Home Health and Hospice Compliance Essentials
Master Home Health and Hospice Compliance, Documentation, Survey Readiness, and Regulatory Best Practices with a Flexible Certificate Program.
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Hours
Lectures
Content
About This Course
One overlooked compliance gap can lead to audits, payment denials, corrective action plans, or regulatory scrutiny. Home Health and Hospice Compliance Essentials provides a practical understanding of the regulatory and operational requirements for compliant home-based healthcare. Learn documentation standards, billing compliance, patient rights, quality assurance, survey readiness, and risk management strategies that strengthen compliance programs, improve care quality, reduce organizational risk, and support long-term regulatory readiness for home health and hospice providers.
What You'll Learn
- Understand the regulatory framework governing home health and hospice providers
- Identify the key components of an effective healthcare compliance program
- Apply the Patient-Driven Groupings Model (PDGM) correctly in reimbursement planning
- Ensure accurate documentation through OASIS-E and coding compliance
- Evaluate hospice eligibility criteria and terminal prognosis certification
- Recognize compliance risks related to FCA, AKS, and Stark Law
- Prepare organizations for government audits and investigations
- Implement QAPI programs to monitor performance and mitigate regulatory risk
- Strengthen organizational compliance culture and ethical decision-making
Requirements
- No prior compliance experience required
- Basic understanding of healthcare operations is helpful but not necessary
- Interest in home health, hospice care, healthcare quality, or compliance
- Commitment to improving regulatory knowledge and patient care practices
- Suitable for both new and experienced healthcare professionals
This Course Includes
- Comprehensive self-paced online training
- Professional certificate of completion
- Practical compliance case studies and examples
- Downloadable learning resources
- Regulatory compliance frameworks and guidance
- Knowledge assessments and quizzes
- Real-world home health and hospice compliance scenarios
- Lifetime access to course materials
- Mobile, tablet, and desktop access
- Ongoing reference materials for workplace application
Who Is This Course For?
This course is designed for home health administrators, hospice administrators, compliance officers, nurses, clinical managers, quality improvement professionals, healthcare consultants, patient care coordinators, billing specialists, survey readiness teams, and healthcare professionals seeking a stronger understanding of home health and hospice regulatory requirements. It is also valuable for organizations looking to strengthen compliance programs, reduce risk exposure, and improve operational performance.
Certification
Compliance and Regulatory Alignment
Home Health and Hospice Compliance Essentials aligns with key regulatory principles governing home-based healthcare services, including Medicare participation requirements, patient rights protections, quality improvement expectations, documentation standards, compliance program guidance, and industry best practices. The course supports organizations striving to maintain regulatory readiness and strengthen compliance oversight.
Why Compliance Training Matters
Healthcare compliance failures can affect patient safety, reimbursement, organizational reputation, and regulatory standing. Effective compliance training helps professionals identify risks before they become violations, improve documentation accuracy, support ethical care delivery, and strengthen survey preparedness. Home Health and Hospice Compliance Essentials provides practical knowledge that helps organizations operate more confidently in an increasingly regulated healthcare environment.
Career Benefits
Demand continues to grow for professionals who understand healthcare regulations, quality oversight, documentation standards, and compliance management. Completing Home Health and Hospice Compliance Essentials can strengthen qualifications for roles in home health administration, hospice operations, compliance management, quality improvement, clinical leadership, healthcare consulting, and regulatory oversight. These skills are increasingly valuable as organizations prioritize compliance, risk reduction, and patient-centered care.
Course Curriculum
20 Lessons •4-6 Hours
Module 1 — Regulatory Foundations & Enterprise Governance
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1. Conditions of Participation (CoPs) vs. Conditions of Payment
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2. The OIG's Seven Foundational Elements of a Compliance Program
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3. Overview of Anti-Fraud Statutes: FCA, AKS, and Stark Law
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4. Internal Monitoring, Auditing, and Corrective Action Plans
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Module 1 Quiz
Module 2 — Home Health Compliance: PDGM and Documentation Integrity
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1. Medicare HHA Eligibility: Homebound Status and Medical Necessity
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2. Mastery of the Patient-Driven Groupings Model (PDGM) Reimbursement
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3. OASIS-E Documentation, Coding Accuracy, and Audit Defense
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4. Value-Based Purchasing (VBP) and Quality Outcome Compliance
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Module 2 Quiz
Module 3 — Hospice Compliance: Eligibility, Quality & Audit Defense
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1. Terminal Prognosis Certification and Eligibility Documentation
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2. Interdisciplinary Group (IDG) Requirements and Care Plan Compliance
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3. Hospice Quality Reporting Program (HQRP) and Financial Penalties
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4. Identifying and Mitigating the OIG's 27 High-Risk Areas
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Module 3 Quiz
Module 4 — Enforcement, Fraud, and External Scrutiny
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1. False Claims Act (FCA) Risks and the Worthless Services Doctrine
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2. Government Audits: TPE, RAC, and UPIC Investigation Protocol
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3. Structuring Arrangements to Meet AKS and Stark Law Safe Harbors
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4. Crisis Management, Audit Response, and Attorney-Client Privilege
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Module 4 Quiz
Module 5 — Quality Assurance, Ethics, and Strategic Oversight
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1. Developing a Data-Driven QAPI Program for Risk Mitigation
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2. Embedding Compliance into Organizational Culture and Ethics
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3. Navigating Ethical Dilemmas in End-of-Life Care and Autonomy
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4. Vendor, Technology, and Partner Oversight (BAAs and DME Risk)
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Module 5 Quiz
Course Conclusion
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Final Quiz
Frequently Asked Questions
Home health and hospice compliance training teaches healthcare professionals how to follow federal regulations governing Medicare eligibility, documentation standards, reimbursement rules, and fraud prevention laws for home health agencies and hospice providers.
This course is suitable for compliance officers, administrators, hospice managers, clinical supervisors, billing specialists, and healthcare consultants who work with home health or hospice organizations.
Home health and hospice organizations must comply with regulations such as Medicare Conditions of Participation, the False Claims Act, Anti-Kickback Statute, Stark Law, PDGM reimbursement rules, and hospice quality reporting requirements.
The Patient-Driven Groupings Model (PDGM) is the Medicare reimbursement system used for home health agencies. It determines payment based on patient characteristics, clinical groupings, functional impairment level, and comorbidities rather than therapy volume.
Accurate documentation supports medical necessity, patient eligibility, and proper reimbursement. Inadequate documentation can trigger Medicare audits, claim denials, or False Claims Act liability.
Yes. After completing the training, learners receive a certificate of completion from US Compliance Institute confirming their knowledge of home health and hospice compliance fundamentals.