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How Does Medicare Address Cultural Competence in Home Health Care?
Date Updated: October 29, 2025
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Medicare addresses cultural competence in home health care through its provider certification procedures. Only home health agencies that meet certain standards obtain Medicare certification. Additionally, legislation prevents discrimination, and guidelines encourage cultural sensitivity and awareness from any publicly funded health care provider, including hospitals, clinics and home health companies.
Relevant Laws and Guidelines
Title VI of the Civil Rights Act of 1964 prevents government-funded health care providers from discriminating against patients because of their race or nationality. Legislative provisions extend to Medicare-certified home health care agencies. Section 1557 of the Affordable Care Act of 2010 contains similar protections from discrimination. Laws also oblige agencies to provide culturally appropriate services.
Additionally, agencies must follow the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. These standards include:
- Providing respectful and equitable quality care that accounts for cultural diversity related to health beliefs
- Recruiting people from differing cultural backgrounds
- Training staff in cultural practices and policies
- Offering free language assistance to those with limited English proficiency
How Home Health Care Agencies Can Promote Cultural Competence
While bound by legal and regulatory measures, home health care agencies can take various steps to ensure culturally appropriate care, which can enhance patient satisfaction and foster respect. Home health care providers may:
- Operate ongoing staff training covering respect for cultural differences, understanding health beliefs that can impact care and effective communication techniques
- Include cultural preferences with customized care plans
- Discuss culturally appropriate interventions with family members
- Schedule visits from a medical professional with a similar cultural background as the patient, where staffing permits
- Collaborate with community health care workers
- Provide written information in a patient’s first language
For example, agencies may plan visits outside of prayer times for people who follow particular religious practices. They may arrange caregivers of the same gender as patients or schedule visits alongside a chaperone. Many seemingly small actions, such as removing shoes before entering a home, can also demonstrate cultural awareness and respect.