Home Health & Hospice Week

Deeming could be alternative to going state agency route.

Home health agencies gearing up for Medicare certification could hit a big obstacle: a state survey agency that won't take your application.

State agencies in charge of overseeing Medicare certification for home health agencies and other providers recently heard from the feds that resources are thin--and getting thinner.

Impact: Providers hoping for certification will have to take a back seat at best to the needs of existing certified providers, reports Denise Bonn, deputy director of the National Association for Home Care & Hospice's Center for Health Care Law.

"CMS' longstanding policy makes complaint investigations, re-certifications, and other core work for existing Medicare providers a higher priority compared with certification of new Medicare providers," said the agency in a Nov. 5 survey and certification memo (S&C -08-03).

For at least one state, the crunch has translated into a quick move to halt new certifications altogether for the current fiscal year, which runs through Sept. 30, 2008. Florida's Agency for Health Care Administration recently redirected all providers seeking certification toward the accreditation process and deemed status certification.

Texas, which stopped processing initial certification requests for home health agencies late last year, recently added to the provider types that must seek certification through deeming, reports Sharon Newton of HealthCare ConsultLink in Fort Worth, TX.

Bright side: Agencies seeking certification through deeming could achieve their goals faster than by wrangling with state survey agencies.

"If you're in a state that has had a huge increase in the number of agencies and has tight funding, then it may be better than waiting forever for the state survey team," says Steve Jones of Moore Stephens Lovelace in Clearwater, FL.

Florida had a backlog of about 170 HHA applications waiting when it made the announcement, reports Gene Tischer of the trade group Associated Home Health Industries of Florida in Tallahassee.

Too fast, too soon: "[Certification through ac-creditation] is great public policy," says Tischer. "But the sudden implementation of the policy [in Florida] is all wrong. It's really creating hardships for many agencies."

For HHAs already faced with start-up expenses, adding accreditation costs to the equation can be a shock. But many in Florida seem to be forging ahead--based on an increase in inquiries received by the three deeming organizations.

Access Accreditors Now

"These accrediting organizations are going to get busy pretty quickly, so I'm telling clients that they should make sure they give themselves adequate lead time," says Jones.

For information about home health accreditation, contact one of the three organizations with CMS' "deeming" stamp of approval:

• Accreditation Commission for Health Care, 919-785-1214 or www.achc.org.
• Community Health Accreditation Program, 800-656-9656/202-862-3413 or www.chapinc.org.
• The Joint Commission, 630-792-5000 or www.jointcommission.org.

Resource: To see the 13-page memo, go to www.cms.hhs.gov/SurveyCertificationGenInfo/ and select "Policy and Memos to States and Regions."