HQAA Blog

Towards the end of the Provision of Services (PS) standards, almost to the end of the section, is the very simple accreditation standard PS 9: The Coordination of Care.  The standard, in very simple, straightforward language, reads:

The organization documents the coordination of care between all those involved in the delivery of services or equipment/devices to the client. The organization documents communication with the client and between providers in a standardized manner within the client medical record.

Quality improvement (QI) is often cited by owners and managers as one of the most difficult processes to understand.  Programs are established and resources spent in an effort to maintain compliance in this area.  Organizations report to surveyors that the process of maintaining their QI program can be cumbersome, time consuming, and useless. 

Fed Ex, UPS, and the US Postal Service have consistent, easily identifiable, and even iconic delivery vehicles.  Pizza delivery vehicles often sport magnetic signs and/or rooftop billboards identifying the vehicle as part of their organization.  And who hasn’t seen an Edible Arrangements truck cruising down the highway?  This “branding” serves several useful purposes including marketing an organization.  Delivery vehicles have been part of home medical equipment services since the inception of the industry.  Be it a large truck from an industrial gas company, a cargo van, open pickup truck, or even a small, gas efficient compact car, delivery vehicles are an integral part of any DME organization. 

It might surprise some readers to learn that there are enough rules and regulations, quirks and nuances, and potential problems to devote an entire blog article to a topic limited to “oxygen orders”.  The fact is that oxygen orders are a complex enough issue to devote an article to, and more importantly, for your company to devote resources including training time --toward the goal of compliance.

Companies going through an accreditation process usually experience at least some degree of anxiety.  The importance of achieving and maintaining accreditation is often “life and death” to an organization—lose it and you may not be able to continue billing or receive referrals from a payer or a referral source.  If it’s the first time you’re going through the process, you can also add the fear of the unknown to that equation.  Add these factors together and you have a combination that can cause a lot of stress!

The nature of accreditation is that a company embraces a continuous quality improvement methodology and operates its business in compliance with laws, regulations, and industry best practices to the best of its ability. Accreditation is a journey not just a destination – a journey full of learning opportunities, education, and revision and tweaking of your company’s processes and procedures.

That process doesn’t lend itself well to quick “punch lists” and it is not advisable to look for shortcuts along the journey. However,

Clinical respiratory services (CRS) are hands on care, assessment, or treatment, governed by state regulations including Respiratory Practice Acts and Licensure Laws.  It is usually physician-prescribed in conjunction with medical equipment services.  Most of the DME organizations that provide CRS do not get paid for the services and do them as an adjunct to providing some kind of equipment services, such as an oxygen or ventilation program.  Because of the limited opportunities for reimbursement for these services, organizations

HME organizations struggle with the concept and implementation of informing their customers of their financial responsibilities.  This area of patient rights is often misunderstood and sometimes poorly implemented by organizations.  To establish an effective procedure and mindset for your staff and to serve your customers appropriately, it is important to understand the rationale for this right and requirement.

Organizations are sometimes surprised to find out that surveyors look at various state and federal laws along with accreditation standards during the survey.  The fact of the matter is that law and regulation overlaps accreditation standards in many ways and in many places.  In fact, many accreditation standards have their basis in law and regulation.  Standard ORG 2 states that an organization willdemonstrate compliance with “all required federal, state, and local licenses, permits, certifications, and registration requirements”.  It also references compliance with Medicare enrollment standards, meaning that you must comply with the Quality Standards, which were the basis for all accreditation standards.  Essentially, what ORG 2 says is that you must follow all applicable law and regulation. 

“Ride alongs” are home visits that are performed with a new orientee or current staff member where an evaluator rides along to teach and observe the staff member performing the visit.  These visits are typically done during orientation/training and on an on-going basis for competency assessment.  These visits ensure that all of job-related tasks are being performed in a correct manner while the staff member is unsupervised in the field.