Statistics show that only 20% of HME providers are accredited, and now because of new Medicare requirements, more are considering or signing up with one of the accreditation agencies. Even so, many companies are holding back and perhaps cannot see the value of accreditation. Although the process may seem complicated and expensive, it will lead to a more profitable company in the long run.

First, accreditation can lead to a better-run, and therefore more profitable, company. Second, accreditation helps companies stay in compliance with laws and regulations—and that means “peace of mind.”

Think about the costs associated with employee turnover. There are the costs of interviewing, hiring, training, and the loss of productivity during a new employee training period.

In fact, the benefits of accreditation tend to feed off of each other. Just a few of those benefits include:
• a proper orientation program;
• thorough job descriptions so employees are aware of their responsibilities;
• annual performance reviews that help to maintain employee relationships;
• employee competency checks and in-service training that lead to better employees and better customer service.

Joe Groden

Some providers may view some of the requirements as unnecessary. However, there is often hidden value. For example, maintaining adequate and complete personnel files can prevent loss of crucial ID-9 forms. These forms are supposed to be kept on file for all employees and a violation could be costly.

A well-developed infection control program is another requirement that not only protects clients but also employees. Imagine a tuberculosis client infecting a delivery technician. In addition to the personal tragedy for the individual, lost time for the company is expensive. Also, consider an infection passed to other employees and the costs are magnified.

Checking home safety for a new client is also extremely important. Setting up a concentrator in a home with a faulty outlet can lead to a fire and even a lawsuit. Back at the shop, an unsafe work environment can lead to accidents and possible OSHA sanctions.

Maintaining adequate and complete client records is yet another huge benefit. Imagine if you have a Medicare audit and lack proper documentation. Also, with HIPAA requirements, a complete client record ensures that proper privacy notices were provided with authorizations signed and on file.

Better Quality, Better Business
When I used to run my own HME company, the QI (quality improvement) standards of accreditation helped the most. Now as a consultant doing surveys, I have found a wide variety of QI processes, some well developed and some inadequate.

A complete QI process should include:
1) A quality improvement committee representing employees and management from different divisions of the company. Even in a small company, it should be a committee project, not a one-person process. There should, however, be a designated coordinator to ensure good progress.

2) Scheduled meetings for continuity (at least quarterly).

3) QI processes that identify areas of the company that need improvement. Areas of improvement will vary and may include customer service, patient satisfaction, delivery service, repair service, and client record accuracy.

4) Input from employees, patient satisfaction surveys, and complaint/incident logs.

5) Patient satisfaction surveys. Generally, I have found that when patient satisfaction surveys are left at delivery, the return number is smaller compared with mailing them out. If mailed, they should be sent within a week of service with a stamped, self-addressed return envelope. I have also seen good results with telephone surveys, especially when they are done within a few days of service. In either case, the survey should be easy to fill out and have a relatively small number of questions.

6) Complaint and variance logs recorded faithfully by employees. I have found that this usually is not done regularly and employees have to be reminded to do them. The complaints may be taken care of, but not recorded. The importance of these logs is seen when they are looked at on a quarterly basis, where trends can be identified and addressed.

7) Identifying needs, assessing the actual problem through specific data collection, determining a plan of action, instituting the plan, collecting data again to compare results, and then determining the success. A definition of success should be predetermined. Generally, four or five problems addressed during one quarter should be manageable. The data collection responsibility can be divided among members of the committee so that it is not a burden to anyone.

8) Reporting of data into graph or table format.

9) The opportunity to identify employees that can be considered for leadership opportunities and/or promotion.

Improving these company processes has definitely led to improved customer satisfaction and ultimately more profits for HME companies. Accreditation standards also require employee training in conflict of interest considerations and the importance of confidentiality. Although it is not probable, revealing patient health information improperly could lead to violations and/or customer dissatisfaction.

Compliance
Although not a required standard (it may be in the new supplier standards), a compliance program also can be valuable to your company. Internal audits of client records, personnel records, and billings can prevent problems down the road. I am sure that billing errors occur in most companies, but are not intentional. Instances when the wrong product has been invoiced, or the wrong quantity provided compared to what was billed, can be identified to the quality improvement committee. This is another area that can be audited by Medicare or other insurance programs, and can lead to violations.

Ultimately, accreditation, in some form, will become mandatory for HME providers. Look at it as a process that improves your company, not as an unwanted requirement. The benefits are numerous. DP

Joe Groden is president of JG Consulting, Penfield, NY. Prior to consulting, he ran a 70-employee independent HME company for 15 years. Groden can be reached via e-mail: jgroden@jgconsults.com.