Home Health Survey Checklist for 2026

Most home health agencies don’t fail surveys because they don’t care about quality. They fail because the evidence of quality is scattered across paper binders, EMR notes, text messages, and a coordinator’s memory. Surveyors don’t see what you do — they see what you can show them in 15 minutes.

This checklist is built around the four areas that drive the majority of deficiencies under the CMS Conditions of Participation^[1]: patient rights, comprehensive assessment, care plan execution, and quality oversight. Use it as a mock-survey worksheet 60 days before any expected visit.

1. Patient rights and admission

Surveyors will ask a small number of patients (or family members) to describe what they were told at admission, then cross-check that against your records.^[2] Make sure every active patient chart contains:

• Signed Patient Bill of Rights, in the patient’s preferred language
• Notice of Privacy Practices acknowledgment (HIPAA)
• Advance directive status — captured, not just a checkbox
• Documented complaint/grievance process and how to reach the state hotline
• Verbal consent to care + signed plan of care within required timeframes

2. Comprehensive assessment and OASIS timing

Under 42 CFR §484.55, the Start-of-Care comprehensive assessment must be completed within 5 calendar days of the SOC date.^[1] The most frequent OASIS-related findings stem from timing rather than clinical accuracy:

• SOC visits performed but assessment not finalized within 5 days
• Recertification assessments completed outside the 5-day window before the new cert period
• Resumption-of-Care after inpatient stays not documented within 2 calendar days
• Discharge OASIS missing when patient was discharged from agency care

3. Plan of care execution

Surveyors compare the signed plan of care against actual visit notes for the past 60 days. They are looking for three things:

1. Frequency match — if the order says “SN 2x/week for 4 weeks,” visit notes should reflect that, with documented reasons for any missed visit.
2. Discipline coordination — when PT, OT, SN, and HHA all see the same patient, are their notes referencing each other’s findings? Or operating in isolation?
3. Goal progression — measurable goals with documented progress. “Patient tolerating ambulation well” is not a measurable goal.

4. Quality assessment and performance improvement (QAPI)

Under §484.65, every agency must run a data-driven QAPI program — and surveyors increasingly want to see evidence of action, not just dashboards.^[1] Be ready to walk a surveyor through one specific quality issue your agency identified, what you did about it, and how you measured the result.

5. Personnel files and competencies

Personnel reviews are now a formal, weighted part of the survey process.^[2] For every clinician and aide actively visiting patients:

• Current license / certification on file (not expired)
• Annual competency evaluation, signed by an evaluator with appropriate scope
• TB screening and required immunization records per state rules
• Background check completed before first patient contact
• Annual in-service hours documented (12 hrs/year for HHAs)

What to do this week

Survey readiness is not a binder. It’s a habit. The agencies that pass cleanly are the ones whose Tuesday looks like their survey day.