Change of Ownership (CHOW)
A change of ownership (CHOW) occurs when a Medicare-certified home health agency's ownership transfers to a new entity in a way that meets the regulatory definition at 42 CFR 489.18, such as an asset sale, merger, or consolidation. In a standard CHOW the Medicare provider agreement automatically transfers to the buyer, and with it successor liability for the seller's Medicare obligations, including overpayments.
Definition
A change of ownership (CHOW) occurs when a Medicare-certified home health agency's ownership transfers to a new entity in a way that meets the regulatory definition at 42 CFR 489.18, such as an asset sale, merger, or consolidation. In a standard CHOW the Medicare provider agreement automatically transfers to the buyer, and with it successor liability for the seller's Medicare obligations, including overpayments.
Why it matters
Change of Ownership (CHOW) is part of the Compliance & Survey vocabulary used across home health operations, documentation, and revenue cycle. Understanding it helps clinicians, QA leads, and administrators stay aligned on care quality and compliance.
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