HQAA Blog

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we monitor a delivery person’s driver’s license or a clinician’s clinical license to make sure they haven’t expired or been revoked.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.

On one of the few flights I took the last quarter of 2020 (thanks, Covid!), a seatmate struck up a conversation with me. Yes, it’s still possible to do these simple and rather “human” things we took for granted before the pandemic—even while wearing facemasks. The conversation started with the usual “So, what do you do for a living?” question. A couple exchanges with my new friend later, I found myself drilling down into what DMEPOS is and some of the myriad types of equipment and supplies that fall into the Medicare definition.

Nothing says “Merry Christmas” and “Happy Holiday Season” like a good audit.  The end of the year is an arbitrary date to be sure; but it’s a good marker for reminding us that we need to check our businesses to ensure we’re still compliant with the multitude of law and regulation these businesses face.  As the holiday season approaches, let’s look at a quick checklist of audit activities we can perform to keep up with our complex and ever-changing industry. 

One of the most important tasks a surveyor will perform during your organization’s survey is the patient record review. Whether this is done by combing through manila or Pend-a-Flex folders, or going through an electronic record on computer software with your staff, the patient record is one of the most crucial pieces of documentation to be reviewed during survey.

Surveyors for all the accrediting organizations are back on the road now, surveying up a storm and working to catch up the backlog of new customers and ongoing customers who were scheduled for survey in that March to July 2020 time period. It’s good to be back doing what we love, even with some accommodations and new processes in place.