Are "best practices" the best legal standard?

All across the healthcare spectrum, the focus on the quality of care has heightened. From physician services to overall health plans, politicians, policy-makers, and employers have directed their attention to quality of care measures for provider selection and reimbursement methodologies. Various efforts have sprouted among care providers, regulators, and other interest groups to develop and advance "best practices" to achieve patient-centered, outcome-based care practices and measures that secure both optimal clinical results as well as the efficient use of limited health care resources. Through these efforts, a wide variety of "best practices" are surfacing, ranging from those that are evidence-based to those which are seemingly driven by simple intuition. This article explores the potential application and impact of "best practices" in the legal arena for home care services. In particular, the article addresses the role that "best practices" may play in determining the standard of care for liability purposes and compliance with the Medicare Conditions of Participation.