Accreditation: The Benefits Beyond Billing Medicare

While many providers located in the first 10 MSAs are scrambling to meet the CMS deadline for accreditation of August of this year, many providers are still sitting on the fence and waiting to determine if they will seek accreditation.

But there are benefits to becoming accredited beyond billing Medicare. Most industry experts recommend that providers create a business model that embraces diversification, a combination of retail, insurance and Medicare sales. And in a time when providers should be running a tight and efficient business, the accreditation process can do just that -- putting providers on the right course.

There are four general steps HME providers will have to take to complete the accreditation process:

1. Choose an accrediting agency and buy its manual.

2. Spend time (most likely months) reviewing the manual and making sure all policies and procedures are up to speed.

3. Submit documentation to the accrediting body.

4. Wait for an on-site survey.

There's one catch. The surveys conducted by the accrediting agencies have to be unannounced. Providers will have a year to complete the accreditation process once it begins. While some providers have already started to prepare, others are taking a wait-and-see approach that may result in a backlog when the deadline is finally issued.

The Good News: While accreditation spells more work and more expense for HMEs, the news isn't all bad. There are many benefits to accreditation including:

  • Creates a better business plan and model.
  • Develops stronger risk management strategies.

  • Reduces incidents.

  • Enhances team awareness.

  • Develops greater customer trust.

  • Establishes a credible framework for reviewing policies and procedures.

  • Reduces liability issues.

  • Identifies and highlights capabilities and competence.

  • Improves employee morale.

  • Creates a solid foundation for future growth.

  • Improves methods for providing service.

  • Improves access and credibility to more payers.

  • Improved efficiency.

  • Increased professionalism.

  • Ability to market accredited status.

    Pre-Survey Checklist

    Providers can begin preparing by reviewing the following checklist. Provided to Home Health Products by the Accreditation Commission for Health Care (ACHC), it can be used as a guideline to know what accrediting agencies will be looking for when they conduct their surveys. Use this list to prepare for mandatory national accreditation. According to Tom Cesar, president of ACHC, this checklist will also help HMEs determine if your organization is in compliance with applicable local, state, and federal laws and regulations and best business practices.

  • Business License is displayed and current.
  • HME License is displayed and current.
  • Pharmacy License is displayed and current.
  • Other License(s) required are displayed: List:
  • Copies of all applicable laws and rules are filed or shelved and are available to all staff. These may include Board of Pharmacy, Respiratory Care Board, Board of Nursing, HME Board, Department of Health, etc.
  • Policy and Procedure Manuals are available to all staff.
  • Office is clean and organized.
  • Fire Extinguishers are checked and current.
  • Exits are clearly marked. It is recommended that exit signs are the illuminated type.
  • Exit plan is displayed in each office, hallway, warehouse, and storage area.
  • There is a compliant file/log for storage of all complaints.
  • Review of complaint file shows all complaints were managed per company policy.
  • There is an incident report file/log for storage of all incidents. Review of incident file shows compliance with company policy.
  • Organizational chart is posted and shows all staff.
  • Brochures or other marketing material are available for distribution to staff, clients, and the community.
  • Employee Handbooks are available to all staff.
  • On Call System is effective. Call after hours to check.
  • Warehouse is clean and organized.
  • Clean and dirty area(s) are marked.
  • Maintenance Logs are available. Inspection reveals records are being kept current and up to date on all rental equipment.
  • Check for expiration dates on all products having dates.
  • No expired products
  • First Aid Kit is available and of appropriate size.
  • Check for any expired products.
  • Eyewash station available (check for expiration date).
  • Rental equipment is and kept covered with plastic.
  • Supply area is organized and clean.
  • If oxygen concentrators are provided, calibration records are present for oxygen analyzers. 02 calibration gas tanks with Certificate of Analysis are recommended.
  • If oxygen tanks are being filled (liquid or gaseous), check for compliance with FDA requirements.
  • Check for a tracking log for oxygen which indicates the client dispensed to, lot #, and expiration date.
  • Check for a tracking log that includes any solutions with a lot #, expiration date, and client dispensed to. MSDS files are able with a sheet for all hazardous materials used by the facility.
  • A Safety Inspection of the facility has been performed within the past 12 months. Any discrepancies have been corrected.
  • There is a recall file/log/notebook in which all recall notices are maintained. All recalls are completed per manufacture guidelines with documentation of the resolution.

  • All required posting documents are posted in a prominent area for staff to view. This includes, Family Leave Act, Equal Employment Opportunity Act, OSHA 300A, Job Safety and Health Protection Act, Minimum Wage, Polygraph Protection Act, Blood Borne Regulation and Procedures, and State Poster Requirements. Vans and company vehicles are clean and organized.
  • There is a process for separation of clean and dirty equipment in company delivery vehicles.
  • Delivery vehicles have Personal Protective Equipment (PPE) available to include eyewash, gloves, mask, HEPA mask, gown(s), germicide, towels, hand sanitizer, and plastic bags. MSDS files are available with a sheet for all hazardous materials carried in the delivery vehicles.
  • Placarded vehicles have a vehicle safety inspection performed for each day the vehicle is utilized. The inspection of the vehicle shows no safety deficiencies. This is good practice for all delivery vehicles.
  • Staff receives annual continuing education that includes at a minimum: Safety, Infection Control, Compliance, Ethics, Cultural Awareness, and Clients Rights and Responsibilities. The education is documented.
  • Licensed staff has the state CE requirements documented. The Location staff is in compliance with all reporting requirements as required/requested by the QI Coordinator.
  • (Reprinted with permission from ACHC.)

    Accrediting Bodies

    American Board for Certification in Orthotics and Prosthetics Inc.
    330 John Caryle St., Suite 210
    Alexandria, VA 22314
    (703) 836-7114

    Board of Certification in Pedorthics
    330 John Caryle St., Suite 210
    Alexandria, VA 22314
    (703) 836-7114

    Board for Orthotist/Prosthetist Certification
    7150 Columbia Gateway Dr, Suite G Columbia, MD 21045-1151
    (443) 539-3810

    Commission on Accreditation of Rehabilitation Facilities
    4891 E. Grant Road
    Tuscon, AZ 85712
    (888) 281-6531

    Community Health Accreditation Program
    1300 19th Street, NW, Suite 150
    Washington, D.C. 20036
    (800) 656-6956

    The Compliance Team Inc.
    P.O. Box 160
    905 Sheble Lane, Suite 102
    Spring House, PA 19477
    (215) 654-9110

    Healthcare Quality Association on Accreditation
    217 West Fourth St.
    Waterloo, IA 50701
    (866) 909-4722

    Joint Commission on Accreditation of Healthcare Organizations
    The Joint Commission
    One Renaissance Blvd.
    Oakbrook Terrace, IL 60181
    (630) 792-5000

    National Association of Boards of Pharmacy
    1600 Feehanville Drive
    Mount Prospect, IL 60056
    (847) 391-4406

    National Board of Accreditation for Orthotic Suppliers
    NBAOS c/o SmithBucklin
    401 N. Chicago Avenue, 22nd Floor
    Chicago, IL 60611
    (888) 463-4011

    This article originally appeared in the April 2007 issue of HME Business.


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