Those of us who have been in the DME industry for enough years remember when every DME organization in the country had a storage room full of vertical files and/or bank boxes full of old patient records. The boxes were stored in piles, often piled up to the ceiling. Usually there were labels or writing on the boxes—something like “April 1987-January 1988” or “1990—A-L”. The boxes and filing cabinets were full of manila and Pend-a-flex folders labeled with patient names and chock full of medical records, billing information, social security numbers, dates of birth, and enough demographic information to make a telemarketer’s day.
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.
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.
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!”
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.
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.
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.
I remember filling out paperwork for the first formal job I ever had – a dishwasher and busboy for a restaurant. Some family friends owned the restaurant, so the paperwork was a formality. I remember that it included an application and some kind of a note from my parents since I was under 16 years of age. I didn’t have a driver’s license or a passport, so it’s anybody’s guess what I used for identification or if they even asked for it. I also remember that the simple paperwork seemed intrusive and complicated.
New Year’s Day --with its resolutions, new beginnings, and fresh start attitude-- is a perfect time of year to reflect on continuous improvement and making ourselves better as not only individuals, but as companies set up to serve the public and our customers. It is also a good time to review ways to improve our bottom line, our operational efficiencies, our general attitude, and our business practices. This sometimes requires revisiting mistakes from our past, things we did wrong, and looking at how we’ve improved them. Deficiencies from our past surveys are certainly a worthwhile thing to look at it in an effort to improve.