2023. We’re twenty-three years into the new millennium. Medicare is close to sixty years old. Time is marching on quickly—relentlessly, some would say. New Year’s Eve parties continue the great tradition of partying into the wee hours, ringing in the New Year with a toast, and getting up January 1st with a renewed optimism, a positive outlook on life, and a list of resolutions to improve. You might say it is a great example of continuous quality improvement.
Topics: Employee Training, Security, Quality Improvement, Renewing Accreditation, Compliance, Process Improvement, Materials Management, Showroom, Retail, Warehouse, Work, Disaster Preparedness, Business Practices, Marketing, Equipment
In our January 2022 blog, we talked about fraud, waste, and abuse and touched on compliance programs. The article prompted questions and comments from quite a few organizations and questions of late suggest it might be a good time to do a deeper dive on compliance programs.
Compliance “programs” are sets of policies & procedures specifically designed to help an organization adhere to law and regulation. These policies and procedures are specifically set up to detect, prevent, and correct fraud, waste, and abuse. Medicare requires any provider to have such a program and they have very specific content they want these policies to contain.
A dictionary defines disclosure as “the action of making new information known or the action or process of revealing information.” In the medical world, healthcare providers define disclosure as “a release of information to persons or entities other than the patient who is the subject of the information.”
The pandemic has changed how we look at employment in the United States in a multitude of ways. Many of us now “telecommute” to work, which opens up the opportunity to live farther from the office than ever before. Young people have new and different considerations and priorities when it comes to accepting a job. And of course, there’s the fact that it is increasingly more difficult to recruit and retain good long-term employees. Complicating these issues specifically in our industry are the pesky and sometimes misunderstood background check requirements.
Nothing strikes fear into the hearts of DME owners, managers, and staff more than the Office of the Inspector General (the “OIG”). The fear is perhaps deserved by an extremely small handful of industry people. The vast majority of our industry rank and file have nothing to fear from this sometimes maligned and misunderstood government agency.
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.
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.
As the world slowly but surely returns to normal, surveyors will take to the road once again to visit durable medical equipment organizations across the United States. For several months CMS suspended the accreditation process. On August 12, 2020, CMS gave the approval to resume surveys both onsite and virtual visits (with a follow up onsite visit), or a combination of onsite and virtual survey. With these new guidelines, CMS and the accrediting bodies are beginning to resume surveys with slightly revised procedures and protocols.
A few years back, at 5:00am Saturday during the coldest February Northern Minnesota had seen in decades, a longtime home care patient’s oxygen concentrator failed. The patient’s wife retrieved an E cylinder that was for back up from the guest bedroom and proceeded to try to open the gauge. Her husband—the patient—tried as well but neither could get the tank to open. The couple was a little panicky because the patient had been using oxygen continuously for over a year with only a few moments here and there off oxygen. Regular delivery for portable cylinders was Monday, and they were down to two small portable cylinders with a total of about one hour of oxygen combined.
Many in the home medical equipment industry equate policy manuals to their accreditation inspections. And of course, these bulky tomes are certainly a large part of the accreditation and survey experience for every DME. Policy manuals serve as the road map for how work gets done within an organization, a set of rules for the organization, and the document that defines the structure, function, and philosophy of the organization. Let’s look at what a policy manual should contain and how it impacts not only accreditation, but also the overall day-to-day operation of an organization.
Topics: Employee Training, HIPAA, Security, Personnel Files, Quality Improvement, Billing, Renewing Accreditation, Quality Standards, HQAA Accreditation, HME Accreditation Requirements, Patient File Requirements, Compliance, Patient Privacy, Clinical Practice Guidelines, Materials Management, Avoiding Deficiencies, CMS, Complaint Process, Quality Care, Showroom, Retail, Delivery, Clinical Respiratory Services, Oxygen, Warehouse, Safety Officer, Competence, Customer Service, Disaster Preparedness, Emergencies, Business Practices, Marketing