Home Health & Hospice Week
OIG Wants More HHA Surveys
Surveyors rarely terminate providers, investigators found.
The reason for alternative sanctions that take effect in July seems clear to the HHS Office of Inspector General. In a new report, the watchdog agency notes that surveyors rarely use termination to address home health agency noncompliance with the Medicare Conditions of Participation, even when the noncompliance is repeated.
Surveyors cited 12 percent of HHAs up for recertification surveys with condition-level deficiencies in 2010 and 2011, the OIG says in its report. Ninety-three percent of these HHAs corrected their condition-level deficiencies within the required 90-day timeframe; the remaining 7 percent corrected the deficiencies late or left Medicare.
Surveyors conducted surveys of nearly all of the 15 percent of HHAs that had complaints lodged against them. Surveyors cited 7 percent of the complaint-surveyed agencies with condition-level deficiencies, and nearly all the HHAs corrected all condition-level deficiencies cited.
Even when "HHAs had the same deficiencies cited during multiple recertification surveys … CMS rarely used the only sanction available — termination — to address HHA noncompliance," the OIG notes.
Reminder: In addition to termination from the Medicare program, your surveyors soon will be able to impose five new alternative or intermediate sanctions (see Eli’s HCW, Vol. XXI, No. 41 for details on each sanction). Medicare also will offer an informal dispute resolution (IDR) process for home care surveys.
The temporary management, directed plan of correction, and directed in-service training sanctions will take effect this July, the Centers for Medicare & Medicaid Services said in the rule published in the Nov. 8, 2012 Federal Register. The civil money penalty, payment suspension, and informal dispute resolution (IDR) provisions will take effect in July 2014.
Watch out: The OIG also recommended that CMS conduct more look-back surveys to check up on state surveyor performance. CMS currently conducts these for the three accrediting bodies that have deemed status, but not often for state survey agencies. That could mean more agencies getting hit with double surveys.
Stay tuned: CMS will work with its regional offices to identify state agencies with the greatest need for the look-back surveys, the agency says in its response to the report.
Note The OIG report is online at http://go.usa.gov/Ttwm
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