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Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3, 2005
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Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Dec 31, 2015

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Page 1: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Mandatory Accreditation:Can We Afford It?

AARC 51st International Respiratory Congress

Bob Floro, RRT, Associate Director Joint Commission December 3, 2005

Page 2: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Topics for Today

Value of Accreditation Value of Joint Commission Accreditation MMA and Mandatory Accreditation Can We Afford It?

Page 3: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Value of Accreditation

Page 4: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Improves the Quality of Care

Meeting Requirements– Accreditation Participation Requirements– National Patient Safety Goals– Standards– Performance Improvement

Survey Process and PPR– External Validation

Through Commitment to Quality Quality and Corporate Culture

Page 5: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Improves Patient Safety

Public Notice to Patients and Employees Standards Compliance Performance Improvement Culture

Page 6: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Compliance and Liability

Regulatory Agencies Law and Regulation Standards

– Rights, Ethics and Responsibilities – All Stds– Provision of Care – Care Planning– Leadership – Responsibility and Accountability– Environment of Care

Operable Equipment PM/Maintenance Records

– Management of Information – Documentation Decrease In Liability Costs

Page 7: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

State and Federal Recognition

State Recognition of Accreditation– HME Licensure

CMS– Recognition of Quality

Growth Post MMA

Page 8: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Access to Third Party Payors

Private Carriers – Traditional and MCO State Medicaid Programs CMS!

– Payment for Quality

Page 9: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Deemed Status

Definition Equivalent Standards

Page 10: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Joint Commission Accreditation

Page 11: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Leader In Health Care Accreditation

56 Years Private – Not For Profit 15,000 Health Care Organizations 4,000 Home Care Organizations 1,500 HME Organizations (4,745 locations)

– All Accreditors – Approx. 27% Market Penetration

Page 12: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Standards And Survey Process Development

Internal Resources– Program– Standards– Research

External Resources– Advisory Councils– PTAC– SSP

Page 13: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Patient Focused Survey Process

Patient Tracer Methodology Systems Tracer Methodology Value

– Third Party View– Standards of Practice– Education and Consultation

Page 14: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Consistent Accreditation Decisions

Decisions Based on Consistent Scoring Preliminary Decisions Revealed on Survey Clarification During and Post-Survey Appeals Process Review and Scan

– 100% for Deemed Status

Page 15: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Surveyor Qualifications

Bachelors/Masters 5 Years in HME Professional - HME Specialist, RCP, & Rehab Tech Training

– Initial– Conference– Distance Learning

Accountability– Certified– Supervised Observation– Scans

Page 16: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Improved Access to Referrals

Recognition of Joint Commission Accreditation

Similar Processes Public Awareness

– Speak Up

Page 17: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Representation to Public As A Quality HME Organization

• Public Notice to Patients and Employees• Accreditation Status and Quality Check• Random Unannounced Surveys• Unannounced Surveys• Organizational Responsibility to Promote• Gold Seal

Page 18: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Professional Recognition in HME

Since 1988 Clinical Respiratory Services Rehabilitation Technology

Page 19: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Culture of Quality

Continuous Process – 100% - 100% Elimination of Survey Prep PPR Accountability to Public

Page 20: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

The MMA andMandatory Accreditation

Page 21: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

The MMA, Competitive Bidding & Mandatory Accreditation

Elements– Competitive Bidding– Equipment Categories– Implementation Schedule and MSA’s– CMS Quality Standards– Approved National Accrediting Bodies– Mandatory Accreditation

Page 22: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Competitive Bidding

Specific Equipment Categories Implementation Schedule and MSA’sCMS Quality StandardsConcern for Small BusinessesBidding MechanismsPAOC (www.cms.hhs.gov)

Page 23: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Equipment Categories

Categories vs. Single Items High Dollar Categories High Volume Categories Some Suspects:

– Oxygen– Diabetic Equipment and Supplies– Wheelchairs– Orthotics/Prosthetics

Page 24: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Implementation Schedule And MSA’s

Definition – MSA January 2007 – 10 MSA’s January 2009 – 80 MSA’s January 2010 – All Participants

Page 25: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

CMS Quality Standards

Proposed Standards– Supplier Business Quality Standards (11 pages)

Administration Financial Management Human Resource Management Beneficiary Services Performance Management Equipment and Safety Beneficiary Rights and Ethics Information Management

– Appendices for Supplier Product Specific Service Requirements – Appendices A – O (89 pages)

– Unannounced and 100% Sample

Page 26: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Approved National Accrediting Bodies & Mandatory Accreditation

National Accrediting Bodies to Implement CMS Quality Standards

Equivalency in Standards Joint Commission and CMS

Formal Process for CMS Approval of Accreditor

Volumes and Access to Accreditors

Page 27: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Accreditation Fees

Page 28: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Accreditation Fees

Fees Based on 3 Factors

• Services

• Size

• Number of Locations

Page 29: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

2006 HME Fee Calculation – 3 Years

Classification: Size: Fee:Very Small 1 – 50 $3565

Small 51 – 300 $5185

Medium 301 – 999 $6900

Large 1000+ $9790

Page 30: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Miles from Main Site: Fee Per Site:

Less than 59 $395

60 - 119 $730

120 – 199 $1070

Over 200 $1380

2006 Fee Calculation - Locations

Page 31: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Can We Afford It?

Cost of Preparation Cost of Maintenance Cost of Survey Value vs. Cost Cost of Culture Change

Page 32: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

“The success of Joint Commission accreditation will be measured by our ability to assist HME organizations in embracing quality patient services and safe provision of care as an integral element of their corporate and organizational culture.”

Philosophy

Page 33: Mandatory Accreditation: Can We Afford It? AARC 51 st International Respiratory Congress Bob Floro, RRT, Associate Director Joint Commission December 3,

Joint Commission Home Care Accreditation Program

Central Office – 630-792-5000 (www.jcaho.org)

Program office – 630-792-7441

Bob Floro – 630-792-5741 ([email protected])

Account Representative – 630-792-3004

Standards Interpretation – 630-792-5900