASIS data.
CMS sought information and provided a summary related to following: a change to the final data submission deadline period from 4.5 months to 45 days, on the digital quality measurement (dQM) transition request for information (RFI) for HHAs, and on the current adoption of health information technology (IT) and standards including Fast Healthcare Interoperability Resources (FHIR), including related challenges or barriers HHAs are facing. Finally, CMS sought input and summarized that input received on future HH QRP quality measure (QM) concepts of interoperability, cognitive function, nutrition, and patient well-being.
| | |
Updated Quarterly OASIS Q&As
October 2025 OASIS Q&A's are available in the OASIS Quarterly Q&As section of the CMS QTSO HHA Reference and Manuals webpage.
| | |
OASIS Answers Home Health Training Webinars
The OASIS Answers, Inc. (OAI) home health training webinars are designed to provide the most innovative training to your clinicians, clinical leaders, quality improvement teams and auditors. These sessions will ensure that you are aware of and know how to apply the most recent, most relevant, and most accurate CMS home health information. Topics are based on the issues that are most pertinent to agencies and will be driven by CMS updates or changes that are critical to agency success. Check out the webinar topics listed HERE!
| | |
Interested in Serving on an IDR Panel?
Kentucky requires one member of the IDR panel to be "a person currently engaged in the provision of Home Health Agency services who has no affiliation with the provider disputing a deficiency." Typically, a Home Health Agency Director is on each IDR panel. There is no payment or travel reimbursement for a Director serving on a panel. Directors will be rotated. If a Home Health Agency Director is interested in serving on a panel, a confidentiality statement must be signed prior to the participation in the first IDR panel.
Please complete the Confidentiality Agreement and submit via email, fax or mail to:
Jennifer Smith, RN
RAI/Oasis/IDR-IIDR Coordinator
Office of Inspector General
Division of Health Care
275 E. Main St., 5E-A
Frankfort, KY 40621
Fax: (502) 564-6546
| |
Home Health Agency Questions and Answers
Home Health Agency (HHA) Providers can access the Home Health and OASIS Q&As and other reference manuals on the HHA Providers Reference site.
These questions and their responses have been developed over many years of experience training OASIS coordinators and are currently used as part of the Home Health Agency Surveyor Training program. They can and should be used by home health agency providers in training new staff on the basics of OASIS and also as a refresher for existing staff.
| | | | OASIS CONTACT INFORMATION | |
For questions regarding OASIS Assessment, Coding, Transmission or Technical Issues,
email KY OIG HC Support.
For questions regarding HHA Licensing or Regulations,
contact Rose Thompson via e-mail.
| |
Please note: Do not send any identifiable patient information through e-mail. This includes patient names, SSNs, dates of birth or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA. Please redact any PHI prior to sending.
| | OASIS DATA SPECIFICATIONS | The OASIS Data Submission Specifications Version 3.01.1 are now available in the downloads section of the OASIS Data Specifications website. | |  |
KARES
To enroll in KARES voluntarily, please click the icon above and follow the self-directed enrollment process.
For additional information about the program, please contact the help desk at (502) 564-2159 or via email.
| |
Click here to visit the website or click here for guidance on how to verify and update home health demographic data.
|
Reporting Complaints
Email addresses have been established for use by patients and the general public to report possible violations of regulatory requirements. Click Here for the email addresses and additional contact information based on the facility's location.
| | |
Which Branch
is Serving You?
To provide the highest level of service, the Division of Health Care operates through four regional offices. Knowing the appropriate Branch to contact with questions and concerns will ensure you receive maximum service in minimum time. Review links below for detailed information.
Regional Map
Contact Information
| | |
Quality, Safety & Oversight Memos
CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
| |
Medicare Learning Network
Let the Medicare Learning Network (MLN) be your home for Centers for Medicare & Medicaid Services (CMS) education, information, and resources.
Visit the Medicare Learning Network for free educational materials for health care professionals on CMS programs, policies, and initiatives.
| |
Quality, Safety & Education Portal
CMS's QSEP provides the full curriculum of surveyor training and guidance on health care facility regulations. All training is available on-demand on a top-notch self-service portal. 24/7 access means you have the freedom to learn what you want, where you want, when you want.
| | | |
Sign Up for This Newsletter
If you have received a copy of this newsletter from a friend or co-worker, you can click on the Sign Up button to enter your information and join our mailing list.
|
Employment Opportunities
To search and apply for positions within the Office of Inspector General, please visit the Kentucky Personnel Cabinet's web page by clicking the sign above.
| | Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621 | |
The Office of Inspector General is the regulatory and licensing agency for all health care, day care and long-term care facilities and child adoption/child-placing agencies in the commonwealth.
| | | | |
