Home Health & Hospice Week

The latest move by the Joint Commission on Accreditation of Healthcare Organizations is likely to take providers' stress levels up a notch.

The Oakbrook Terrace, IL-based accrediting body says it will move to making unannounced surveys as early as next year for some providers. Currently, most providers know a few months ahead of time when their survey will take place and who will conduct it, notes consultant Barb Gingerich with Advantage HCMR Consultants in York, PA.

JCAHO will pilot test the surprise survey process with up to 100 volunteer hospitals in 2004, then open up the unannounced surveys to other provider types, likely including home care, in 2005. By 2006, the accreditor wants to move to a completely unannounced survey program.

JCAHO apparently wants providers to be "continually prepared" and meet accreditation standards at any point in the process, Gingerich says.

Indeed, the changes create "the expectation that each accredited organization be in compliance with 100 percent of the Joint Commission's standards 100 percent of the time," says JCAHO President Dennis O'Leary in a release.

"Too often, agencies go into a huge preparation phase for JCAHO to the detriment of all other activities," maintains consultant Beth Carpenter with Lake Barrington, IL-based Carpenter and Associates. Switching to surprise surveys should cut down on those intensive ramp-up periods and reinforce continual accreditation activities.

The new scheduling will encourage agencies to learn about and comply with new standards and initiatives as soon as the Joint Commission issues them instead of lagging behind until survey time, expects Gingerich.

"That will take a lot of work, staying up on all those details," forecasts consultant Robert Thornburg with Seal Beach, CA-based HME Industry Consultation. Some JCAHO-accredited organizations already take on that workload, but many don't and this process will be a big change for them, Thornburg tells Eli.

"Switching to all-unannounced surveys will place JCAHO preparation/monitoring properly as an ongoing activity instead of a scheduled event," adds Carpenter. "Every-day readiness will be most important," agrees Thornburg, who consults on JCAHO accreditation and also is a surveyor for JCAHO competitor Accreditation Commission for Health Care Inc.

The change "will cause more anxiety because they don't know when the surveyor is coming," Gingerich predicts.

Maintaining JCAHO compliance in the face of unannounced surveys will be a challenge for the vast majority of providers, believes Thornburg. "Talk about sweaty palms," he quips.

Thornburg hopes JCAHO will issue more details about the unannounced surveys, which are part of JCAHO's "Shared Visions - New Pathways" reform initiative, such as if even initial surveys will be unannounced.