Summary: Becoming a Medicare-certified home health agency is relatively easy--probably too easy, given the large number of problem agencies cited in various studies in recent years. If owners of home health agencies have not been previously barred from Medicare, they can obtain certification without having any health care experience. Although certified home health agencies must be periodically recertified, serious deficiencies in the process allow problems to go undetected. Once certified, home health agencies have little reason to fear that they will suffer serious consequences from failing to comply with Medicare's conditions of participation and associated standards. Few problem home health agencies are terminated from the program; instead, they are given repeated opportunities to correct their shortcomings, even if the same deficiencies occur from one survey to the next. Moreover, the Health Care Financing Administration has not implemented a range of penalties to sanction problem home health agencies, even though Congress gave it the authority to do so more than 10 years ago.
