Home Health & Hospice Week

Hint: Pick the right organization, and think of the surveyor as your friend.

If you're an unaccredited home medical equipment supplier who is considering pursuing accreditation, you're not alone.
 
With a growing number of states moving toward mandatory accreditation for some HME suppliers (see Eli's HCW, Vol. XIV, No. 7, p. 54), and the feds considering mandatory accreditation under competitive bidding, accrediting organizations are being swamped with inquiries from HME companies.
 
"We've been accrediting medical equipment and our other home care segments since 1988, and in 2004 for the very first time home medical equipment was the number-one segment for new applications," says Maryanne Popovich, executive director of Home Care Accreditation Services at the Joint Commission for Accreditation of Healthcare Organizations. Home health usually occupies the top spot, she reports.
 
While there's no firm number on how many HME suppliers are currently accredited, Bob Thornburg - a Seal Beach, CA-based HME accreditation consultant - estimates the figure at about 35 percent.

Master the Game with These Strategies

Thornburg and other accreditation experts offer these tips for simplifying the accreditation process:

 1. Determine which organization is right for you. While the three major accrediting bodies - JCAHO, Community Health Accreditation Program and the Accreditation Commission for Healthcare - credential HME suppliers and clinical respiratory services, talk to them about any specialized services you offer (e.g., fitter services, mail-order services, etc.) to find out what specific accreditation designations are available, Thornburg suggests.
 
Strategy: Get a feel for which accrediting body has a culture that best matches yours, he adds. Besides talking directly with accrediting organizations, talk with other colleagues who've been through the process.
 
And keep in mind your various business relationships. "Look to organizations you contract with, insurance companies and others, to verify that they will accept accreditation from the organization you wish to go with," advises Joel Marx, president of JCAHO-accredited Medical Service Companies in Cleveland.

 2. Decide how to navigate the process. There are three basic approaches to accreditation: Do it yourself, purchase a manual or hire a consultant.
 
Option #1: Handling the process on your own can be complex and time-consuming, Thornburg cautions. But if you have a good policy writer on staff, that person may be able to do an excellent job. Just don't forget to budget her salary as part of your accreditation costs.
 
Option #2: Manuals can cost from $1,000 to $4,000, but they make life easier by interpreting the standards for you and offering prefabricated policies and procedures you can easily edit to fit your organization.
 
Option #3: Hiring a consultant will cost thousands of dollars, depending on your organization's size and existing infrastructure, but it could save you headaches - and maybe even cash - down the road.
 
Just don't forget to check references. "Talk to a minimum of three people that have used the manuals and the consultants in recent surveys," Thornburg warns.

 3. Calculate costs and budget appropriately. There's a lot of misinformation out there about accreditation fees, Popovich laments. The cost varies among the three accrediting bodies and depends on an organization's size and complexity, but JCAHO's average fee is around $8,900, while a small startup could expect to pay around $4,000. Floyd Boyer, HME clinical advisor for ACHC, says his organization's average fee for a small supplier is about $3,500.
 
The survey process could take anywhere from six months to more than a year to complete, so you need to budget over that period. "Most of the accrediting bodies take a deposit of anywhere from $500 to $1,000 and then will work out a payment schedule as you go through the process," Thornburg notes.
 
Preparation costs in addition to the fee vary widely depending on how your company is currently run. For example, do you already pay for tuberculosis tests and hepatitis vaccines and criminal background checks for all employees who make patient contact? If not, get out your checkbook.
 
What to expect: "The average company that I work with, which has 10 employees or so, probably spends between $20,000 to $30,000 on the whole process," Thornburg reports. "That's assuming they hire a consultant."

 4. Delegate, delegate, delegate. Include all employees in the accreditation work plan, Thornburg advises. If Harry is in charge of your warehouse and your trucks, for example, Harry should be in charge of those areas during accreditation.
 
Heads up: "People who don't do well with change could fail, and it's important to identify that early and maybe find them something else to do. And that might not be in your organization," Thornburg warns.

 5. View your surveyor as a resource. Rethink your prejudices about accreditation surveyors, advises Sheila Bond, chief operating officer of Total Health Solutions in Metairie, LA, which earned JCAHO accreditation last year.
 
"So many people like me who've been around the medical profession for a long time cringe when we hear the word 'JCAHO,'" confesses Bond, who comes from a hospital background. "But I found the surveyor to be so helpful - a really wonderful resource. It was actually a very pleasant experience."

Editor's Note: The three major accreditation organizations offer information online at www.jcaho.org, www.achc.org and www.chapinc.org.