Survey & Certification:
Use Exit Conferences To Deflect Unfair Survey Findings
Published on Thu Apr 15, 2004
Surveys get tougher, thanks to GAO. It happens to the best of home health agencies: You've worked your tail off to get your regulatory and compliance ducks in a row, and you expect to reap the rewards at survey-time.
But maybe your surveyor is inexperienced, doesn't know home care or is just plain batty. Whatever the reason, she appears ready to cite you for things you don't agree with. What can you do?
That scenario may be on the rise, thanks to the General Accounting Office's charge to surveyors to get tougher on HHAs (see Eli's HCW, Vol. XII, No. 5, p. 34). With the onset of the prospective payment system, "surveys have receded in home health agencies' consciousness," said Chicago-based regulatory consultant Rebecca Friedman Zuber in a March 31 presentation at the National Association for Home Care and Hospice's National Policy Conference in Washington, DC.
But surveyors appear to have ratcheted up the survey process, especially in some areas of the country, Zuber warned in her presentation, "The Medicare Home Health Survey - What to Expect & How to Respond."
The exit conference is HHAs' best hope for deflecting unfair survey findings, said co-presenter Charlotte Hughes, assistant vice president for regulatory affairs for national HHA chain Gentiva Health Services Inc.
The survey formal appeals process is so slow that agencies will be out of business before they can appear in front of an administrative law judge, Hughes warned. "The survey is one of the areas where you don't have a heck of a lot of appeal rights."
The exit conference is agencies' first and best stage of appeal and rebuttal of the surveyor's findings, Hughes told conference attendees. Once the surveyor reports your supposed deficiencies, "they are the very devil" to have rescinded, she commented.
Every HHA should follow these survey steps, Hughes advised: 1. Secure your exit conference. Every agency has the right to an exit conference, but surveyors may try to avoid it, Hughes cautioned. Or they say they'd like to conduct it over the phone, once they get to their offices.
Don't fall for that trick, Hughes urged. Once the surveyor has left the premises, your arguments lose validity and you have a harder time making her prove her charges. 2. Document. You have the right to tape your exit conference, as long as you run two tapes and furnish one to the surveyor, Hughes related.
But know when to pick your battles, she added. If your surveyor is vehemently against the idea of taping the conference, you're unlikely to get many helpful details out of her. Instead, you can have multiple clerical personnel take very detailed notes of the conference, if you deem it the wiser course. 3. Attend. Don't be afraid to [...]
