Despite public concern over substandard healthcare quality, the federal government is giving some home-care agencies a break from strict quality evaluation requirements.
HCFA earlier this month put in place its new policy to permit some home-care agencies to be surveyed for purposes of Medicare certification every 24 to 36 months instead of every year.
In the past, home-care providers have had to pass unannounced annual surveys conducted by either state agencies or HCFA-approved accrediting organizations to be able to participate in Medicare.
Home-care providers will still be able to choose whether they want to receive certification through a state agency or an accrediting organization, but they may no longer be subject to random annual reviews.
The fiscal 1997 budget included an industry-backed proposal to increase the interval between standard surveys of home-care agencies. The plan freed up $8 million for HHS to certify new Medicare providers.
Following HCFA guidelines, state agencies began using the new survey cycles in October 1996. This month, HCFA approved survey-frequency plans of the Joint Commission on Accreditation of Healthcare Organizations and the Community Health Accreditation Program, which is run by the National League of Nursing.
The accrediting organizations will evaluate home-care agencies to ensure they are meeting their HCFA-approved standards and will then determine an appropriate survey cycle.
Margaret VanAmringe, the JCAHO's director of federal relations, said the longer time between surveys will provide a more effective use of government resources and provide incentives for organizations to perform well. She described the survey process as a "top-to-bottom review" with a number of safeguards to prevent troubled companies from slipping through the cracks.
VanAmringe said organizations under the 36-month cycle should have strong track records. She added that patient and staff complaints can be pursued any time during the interim between surveys. In addition, she said a random sample of 5% of the organizations under the 36-month cycle will have unannounced surveys about midway through their cycle.
Mary St. Pierre, the director of regulatory affairs for the National Association for Home Care, which lobbied for the new policy, said HCFA will now be able to focus its resources on providers that raise concerns. "Before, they weren't able to investigate complaints as promptly as they needed to," she said.