Home Health & Hospice Week

You’ll need to weigh cost versus risk.

If an ounce of prevention is worth a pound of cure, you may want to consider acquiring certification through the deemed status process.

How it works: Instead of getting surveyed by your state, you can undergo accreditation surveys from one of two deeming authorities authorized by the Centers for Medicare & Medicaid Services — The Joint Commission (formerly JCAHO) in Oak-brook Terrace, Ill., or the Community Health Accreditation Program (CHAP) in Washington, D.C.

When a deeming authority surveys you, you aren’t subject to alternative sanctions including civil money penalties and payment suspensions, CMS has confirmed.

Agencies in some states with long backlogs for initial surveys have been turning to these accreditation organizations already to bypass the wait. But many HHAs have eschewed accreditation as too expensive and unnecessarily burdensome.

Accreditation is costly, allows attorney Robert Markette Jr. of Hall Render in Indianapo-lis. “But it’s less expensive than alternative sanctions,” he says.

Loopholes: Deemed HHAs may still be subject to alternative sanctions in two situations, Markette points out. The state may initiate a survey based on a complaint received, and state surveyors may conduct a validation survey.

#1: Complaint surveys can pose a danger to agencies, Markette notes. A disgruntled employee may phone in a complaint during an inopportune time — such as during a software transition or physical office move. That happened to one agency Markette is familiar with, when its DON quit “in a huff.”

#2: Validation surveys are unannounced surveys used to validate The Joint Commission’s or CHAP’s accreditation process. They occur shortly after the accrediting body’s original survey.

Even with those two exceptions, “the likelihood of getting alternative sanctions goes down significantly” with accreditation, Markette judges.

One reason CMS allows these loopholes may be to ease the workload of its state survey agencies, Markette suggests. SSAs are short of surveyors all over the country, he notes.

Expect to see the number of agencies accredited rise due to this benefit, Markette says. The business decision of whether to pay a smaller amount up front for accreditation versus a punishingly large amount if CMPs are imposed may swing the scales toward the third-party survey. HHAs are likely to say, “If I can afford accreditation, I’m going to go there,” Markette predicts.