CMS Audit

Specialties Home Health

Published

Sooo long story short cms is coming in for a on site survey saying theyre gonna pick at least 2 charts read them and go along with nurses on visits. i know this is happening at many agencies and i also know many agencies (or as it seems from reading this thread) have difficulties with organization, making it easy for cms to find things wrong. Really I just want to know what to expect, how bad/mean/intimidating they will be. QA has given overall pretty good reviews on most of my charts and ive been checking through them myself to make sure nothing is missing etc. were also right in transition to electronic so things are a mess, things like checking to see if doctors signed and returned all faxes is hard to keep up with for example, as full time RNs we are responsible for everything (hha and lpn supervisory notes and careplans and all OASIS) so theres a lot to keep up with. really just looking for advice from anyone who has dealt with this. im almost overloaded with patients and have continuously talked to the agency about being realistic with what i can actually do while following policy almost perfectly so just seeing what i can do in preparation for this surveyor to come! are they looking at nurses individually and/or just the agency?! i dont think i am doing anything terribly wrong but when it comes to medicare they can find anything and i dont wanna get in any trouble!

Thanks!

Isabelle49

849 Posts

Specializes in Home Health.

I was in the field when a visit was made to our agency and one of the surveyors did attend a visit with me at two of my patient's homes. I can tell you this, the first thing the surveyor did at the patient's home was ask where medications and in home agency med list was and checked every single medication against the list. They very closely monitor hand washing, wound care, placement of the nurse's belongings (Never on the floor, on clean newspaper if necessary on the floor). They also ask the patient questions about the care received. Surveyor will also very closely monitor the records visits made as authorized, aide supervisory visits, wound dare documentation that matches wound orders. If any patient is a diabetes, and orders are to monitor cbg log, SN better have that information in the records. Hope this helps. CMS is making sure we are doing what we are supposed to be doing, nothing more really.

ctrn3478

22 Posts

thank you this is definitely straight forward and helpful. I am only concerned now about in home med lists, i gave up on those for most patients since many of them were losing them not keeping with meds or med boxes for whatever reason, i have many patient that i let organize themselves as long as they can repeat back to me what theyre doing and it matches my list. guess all i can do is make sure i have up to date med list with me that day for all patients. thanks again!

Specializes in ICU, BURNS, TRAUMA, TRANSPORT, HH.

YOU do not have to worry about anything if you work for a good agency and if you are following the rules and policy/procedure.

Be honest with the surveyor.

Do not offer them information.

Answer only the question asked.

It is not your job to socialize with them or entertain them.

They should travel in a separate vehicle from you to and from the visits.

You will be fine.

Crispy Critter

49 Posts

Specializes in ER I/CCU Cath lab LTC.

I agree with the above poster. You will be nervous, but resist the urge to chatter. I was observed doing an assessment and med set-up. The surveyor was just there to make sure clients were cared for properly, but she watched everything while chatting with the client. It went fine. My agency gives clients a bright yellow folder on admission which contains their care plan and med list, as well as a list of important numbers and other pertinent info. They are told to keep it where it is easily reached, and as a case manager I would ask to see it on each visit. Some families like to keep a copy of the med list on the fridge. If you feel confident that you're doing things the right way, then just stay with your routine. Everythin' be ok.

ctrn3478

22 Posts

thank you both!!! they came monday, i wasnt chosen for a visit with them and havent spent much time in the office so havent heard the outcome. My agency is pretty disorganized tho I do not feel they are doing anything wrong it had me worried, but i made sure to take care of my personal skills and organizaion the week before. thanks for you advice ill keep it in mind in the future!

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