Providers have two CMS accreditation deadlines that are of immediate concern: 1) September 30, 2009, is the day by which all DMEPOS providers must be accredited; 2) May 14, 2009, is the day that bidders in the second round of competitive bidding (70 MSAs) must have at least started the application process. HME owners and suppliers are scrambling to find ways to meet these constraints.

The concept of accreditation is foreign to many DMEPOS providers. They may have heard the term, but they have never needed to understand how it would apply to their organization—until now. The process simply involves implementing a set of requirements that have been developed to meet CMS' supplier quality standards.

START TO FINISH

Pick an accreditation agency and prepare your policy and procedure manuals. Implement these requirements throughout your company, taking advantage of advice from those who know this process well, and be sure to avoid common pitfalls. After a successful survey, you will achieve the goal.

You will first need to determine which of the 10 accrediting organizations to use. Research these carefully so that you choose an agency that fits your company. These accrediting agencies vary widely in the approaches they use, and further, not every accrediting organization is authorized by CMS to accredit every type of provider.

Once you have determined which agency to use, and you have received a copy of the standards, you can prepare your policies and procedures, and proceed with implementation. Every provider must have a policy and procedure manual that adheres to the accreditation standards. Most companies have some written policies and procedures, but few have developed policies that fully meet the accreditation standards. Policy and procedure manuals can take up to 6 months or more to develop on your own.

With accreditation deadlines looming, little time remains for companies to develop their own policy and procedure manuals. Fortunately, there are several good policy and procedure manuals that meet the accreditation standards that are customizable for individual companies.

Before purchasing a manual, be sure to find out how the seller will customize the manual to fit your company's needs. The seller of the manual should be able to customize the manual for the products and services you provide, and the name, personnel policies, organizational chart, and job descriptions your company uses. In addition, some may even customize for the accreditation agency and specific state regulatory issues.

A policy and procedure manual must contain policies for administration, financial management, human resource management, product safety, information management, and general and specific service standards.

Your policy and procedure manual should also include the forms you will need to show compliance with the standards. Policy and procedure manuals can be found through Internet search, ads, and accrediting organizations. These manuals vary in price, completeness, and level of customization—so it pays to do your research.

IMPLEMENTATION PROCESS

Once you have the completed manual in place and have ensured that it is in compliance with the accreditation standards, you can implement the standards throughout your organization. Data collection is necessary, customer satisfaction must be measured, and internal processes must meet the accreditation standards. This implementation process will generally take at least 4 months to complete.

It is helpful to identify one individual to coordinate all the accreditation activities. Generally speaking, the CEO of the company is not the ideal candidate for the job because they usually have too many other responsibilities. However, CEOs do need to give appropriate authority to the accreditation coordinator so that tasks can be accomplished and the process moves forward.

Establishing a performance management team is another task that should be started as soon as the accreditation preparations begin. Many still know this team as the quality improvement committee. CMS changed this name in their supplier quality standards, but the function is the same. This team will be responsible for developing the process that measures outcomes in the areas of consumer services, billing practices, billing audits, infection control, incidents, and adverse events.

AVOID PITFALLS

• Do not try to work without a policy and procedure manual. If you have never had one, purchase one.
• Do not select the wrong staff member to coordinate the accreditation process. When selecting a staff member to coordinate the process, make sure she is detail-oriented, is capable of leading and completing a project, and has the authority to complete all necessary tasks.
• Do not fail to properly educate staff members. Great emphasis is placed on the education of the staff when the surveyor is on site. They will interview various staff members and will expect them to be prepared in the areas of the standards. All staff members must complete the mandatory in-service education, must be familiar with the forms used by the company, and must have an understanding of the accreditation standards.
• Get a handle on the performance management process. If you are struggling with performance management, contact your accreditation agency for guidance or engage a knowledgeable consultant. Education in this area is vital to survey success.
• Do not fail to adequately audit patient charts, billing records, and employee files. The accreditation standards require that periodic audits be performed of patient charts, and the compliance program requires billing audits to be performed, to ensure that you are in compliance with all regulatory agencies.

SHOULD YOU USE A CONSULTANT?

Good consultants can be worth every penny they charge and smooth the accreditation process, saving hours of preparation. Consultants can make themselves available via telephone as well as on site to assist in the accreditation process.

To find a good consultant:

• Ask your accreditation agency if they maintain a list of recommended consultants.
• Ask consultants for their credentials. Choose a consultant who has worked in the industry and has experience with the products and services you provide.
• It is a big plus if a consultant is or has been an accreditation surveyor.
• Ask for references, and check them out.
• Ask consultants what their recommended process is to assist the company in successful accreditation. A seasoned consultant should be able to lay out a plan that will offer the best results for each company.
• Ask what the consultant's fees and expenses will be.

Companies working toward accreditation should start now and stay focused until the job is completed. They should expect change, make it a team effort, and adopt the changes as part of their everyday business plan. While the accreditation process is definitely a big task, it is really just good business practice that will bring many benefits beyond just becoming accredited.

From the starting point of choosing an agency and preparing your manual, and throughout the implementation process, your company can take advantage of the demands of the accreditation process to improve many aspects of your company's operations. Your achievement of accreditation status will then be evidence of the new level of excellence your organization has reached.

Julie A. Bowman, RRT, RCP, is founder and president of HME Solutions LLC, which offers HME business consulting in the areas of operations strategy, business execution, and accreditation. She can be reached via e-mail through the HME Today editor: .