Home Health & Hospice Week

Wide variation in how surveyors apply the new Home Health Conditions of Participation could hamper home health agencies' efforts to get up to speed on CoP compliance.

"My worry is that different state survey agencies and surveyors ... will survey differently," says consultant Sharon Litwin with 5 Star Consultants. That's what they do now, she insists.

"Currently some surveyors don't cite things they make big deals about during survey, and then others write up everything they see and give conditions," Litwin blasts. "And some states are easy on agencies," while others are very hard on them.

For example: An agency that is not in very good compliance may get two standard-level deficiencies, and then another agency in another state that "is pretty darn compliant" may get four condition levels, Litwin offers. "It is not the same across the country," she criticizes. Thus, you can expect that in some states, some surveyors will hand down many new CoP-based citations, while in other states, surveyors won't. The survey process "needs to be objective across the country," Litwin urges.

Many of the CoP requirements "are relatively vague and leave a lot to the discretion of agencies," says attorney Elizabeth Hogue. That's not totally bad, because it can give agencies leeway to implement requirements in a way that makes sense for their organization.

But: "It also leaves lots of room for surveyors to have their own ideas about what agencies should be doing and to attempt to impose these ideas on agencies during surveys," Hogue worries.

These types of inconsistencies may be compounded by lack of surveyor readiness, says consultant and physical therapist Cindy Krafft with Kornetti & Krafft Healthcare Solutions. "I anticipate some difference of opinion on interpretations (hearing some already) that will complicate this," Krafft tells Eli.