Anyone gone through the new survey process?

  1. Our agency is due to be surveyed this year. Out last was in 2010. They came up with the new survey process in 2011. My administrator is one who just makes everything okay on paper without making sure it's actually implemented correctly in the field. I've heard that they interview employees and do more home visits now? Any experience with this anyone?
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    Joined: Mar '13; Posts: 207; Likes: 164


  3. by   youngheartoldhead
    Yes we had ours a couple weeks ago. They made sure all field staff stayed in the FIELD. and when they did come to the office they were told to do what they had to do and go away.......and stay away from state surveyor
  4. by   paradiseboundRN
    It depends on the size of the agency. I worked for a hospital agency with a census of about 250. In late 2012, the surveyor wanted to see 5 nursing visits which included wound care visits. Of course, she also went out with the other disciplines.
  5. by   tktjRN
    The surveyors, in Wisconsin, do not go with clinicians anymore to watch visits . A surveyor sees a patient,with one of the managers, for a one on one interview. They make sure the home folder is in order and medications are accurate. They honed in on OTC medications.
  6. by   youngheartoldhead
    this may help some.

    also you can google: home health care guidelines for surveyors

    a few things i can remember are they zero in on medications...(has always been that way)..when they do home visits, the patients meds have to match what is on file at the agency and what is on the patients home care folder. (unless the change occurred since last visit). make sure patient has all info on the meds, side effects, directions and they are taking them correctly.

    patient should know who to contact at the agency if they have major problems, how to contact a nurse after hours, the 1-800 number to report abuse. they just need to know these numbers are located in their home folder.

    they have to have a basic idea of their privacy rights/ patient rights and that we are billing their insurance for payment....

    coordination of care is a big deal . the nurse needs to communicate with all other services the patient is receiving ...physical , occupational therapy, social worker, etc. make entries in the record that you discussed the patient with each other and a basic run down of what u discussed. usually its just getting an update on patient. or discussing any problems.

    also if the patient has waiver services from another agency such as a home care attendant, then the agency needs to communicate with them and know what their plan of care is: what they are doing for patient, how often they visit turn the agency informs them of what aspects of patient care we will be doing (just basic need to know info, such as when we will be changing catheter, who is responsible for calling in regular refills, etc). this is important because both agencies may incorrectly assume that the other taking care of a particular need for the patient and it ends up not being done at all.
    Last edit by youngheartoldhead on Sep 19, '13
  7. by   turningred15
    We (in Wisconsin) had surveyors come a couple of weeks ago. Making sure med lists were accurate and up to date, infection control and care coordination were the focus. We were cited several times. (I was not cited though!) We have implemented a corrections plan and are awaiting resurvey. I think it really depends on what person does the survey. Some are much more thorough than others.
  8. by   LaRN
    this is a guidance for surveyors , which is just the regulations with some pointers to them on how to determine if home health agencies are following them.

    the entire thing is about 95 pages. there may be a more recent version of this document since the regulations were updated in 2011:

    State Operations Manual
    Appendix B - Guidance to Surveyors: Home Health

    (Rev. 11, 08-12-05)
    Part I – Investigative Procedures
    Subpart A - General Provisions
    484.1 Basis and Scope
    484.2 Definitions
    484.4 Personnel Qualifications
    Subpart B - Administration
    484.10 Condition of Participation: Patient Rights
    484.10(a) Standard: Notice of Rights
    484.10(b) Standard: Exercise of Rights and Respect for Property and Person
    484.10(c) Standard: Right to be Informed and to Participate in Planning Care and
    484.10(d) Standard: Confidentiality of Medical Records
    484.10(e) Standard: Patient Liability for Payment
    484.10(f) Standard: Home Health Hotline
    484.11 Condition of Participation: Release of Patient Identifiable OASIS Information
    484.12 Condition of Participation: Compliance With Federal, State and Local Laws,
    Disclosure and Ownership Information, and Accepted Professional Standards and
    484.12(a) Standard: Compliance With Federal, State, and Local Laws and Regulations
    484.12(b) Standard: Disclosure of Ownership and Management Information
    484.12(c) Standard: Compliance With Accepted Professional Standards and Principles
    484.14 Condition of Participation: Organization, Services, and Administration
    484.14(a) Standard: Services Furnished
    484.14(b) Standard: Governing Body
    484.14(c) Standard: Administrator
    484.14(d) Standard: Supervising Physician or Registered Nurse
    484.14(e) Standard: Personnel Policies 484.14(f) Standard: Personnel Under Hourly or Per Visit Contracts
    484.14(g) Standard: Coordination of Patient Services
    484.14(h) Standard: Services Under Arrangement
    484.14(i) Standard: Institutional Planning
    484.14(i)(1) Standard: Annual Operating Budget
    484.14(i)(2) Standard: Capital Expenditure Plan
    484.14(i)(3) Standard: Preparation of Plan and Budget
    484.14(i)(4) Standard: Annual Review of Plan and Budget
    484.14(j) Standard: Laboratory Services
    484.16 Condition of Participation: Group of Professional Personnel
    484.16(a) Standard: Advisory and Evaluation Function
    484.18 Condition of Participation: Acceptance of Patients, Plan of Care, and Medical
    484.18(a) Standard: Plan of Care
    484.18(b) Standard: Periodic Review of Plan of Care
    484.18(c) Standard: Conformance With Physician Orders
    484.20 Condition of Participation: Reporting OASIS Information
    484.20(a) Standard: Encoding OASIS Data
    484.20(b) Standard: Accuracy of Encoded OASIS Data
    484.20(c) Standard: Transmittal of OASIS Data
    484.20(d) Standard: Data Format
    Subpart C - Furnishing of Services
    484.30 Condition of Participation: Skilled Nursing Services
    484.30(a) Standard: Duties of the Registered Nurse
    484.30(b) Standard: Duties of the Licensed Practical Nurse
    484.32 Condition of Participation: Therapy Services
    484.32(a) Standard: Supervision of Physical Therapy Assistant and Occupational
    Therapy Assistant
    484.32(b) Standard: Supervision of Speech Therapy Services
    484.34 Condition of Participation: Medical Social Services
    484.36 Condition of Participation: Home Health Aide Services
    484.36(a) Standard: Home Health Aide Training
    484.36(a)(1) Standard: Content and Duration of Training 484.36(a)(2) Standard: Conduct of Training
    484.36(a)(3) Standard: Documentation of Training
    484.36(b) Standard: Competency Evaluation In-Service Training
    484.36(b)(1) Standard: Applicability
    484.36(b)(2) Content and Frequency of Evaluations and Amount of In-Service Training
    484.36(b)(3) Standard: Conduct of Evaluation and Training
    484.36(b)(4) Standard: Competency Determination
    484.36(b)(5) Standard: Documentation of Competency Evaluation
    484.36(b)(6) Standard: Effective Date
    484.36(c) Standard: Assignment and Duties of the Home Health Aide
    484.36(c)(1) Standard: Assignment
    484.36(c)(2) Standard: Duties
    484.36(d) Standard: Supervision
    484.36(e) Personal Care Attendant (PCA): Evaluation Requirements
    484.38 Condition of Participation: Qualifying to Furnish Outpatient Physical Therapy or
    Speech Pathology Services
    484.48 Condition of Participation: Clinical Records
    484.48(a) Standard: Retention of Records
    484.48(b) Standard: Protection of Records
    484.52 Condition of Participation: Evaluation of the Agency’s Program
    484.52(a) Standard: Policy and Administrative review.
    484.52(b) Standard: Clinical Record Review
    484.55 Condition of Participation: Comprehensive Assessment of Patients
    484.55(a) Standard: Initial Assessment Visit
    484.55(a)(2) 484.55(b) Standard: Completion of the comprehensive assessment.
    484.55(c) Standard: Drug Regimen Review
    484.55(d) Standard: Update of the comprehensive assessment.
    484.55(e) Standard: Incorporation of OASIS Data Items
    The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation
    for home health agencies (HHAs). The Interpretive Guidelines merely define or explain
    the relevant statute and regulations and do not impose any requirements that are not
    otherwise set forth in statute or regulation.
    Conduct the HHA survey in accordance with the appropriate protocols and look to the
    substantive requirements in the statute and regulations to determine whether a citation of
    non-compliance is appropriate. Base any deficiency on a violation of the statute or
    regulations, which, in turn, is to be based on observations of the HHA’s performance or
    practices. (See 2712.)