HQAA Blog

In early September 2021, President Biden issued an executive order instructing OSHA to issue a standard requiring employers to require vaccination or weekly testing for Covid 19. There are exceptions including religious exemptions and also various disabilities (a physician’s statement that a person cannot receive the vaccination). The executive order applies to all Federal employees, contractors, healthcare workers, and employees of private sector employers with 100 or more employees. Various dates for implementation are mentioned in the order-- most of them are in November and/or December of 2021.

The pandemic has changed our society in many ways. In some cases, it seems to have done irreparable harm. Fortunately, there have been some upsides and our society has learned some useful lessons along the way. One thing that some folks find beneficial and positive is that many companies and employees have learned that working remotely can actually work!

Since the early days of the Covid pandemic, surveyors have been avoiding “home visits”—those interactive ride alongs where the surveyor goes with a delivery person or clinician to visit a patient/customer in their home. This is for the safety of the staff members, the surveyor, and most important, the patient/customer. Although our process has changed a bit over the last few months, the surveyors are still not going out on home visits and are not likely to start that process up again any time soon.

We’ve talked about retail showrooms before, but in the several years since we’ve covered the topic, retail has made a triumphant resurgence. The DME retail showroom’s amazing comeback is a product of a perfect storm of factors in the industry. Certainly, declining reimbursement and limitations to coverage for DME products and services is at least partially responsible. The fact that Baby Boomers are retiring and becoming eligible for Medicare is also a factor. Retirees today –compared to retirees of a decade or so ago—are tech savvy computer users who are comfortable shopping on line and also somewhat conditioned to paying for larger portions of their healthcare out of pocket. The bad news for local DME’s is that they are tech savvy and capable of shopping on Amazon-like platforms. The good news for local DME’s is that they are willing to pay more out of pocket for healthcare. Retail provides a “hedge” for your organization. If someone wants the traditional “deliver it and bill my insurance” DME model, you can do it. But you also have a showroom and are prepared to deal in cash.

Its hurricane season in Florida and the Southeast of our country. Some years are not as bad as others, but a “bad” hurricane season can include major disruptions to travel and business operations, damage to businesses and buildings, lost and ruined equipment, and even destroyed homes and loss of life. The DME industry has seen its share of missteps and mistakes with regards to preparation for these catastrophes, but they’ve also seen many successes. Seeing an organization work their way through a hurricane (or any major disaster) can be impressive. Let’s look at the two extremes in preparation.

Many durable medical equipment company employees equate “OSHA” with those plasticized posters typically hung in a breakroom or kitchen in the organization. Training requirements by both accreditation standards and OSHA itself have gone a long way to educating employees about the various OSHA mandated requirements and led to a better understanding of OSHA. This in turn has led to better adherence to the rules and regulations and ultimately to a safer workplace.

I like the analogy that compares an organization’s staff to a sports team. You have a coach (an owner, manager, or supervisor). You have players/team members (the staff). You have a common goal (winning the “game”; game defined as whatever your goal is—be it increasing sales, improving some process, or achieving better customer satisfaction). You have a set of rules (think of the myriad regulations, billing/reimbursements requirements, etc.). And you work toward that shared, common goal together; team members supporting each other to “win.”

Imagine how hard it would be to adequately assess whether a person could do some specific task (such as teach school, perform surgery, re-wire a house’s electrical system, or build a bridge) without actually observing them doing that task. We hire employees based on applications and resumes, we evaluate their performance in a job by checking their attendance record to insure they show up to work on time, and we monitor a delivery person’s driver’s license or a clinician’s clinical license to make sure they haven’t expired or been revoked. But no tool works as well to assess a person’s ability to do their job as well as actually watching them do their job. Competency assessments are an integral part of the evaluative process and some would say, THE most important part of that process. If you are hiring a marksman for their ability to hit a target, at some point, you’re going to go out into the field and say “Show me what you’ve got!”

Sentinel – noun – “A soldier or guard whose job is to stand and keep watch”

Sentinel – verb –"To watch over, stand guard, or protect some place, person, or area”

In medical industries, sentinel events are defined as “unanticipated events or occurrences resulting in death or serious injury to a patient; not related to the patient’s illness, but related to the medical equipment, supplies, or care being provided." For the purposes of our discussion here, “adverse events” and “sentinel events” are one in the same.

Ask any owner what they think the most intrusive part of an accreditation survey is and chances are pretty good they’ll mention the financial documents review portion. In my experience, this is because of two equally important reasons: 1) It is certainly information that a business owner does not like or feel comfortable sharing, and 2) Many -if not most- DME business owners are more conversant in and knowledgeable talking about the day to day issues they face in their businesses. Things like new billing software, technological advances with medical equipment, and those new “Sprinter” delivery vehicles are all topics that they love to chat about with fellow business owners. How much money they actually put in their pockets and how difficult (or easy) it was to pay the bills that keep the lights on are topics we just don’t feel as comfortable sharing.