Home Health & Hospice Week

If your state survey agency is slow to survey you for initial certification, you may be stuck serving Medicare patients you can't get paid for.

That's what happened to one agency that says the Wisconsin state survey agency failed to survey it promptly.

KidZ Care Home Health Care Inc. asked an administrative law judge to change its Medicare certification date from April 24, 2002 to Feb. 7 of that year, in part because the state unreasonably delayed its survey for no reason related to the home health agency, according to KidZ Care v. Centers for Medicare & Medicaid Services, Doc. No. C-02-735. KidZ Care began furnishing home care services under its state license on Feb. 7.

Wisconsin surveyed KidZ Care on April 10 and 11 and found a "low-level deficiency," according to the decision. KidZ didn't dispute the deficiency, but claimed it was due to a software problem that wasn't its fault.

The HHA subsequently mailed a plan of correction to the survey agency April 17. After receiving no response, KidZ Care hand-delivered its correction plan April 24, and the agency immediately approved it and granted its certification on that date, according to the ALJ decision.

Regardless of why surveyors were tardy in completing the HHA's survey, Medicare regulations don't allow for an agency to gain certification until the date of a successful survey or the date its plan of correction is accepted after an initial survey, the decision notes. "I have no authority to either disregard these regulations or to compel CMS to waive them," ALJ Steven Kessel says.

Because KidZ Care furnished its correction plan to the survey agency April 17, and the agency later approved basically the same plan that was hand-delivered, the ALJ changed the effective date of its certification from April 24 to April 17.

KidZ Care didn't respond to a request for comment.