CMS docks one thirtieth of the period payment for every day past the five-day deadline. That is the clearest money in home health, and it is not the only clock — forty-eight hours for the first visit, five days for the assessment, thirty for the face-to-face, then a 60-day cycle that repeats for as long as the patient is on service.
The rulebook is the Home Health Conditions of Participation, plus the certification requirements at 42 CFR 424.22. Fifteen of those requirements attach to an individual patient and carry a date, and every one was written from the citation itself rather than from a survey-prep checklist. The rule set is entirely separate from hospice, because the clocks and the documents are different.
These nine run from the day you send us a patient list. No integration, no new software for your clinicians, nothing to install.
Within 48 hours of the referral, within 48 hours of the patient getting home, or on the start-of-care date the doctor ordered. Whichever applies, the clock is short and it starts before anyone has opened a chart. We check it against the first visit your report actually shows, so a visit made on day one is never flagged as missing.
42 CFR 484.55(a)(1)Five calendar days from the start of care, not five business days. A weekend eats most of the window. If your report carries the completion date we use it, so an assessment you finished on day three is never flagged as late.
42 CFR 484.55(b)(1)This one costs money directly. Every day the notice is late cuts that 30-day payment by another 1/30th, counted from the start-of-care date until the notice is actually filed. Filed on day ten is a third of the episode gone.
42 CFR 484.205(j)The certifying practitioner has to have seen the patient no more than 90 days before care started, or within 30 days after. Miss the window and the whole claim is at risk. We count down the 30 days after admission so the window does not close while everyone assumes someone else handled it.
42 CFR 424.22(a)(1)(v)Care past the first 60 days needs a fresh signed recertification. An unsigned one puts the whole next period at risk, so we flag the period ending well before it does.
42 CFR 424.22(b)(1)The update has to land inside the last five days of the 60-day period. Doing it early counts against you the same as doing it late, which is why we tell you when the window opens rather than only when it closes.
42 CFR 484.55(d)(1)Reviewing the plan is not the same as recertifying it. Surveyors look for evidence the plan actually changed to match the patient.
42 CFR 484.60(c)(1)Two business days from a planned transfer, or from the day you find out about an unplanned one. We count business days, not calendar days, so a Friday transfer does not look overdue on Monday morning.
42 CFR 484.110(a)(6)(ii)-(iii)It goes to whoever picks up the patient's care next. Easy to forget once the case is closed and everyone has moved on.
42 CFR 484.110(a)(6)(i)Thirty days from the day the assessment was completed. Late transmission shows up in your quality scores as well as in survey. We count from the completion date your report carries and tell you when the window is closing, then when it has closed.
42 CFR 484.45(a)Fourteen days, for every patient with an aide in the home and skilled services also in place. One of these can be virtual once per 60-day episode, but an in-person visit each year is required. If your report names supervisory visits we use those. If it does not, we count from the last nursing visit and tell you that is what we did, rather than pretending to know something we do not.
42 CFR 484.80(h)(1)Aide-only cases are the ones that go quiet, because nothing in the week forces a nurse back into the home. They also need a twice-yearly in-person watch of each aide actually doing the care. We watch the gap since the last nursing visit and raise it well before it reaches sixty days.
42 CFR 484.80(h)(2)If the plan says twice a week and the chart shows once, that gap is a finding even when the patient did fine. We compare who and how often the plan orders against what has actually been delivered, and name any discipline that has not.
42 CFR 484.60(a)(2)Nothing else on this page has such a direct price. The clock starts on the start-of-care date and every day the notice is unfiled removes another thirtieth of that 30-day payment. Five days late is a sixth of the episode. Ten days late is a third. It is not a survey risk to be argued about later — it is money that has already gone by the time anyone notices.
It is also the single easiest thing on this list to automate a warning for, because the only inputs are a date you already recorded and a date the notice was filed.
Two of these clocks are counted in different units, and the difference is easy to miss. The five-day comprehensive assessment is five calendar days, not five business days — a Friday start of care leaves you two working days. The transfer and discharge summaries, by contrast, genuinely are counted in business days, which is why we count them that way and a Friday transfer does not show as overdue on Monday morning. Getting either unit wrong produces a false alarm or a missed one, so we do not guess.
The face-to-face window is the one that puts a whole claim at risk. The practitioner has to have seen the patient within 90 days before care started or 30 days after. It usually fails not because nobody saw the patient but because nobody confirmed the date in writing before the window shut, while each party assumed the other had it.
The assessment update is the only deadline here you can fail by being early. It has to land inside the last five days of the 60-day period. An agency that gets ahead of itself and completes it on day 50 is in exactly the same position as one that forgot until day 62. That is why we tell you the day the window opens, not only the day it closes.
Aide-only cases go quiet. Nothing in the ordinary week forces a nurse back into that home, so the sixty-day gap opens without anyone deciding to let it. It is the same failure shape as bereavement in hospice: not a mistake, an absence of a prompt.
Your team sets up one recurring census export from your EMR during onboarding. After that, nobody touches it. That is a setting inside your own system — no integration, no vendor call, no access to your EMR granted to anyone. We send written instructions for your specific EMR, and you can also send files by hand through the client portal any time.
Send us one census export. We will run all fifteen rules against your own dates and show you exactly what is open today, with the citation and the evidence behind each one — starting with any Notice of Admission that is already costing you money.
Get Your Free Compliance CheckComplyWell runs the requirements for your service line and nothing else. A home health agency is never asked about a hospice benefit period, and a dialysis facility is never sent an OASIS deadline. Your rulebook is chosen by the service line on your account, and every finding names the paragraph it came from.
Send one export. We run the home health rulebook against ninety days of your own history and send back what is open, what is due and what has already passed — with the citation beside each one, and a plain note against anything your export did not carry the data for. If a Notice of Admission went in late, you will see the date and the arithmetic.