Separate Entities (Separate Lines of Business)

2183 - Separate Entities (Separate Lines of Business) (Rev 125, Issued: 10-31-14, Effective: 10-31-14, Implementation: 10-31-14) The surveyor must be able to identify the corporate, when applicable, and organizational boundaries of the entity seeking certification or recertification. The Medicare CoPs apply to the HHA as an entire entity and in accordance with §1861(o)(6) of the Act, are applicable to all individuals served by the HHA and not just to Medicare beneficiaries. While the purpose of the CoPs is to help ensure proper care for Medicare beneficiaries, the CoPs do this by defining the standards for an HHA in which Medicare beneficiaries may be treated, instead of establishing requirements applicable only to Medicare beneficiaries served by the HHA. If however, the HHA is able to demonstrate that it operates a “separate entity” or separate line of business to which the CoPs do not apply, it must provide the surveyor with the information to differentiate the separate line of business from the HHA. Neither the Act nor the Medicare regulations define a “separate entity” with respect to HHAs that Medicare approves as an HHA in accordance with the Act and the CoPs. When an HHA alleges that it is operating a separate line of business to which the CoPs do not apply, ask the HHA to produce information to enable the surveyor to differentiate between it and the HHA. Use the following guidelines, on a case-by-case basis, to assist in determining if a separate entity exists. The following criteria should be considered in making a decision regarding a separate entity: • Operation of the HHA; • Consumer awareness; and • Staff awareness.