Sixty-one dated requirements across five service lines. These are the ones a surveyor scores you against — and every one of them is a date in a record you already hold.
None of these are obscure. They are the dates that decide whether a finding is written up, and every one of them is a subtraction anybody could do — if anybody were doing it every morning.
A home health Notice of Admission filed after the fifth day reduces the 30-day payment by one thirtieth for every day late, counting from the start-of-care date. Nothing else on this page is that mechanical.
42 CFR 484.205(j)An unsigned hospice recertification does not reduce the payment. It makes the entire benefit period ineligible, which is the difference between a deduction and a repayment.
42 CFR 418.22Hospice, home health, skilled nursing, dialysis and opioid treatment each carry their own Conditions of Participation. We run only the ones for the lines you actually operate.
42 CFR Parts 418, 484, 483, 494 and 8Not a portal you have to remember to open. A dashboard that holds the current state, one email each morning to the person who owes the work, and a text only when something is already past due.
| State | Who | Requirement | What we found |
|---|---|---|---|
| Past due | Halvorsen, R. | Visit notes signed, and signed on time42 CFR 418.104(b) | 1 visit note still unsigned, oldest from 28 days ago. |
| Past due | Garcia, P. | Plan of care reviewed every 15 days42 CFR 418.56(d) | The most recent plan of care date is 19 days old. |
| Action due | Chen, M. | Aide supervisory visit every 14 days42 CFR 418.76(h)(1)(i) | Last supervisory visit 12 days ago. Due in 2 days. |
The dashboardEverything open, who owns it, and the citation behind it.
The morning emailOne brief a day, to the person who owes the work.
The textReserved for the ones that cannot wait for email.
All sixty-one, grouped by the service line they belong to. We run only the lines you operate, so a hospice never sees a dialysis finding.
42 CFR Part 418 · 14 rules
An unsigned recertification makes the whole benefit period ineligible.
Cited at 13% of hospices surveyed. The easiest requirement to let slip.
Cited at 17% of hospices surveyed.
The first deadline of the admission, and the easiest to miss.
Missed HOPE submissions carry a four-point payment cut.
Requires the plan of care to know which disciplines were ordered.
Plan of care content is the most cited hospice requirement in the national data - 57% of hospices surveyed.
Cited at 18% of hospices surveyed.
Cited at 11% of hospices surveyed.
Cited at 12% of hospices surveyed.
Cited at 15% of hospices surveyed.
Late closure is how documentation drifts from what actually happened.
Cited at 19% of hospices surveyed for authentication alone.
The most cited hospice requirement in the national data, at 57% of surveyed hospices. Surveyors check that the plan names interventions for pain and symptoms, the scope and frequency of each service, measurable outcomes, drugs and treatments, supplies and appliances, and the patient's understanding and agreement.
42 CFR Part 484 and Part 424 · 15 rules
The first visit has to happen 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.
Five calendar days from the start of care, not five business days.
This one costs money directly. Every day late cuts the 30-day payment by another 1/30th, counting from the start-of-care date until the notice is filed.
The doctor or 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.
Care beyond the first 60 days needs a fresh signed recertification. An unsigned one puts the whole next period at risk.
The update has to land inside the last 5 days of the 60-day period. Doing it early counts against you the same as doing it late.
Reviewing the plan is not the same as recertifying. Surveyors look for evidence the plan actually changed to match the patient.
Two business days from a planned transfer, or from the day you find out about an unplanned one.
Goes to whoever picks up the patient's care next. Easy to forget once the case is closed.
Thirty days from the assessment completion date. Late transmission shows up in your quality scores as well as in survey.
Applies when skilled services are also in place. One of these can be virtual once per 60-day episode, but an in-person visit each year is required.
Aide-only cases still need a nurse on site every 60 days, plus a twice-yearly in-person watch of each aide actually doing the care.
Diagnoses, visit frequency and duration, medications, safety measures, risk of going back to hospital, and advance directives all have to be there.
The nurse records and signs it, then the practitioner has to authenticate and date it. Both halves get checked.
If the plan says twice a week and the chart shows once, that gap is a finding even when the patient did fine.
42 CFR Part 483 · 15 rules
The MDS comprehensive assessment has to be completed within 14 calendar days of admission. Surveyors pull recent admissions first and this is the date they look for. A late assessment makes the care plan that follows it late too.
When a resident's physical or mental condition changes significantly, a full comprehensive assessment is due within 14 calendar days of the facility identifying it. This rule only speaks for residents whose export carries a date for the change itself.
Long-stay residents drift past the anniversary quietly because nothing about their care changed to prompt it. The regulation requires a full comprehensive assessment not less often than once every 12 months, on top of the quarterly reviews.
Between the yearly comprehensive assessments, a quarterly review assessment is required not less frequently than once every 3 months. Three months is taken here as 92 days, which is the widest reading of the regulation's own words.
Encoding is the step between finishing the assessment and being able to send it. The regulation gives 7 days from completion. It is a separate deadline from the 14-day transmission deadline and is missed far more often.
The completed MDS has to be electronically transmitted to the CMS system within 14 days of the assessment being completed. Late transmission is visible to CMS without anyone visiting the building, so it is the easiest finding in the regulation to prove.
Every resident needs a baseline care plan within 48 hours of walking through the door - long before the comprehensive assessment is finished. It is the plan that covers the first two weeks, and a missing one is a common early-survey finding.
The baseline care plan has to carry the resident's initial goals from the admission orders, the physician orders, the dietary orders, the therapy services and the social services. ComplyWell checks each element is present. It does not judge whether the wording is clinically adequate.
The comprehensive care plan has to be developed within 7 days of the comprehensive assessment being completed, and revised after each later assessment. A care plan still dated before the most recent assessment is the shape a surveyor looks for.
A discharged resident needs a discharge summary carrying a recapitulation of the stay, a final summary of their status, a reconciliation of pre-discharge and post-discharge medications, and a post-discharge plan of care.
Residents must be seen by a physician at least once every 30 days for their first 90 days. This rule watches the first of those visits. The regulation also treats a visit as timely up to 10 days after it was required, so ComplyWell does not call it red until day 40.
After the first 90 days a resident must still be seen by a physician at least every 60 days, and a visit counts as timely up to 10 days after it was due.
Every resident's drug regimen must be reviewed at least once a month by a licensed pharmacist. A month is taken here as 31 days so that a review done on the same date each month never counts as late.
A PRN order for a psychotropic drug is limited to 14 days. Beyond that the prescriber has to document a rationale and a duration, and for anti-psychotics has to re-evaluate the resident first.
Each resident must be offered an influenza immunization October 1 through March 31 every year, and the record has to show the education given and whether they took it, refused it or were contraindicated.
42 CFR Part 494 · 10 rules
The clock runs from the first outpatient dialysis session and ends at whichever comes later, so a busy patient can hit 13 sessions long before day 30 and a light one can pass day 30 first.
This one is easy to lose because it is a one-off deadline that sits between the admission rush and the ordinary annual cycle.
A missing month of delivered Kt/V is one of the fastest findings a surveyor can write, because the gap is visible straight off the lab log.
Four months is long enough that nobody remembers it is due, and peritoneal patients are usually the small group nobody has a routine for.
Long-standing patients drift past the anniversary quietly because nothing about their care changed to prompt it.
Once a patient has been hospitalised or has lost ground, the reassessment interval drops to monthly, and surveyors check that the facility noticed the switch.
The plan has to be in use, not just written, by the same deadline the initial assessment runs to.
An assessment that never turns into a changed plan of care within 15 days is what this rule catches.
The proof required is a monthly progress note in the record, so a visit that happened but was never noted counts as a miss.
Home patients are out of sight between clinic visits, so the two-month review is the only scheduled check that they are dialysing safely.
42 CFR Part 8 · 7 rules
A patient can start medication after the screening exam, but the full history and physical still has to land inside 14 days. Surveyors pull new admissions first and this is the date they look for.
The initial psychosocial assessment has to be finished inside 14 days of admission and has to produce a care plan. A late assessment makes every later plan review late too.
The care plan has to name the patient's own goals and the actions agreed with them, their education, training and employment goals, the recovery support services they need and want, and how often each service will be given. ComplyWell checks each element is present. It does not judge whether the wording is clinically adequate.
Long-standing patients drift past the anniversary quietly because nothing about their treatment changed to prompt it. The regulation says this examination should happen not less than once each year and be done by an OTP practitioner.
The rule is a yearly total - no fewer than eight random tests per patient per year. ComplyWell watches the gap since the last test, because a gap wider than about six weeks is how a patient quietly ends the year short of eight.
Interim treatment is capped at 180 days, and the written plan for what happens after it has to be in the record by day 120. Missing it leaves nowhere for the patient to go when the cap arrives.
Interim treatment cannot run longer than 180 days in any 12-month period. A patient still on interim past that mark is a finding the surveyor can read straight off the admission date.
Breach notice, access termination, risk analysis and the six-year retention piles.
$149 a monthBloodborne pathogens, hepatitis B, respiratory protection and the injury records.
$149 a monthTake one area on its own at $149 a month, or take Complete — every rule — at $649 a month billed annually. The whole price is on one page.
Send us a recent export and we will run these rules against your real records and show you what is already open today. No obligation, and nothing is kept unless you decide to go ahead.