Bridging Compliance and Quality in Home Health and Hospice

Part of a Larger Conversation

This blog is part of a continuing series exploring how compliance and quality intersect across different healthcare sectors. While the frameworks and regulatory pressures may vary, one theme remains constant: organizations are at their best when compliance and quality work together—not in parallel, but in partnership.

In this installment, we focus on home health and hospice—two sectors where quality outcomes are deeply personal and where compliance missteps can have far-reaching consequences.

The Intersection in Home-Based Care

Home health and hospice providers operate in an environment shaped by intense regulatory oversight and growing public transparency. Whether it’s star ratings on the Care Compare website, survey deficiencies, or value-based purchasing adjustments, organizations are under pressure to perform—clinically, operationally, and ethically.

At the same time, home-based care is uniquely vulnerable to fragmentation. Clinical teams are dispersed, documentation systems vary, and workflows depend on individual accountability.

In this setting, quality and compliance cannot function in silos. They must be integrated.

Why Alignment Matters More Than Ever

Here are just a few of the ways quality and compliance intersect in home health and hospice:

• Hospice Conditions of Participation (CoPs): The QAPI program must be data-driven and organization-wide—but the same data often triggers compliance reviews, corrective actions, or even self-reporting obligations.

  
  

• Home Health Value-Based Purchasing (HHVBP): Agencies are scored on hospitalization rates, patient experience, and outcome measures. Accurate documentation, compliant billing, and timely plan of care updates are essential to performance—and all fall squarely in the compliance domain.

  
  

• Survey Preparedness: Whether from CMS or accrediting bodies, deficiencies often reveal failures in both care delivery (quality) and adherence to standards (compliance). The same root causes often appear in both tracks.

  
  

Too often, quality identifies the symptom, and compliance identifies the rule—but no one connects the two.

From Parallel to Integrated: Strategies That Work

1. Aligning QAPI and Compliance Work Plans

   Instead of developing separate audit calendars and initiatives, bring compliance and quality teams together to identify overlapping risk areas. Examples might include wound care documentation, medication reconciliation, or timely initiation of care.

   
   

   When the same data informs both regulatory compliance and quality improvement, teams can avoid redundancy and focus on shared outcomes.

   
   

2. Joint Root Cause Analysis

   When a hospice survey reveals a care planning issue, or a home health audit uncovers missing documentation, the response shouldn’t live in a vacuum. Joint root cause analysis sessions—led by both quality and compliance—can pinpoint whether the issue stems from training, process gaps, or unclear expectations.

   
   

3. Shared Training Opportunities

   Quality education often focuses on clinical best practices. Compliance training, by contrast, emphasizes documentation, billing, and policy adherence. But in reality, most frontline staff need both. Integrated training modules—for example, on the Plan of Care or medication management—help staff connect the dots between doing things well and doing them right.

A Risk-Based, Outcome-Oriented Model

In both hospice and home health, compliance isn’t just about meeting requirements—it’s about protecting the quality of care. Likewise, quality isn’t just about performance metrics—it’s about building systems that can stand up to scrutiny.

By treating compliance and quality as complementary tools, not competing priorities, agencies can better manage:

• CMS survey readiness

• VBP incentives

• Clinical performance under HHCAHPS or HIS

• OIG scrutiny and billing audits

  
  

This is not theoretical. Agencies that align these programs are more resilient, more efficient, and better positioned to deliver high-value, compliant care in an increasingly competitive environment.

Looking Ahead

As the regulatory environment continues to evolve—particularly with increased transparency, value-based purchasing, and public reporting—home health and hospice organizations must adopt a new mindset. Compliance and quality must be integrated into a single, strategic approach to performance and risk.

Need help aligning your compliance and quality strategies in home health or hospice?

Simply Compliance works with providers to create integrated models that support survey readiness, value-based care, and regulatory accountability—all while staying focused on compassionate, patient-centered outcomes.

Get in touch with Jessica Zeff @ Simply Compliance.