Complimentary Webinar...STEP 7. Work with a dedicated account executive to schedule your survey....

Complimentary WebinarSurvey Options to Meet Medicare, State and Payor Requirements

Your Speaker

Mala VonGunten BSN, MBAAssociate Director

Mala VonGunten has served in the home care sector of healthcare for over 35 years and as a nurse for over four decades. In 2012, Mala began her career with The Joint Commission as a home care surveyor, and today serves as Associate Director for the Home Care Services program.

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− Overview of The Joint Commission

− Survey Options to Meet Medicare, State and Payor Requirements

− Why Choose The Joint Commission?

− Tips and Valuable Resources for Successful Experience

Objectives

A briefintroduction

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‒ Independent, not-for-profit organization

‒ Accrediting Home Care organizations since 1988

‒ Accredits over 6,000 Home Care programs

‒ The Mission of The Joint Commission

The Joint Commission

Home Care Accreditation

To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

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Home Health

Hospice

DMEPOS Pharmacy

Personal Care & Support

Palliative Care

Settings/Services We Serve


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The Leader in Patient Safety and Quality Improvement


Joint Commission accreditation and certification raise the bar for home care settings. Our comprehensive, solutions-focused approach elevates performance on key components of care that foster better outcomes, enhanced safety and greater success with business relationships.

Nationally recognized standards

Superior performance measures

National patient safety goals

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Our Surveyors Are Experienced Industry ProfessionalsThe collaborative, on-site education provided by our surveyors offers strategies that help your organization better meet the intent of the standards and improve performance.

All Joint Commission surveyors are:

− Experienced in the industry

− Understand the day-to-day issues that confront providers

− Have hands-on expertise to help organization to resolve any issues

− Are highly trained and receive continuing education to stay up-to-date


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The On-Site Survey ProcessThe Joint Commission’s accreditation process helps home care organizations improve safety as well as the quality of care and services provided. The on-site survey assesses compliance with our rigorous, evidence-based standards and involves:

− Tracing the patient’s or client’s experience including an examination of records and services performed

− On-site observations and interviews with surveyors

− Review of documents provided by the organization

− Systems tracers target the systems/processes that support operations

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− Communication of survey observations with delivery of preliminary report

− On-site survey report posted on your extranet site within 10 days

− Collaborate with Account Executive and SIG to address compliance issues

− Submit evidence of standards compliance within a 60-day window

− Accreditation granted upon approval of Evidence of Standards Compliance (ESC). The accreditation effective date then becomes the day after the last day of the survey.


What to Expect After the Survey

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Survey Analysis for Evaluating Risk™ (SAFER)

− A transformative approach for identifying and

communicating risk levels associated with

deficiencies cited during surveys

− Helps organizations prioritize

and focus corrective actions

− Provides one, comprehensive

visual of survey findings

− View portal for more

information


http://bit.ly/2qH5jr2

Survey Options for

Medicare Certification

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Medicare Certification for Home Health/Hospice

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The Joint Commission is designated by the Centers for Medicare & Medicaid Services (CMS) as an approved accreditor for home health and hospice agencies seeking Medicare certification.

Conducted in lieu of a state agency, The Joint Commission survey process offers accreditation and Medicare certification simultaneously.

CMS, not The Joint Commission, grants the final decision for Medicare certification. CMS retains the authority to conduct random validation surveys and complaint investigations for Medicare-certified organizations.

The Joint Commission accreditation is also recognized for DMEPOS providers.


About this Survey Option

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BOTH Home Health and Hospice Organizations− Must be operational and providing care − Have satisfied state law or licensing

requirements− Survey is unannounced (required by CMS)

Hospice Agencies Must: − Have must have served 5 patients and have

a minimum of 3 active at the time of survey. − Have the core services of a registered nurse,

physician, social worker and chaplain

Home Health Agencies Must: − Have served 10 skilled care patients and

have a minimum of 7 active at the time of survey

− Have one service line that is a direct hire and provide at least one additional service


Eligibility/Survey Requirements

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Standards

− Incorporates both Joint Commission standards and CMS Conditions of Participation

− Access via E-dition

Crosswalks

− Compares CMS requirements with Joint Commission standards and Elements of Performance

− Home health and hospice versions

− Validated and approved by CMS


Standards

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Steps to Medicare Certification

STEP 8The Joint Commission performs a full on-site

survey, evaluating safety and quality of care in accordance with our standards and CMS

requirements

STEP 6Ensure you meet

eligibility, accreditation and CMS requirements

STEP 9The Joint Commission

awards agency accreditation decision

STEP 10CMS is notified of

The Joint Commission’s

recommendations -CMS makes final decision regarding

Medicare certification

STEP 7Work with a

dedicated account executive to

schedule your survey

STEP 3Send state and CMS letter of intent to seek

Joint Commission accreditation

STEP 1Submit the CMS 855a application

form to CMS

STEP 5Submit your application &

deposit

STEP 2Receive approval letter from CMS

STEP 4Conduct a

successful test transmission of

OASIS data (Home Health only)

Medicare Certification for Home Infusion Therapy

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Beginning January 1, 2021, Home infusion therapy providers must be accredited by a CMS-approved accrediting organization to be eligible for Medicare reimbursement for the nursing component of the home infusion service.

The Joint Commission has been awarded deeming authority for home infusion therapy suppliers. As there is no state survey option, accreditation is the only means of satisfying this requirement.

CMS, not The Joint Commission, grants the final decision for Medicare certification and retains the authority to conduct random validation surveys and complaint investigations for Medicare-certified organizations.

Medicare Certification for Home Infusion Therapy Providers


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About the Therapy − Must furnish infusion therapy to individuals with

acute or chronic conditions requiring administration of home infusion drugs

− Must provide training and education, and remote and other monitoring services

− Must ensure the safe and effective provision and administration of home infusion therapy on a 7-day-a-week, 24-hour-a-day basis

About the Provider− Must be a home health or home infusion provider− This involves the provision of professional

services (including nursing services) furnished in accordance with a physician-established plan of care that describes the type, amount, and duration of infusion therapy services that are to be furnished.

About the Survey− Survey is unannounced (required by CMS)

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Standards

− Uses existing home infusion standards with minor modifications to reflect specific CMS language


Crosswalks

− Version for home infusion therapy providers

− Compares CMS requirements with Joint Commission standards and Elements of Performance

− Validated and approved by CMS


Standards

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− PC.02.01.03, EP #2: The patient plan of care is established and periodically reviewed by a physician and includes the medication(s) route, dose, frequency, and duration for home infusion.

− PC.02.02.05, EP #7: The organization provides the patient with access to nursing services, patient education and training, and remote monitoring services 24 hours a day, 7 days a week.


Standards – New for CMS

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Steps to Medicare Certification

STEP 4The Joint Commission performs a full on-site survey, evaluating

safety and quality of care in accordance with our standards

and CMS requirements

STEP 2Ensure you meet

eligibility, accreditation and CMS requirements

STEP 5The Joint Commission

awards agency accreditation decision

STEP 6CMS is notified of

The Joint Commission’s recommendations - CMS

makes final decision regarding Medicare certification

STEP 3Work with a dedicated account executive to schedule your survey


depositCMS has yet to define any additional elements to this process.

Survey Options for

State Requirements

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Joint Commission accreditation has been approved by many states as an option for organizations seeking initial licensure and re-licensure.

This recognition applies to a wide variety of home and community-based providers offering services such as home health, hospice, pharmacy, and personal care and may be a more timely alternative to state surveys.

State Recognition for Home Care Organizations

Satisfying State Requirements

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Recognitions by State

Recognition of Joint Commission Home Care accreditation/certification may include use for licensing, certification or contracting purposes by various state agencies. View the State Recognition Map to view the types of recognitions by state.


CA

AZ AL

CO

D.C.

FL

GA

IDIL

INIA

KYMO

LA

MDMA

MT

NENJ

NY

NC

OH

OK

OR

TN

TX

UT

VT

WA

VA

WI

WY

https://www.jointcommission.org/accreditation-and-certification/state-recognition/

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Re-Licensure ProcessOrganizations seeking re-licensure through accreditation need to meet applicable eligibility and accreditation requirements.

Initial Licensure ProcessFor organizations seeking initial licensure that do not actively care for patients, but need to provide evidence of their intent to obtain full accreditation, The Joint Commission offers the early survey option. This option consists of two on-site survey events.


Two Paths to State Licensure

Initial LicensureProcess Overview

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Eligibility Requirements for Initial Licensure:− Established home health or hospice agency − Applied with state for licensure− Satisfies state law or licensing requirements− Must have served 10 skilled care patients and

have a minimum of 2 active at the time of second survey

Initial Licensure for Home Care Organizations

Initial Licensure Eligibility/Survey Requirements

Survey Requirements for Initial Licensure:− First survey addresses the physical

facilities, policies and procedures, plans, and related structural considerations

− Upon receiving licensure, The Joint Commission will return on-site to perform a full accreditation survey to evaluate the safety and quality of the care being provided in accordance with our full set of standards.

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StandardsEarly Survey Option Standards Crosswalk

− Outlines the requirements that are applicable to the first survey for the Early Survey Option


Standards

− The second survey employs relevant Joint Commission requirements based on setting and services


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Steps to Initial Licensure

STEP 12The Joint Commission performs a full on-site

survey, evaluating safety and quality of care in accordance with our full set of standards

STEP 11Agency meets

minimum patient thresholds

STEP 10State issues a license

to your agency (provisional for Home

Health agencies)

STEP 9The Joint Commission submits a copy of the LTA award letter and survey report to your

state agency

STEP 8Agencies demonstrating

satisfactory compliance with a limited set of standards

receive a Limited, Temporary Accreditation (LTA)

STEP 7Work with a

dedicated account executive to

schedule your first survey

STEP 2State

acknowledges and processes application for

licensure

STEP 3Agency sends state letter of intent to seek

Joint Commission accreditation

STEP 1Agency applies for licensure with the state


deposit

STEP 6Agencies undergoes

the Early Survey Option (ESO),

consisting of two on-site surveys

STEP 4States sends

approval letter to

agency and The Joint

Commission

Re-LicensureProcess Overview

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Eligibility Requirements for Re-Licensure:− Established home care or community-based

agency − Have active state license− Satisfies state law or licensing requirements− Must have served 10 skilled care patients and

have a minimum of 2 active at the time of survey

Re-Licensure for Home Care Organizations

Re-Licensure Eligibility/Survey Requirements

Survey Requirements for Re-Licensure:− The Joint Commission will perform a full

accreditation survey to evaluate the safety and quality of the care being provided

− The survey employs relevant Joint Commission requirements based on setting and services

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Re-Licensure for Home Care Organizations

Steps to Joint Commission Accreditation

STEP 8Complete any post-survey follow up to receive your accreditation decision

STEP 6Access resources &

prepare for your onsite survey

STEP 9Celebrate & publicize your accomplishment

STEP 10Maintain survey

readiness

STEP 7Participate in your

first Joint Commission survey

STEP 2Review the

requirements

STEP 1Explore your

options with us


deposit

STEP 3Assess your readiness

STEP 5Review & address any identified gaps

Survey Options for

PayorRequirements

Community-Based Palliative Care Certificationfor Providers Affiliated with Blue Shield of California

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Home health and hospice agencies delivering home-based palliative care services are required to achieve certification in order to join or stay in the California Blue Shield network of home-based palliative care providers.

Blue Shield of California is collaborating with The Joint Commission and its Community-Based Palliative Care (CBPC) Certification to help ensure quality care for people with serious illness and provide all its members expanded access to high-quality palliative care programs.

The Joint Commission survey process offers accreditation and CBPC certification simultaneously.

Community-Based Palliative Care Certification


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Eligibility Requirements for the Provider: − Offer community-based palliative care within a

patient’s residence, available to patients 24/7, with on-call services as needed

− Use clinical practice guidelines to deliver care− Be Joint Commission accredited or seeking initial

accreditation along with CBPC certification

Survey Requirements for the Provider: − Have at least three patients actively receiving

palliative care, and five patients served palliative care services in the past 6 months to a year

− Be Joint Commission accredited or seeking initial accreditation along with CBPC certification

− For first survey, have at least 4 months of performance measures data collected, analyzed, and improvements initiated where necessary

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Standards

− Integrated among the Home Care standards, but also displayed in separate chapter

− Access via E-dition;

− Download checklist

− Requirement to select 4 performance measures, 2 clinical and 2 non-clinical


StandardsStandards Focus Areas

− Customized, comprehensive care plans

− After-hour care and services available

− Hand-off communication processes

− Palliative Care Clinical Practice Guidelines (CPGs) identified and utilized

− Interdisciplinary team (IDT) established and core members actively involved with care of designated CBPC patients

https://www.jointcommission.org/-/media/tjc/documents/accred-and-cert/ome-and-phmcy/cbpc-self-assessment.pdf

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Steps to Take for CBPC CertificationHH and/or Hospice organizations that decide to pursue CBPC Certification can do so in one of three ways:

OPTION 2Complete the e-App for a one-

day extension survey to be done between accreditation

surveys

OPTION 3Contact your Account

Executive for assistance

OPTION 1Complete the e-App to add

CBPC at the time of either your initial or next triennial on-site

survey (one day will be added to the on-site survey)

WhyJoint Commission

accreditation

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1. Provides an unparalleled quality foundation

2. Fosters better outcomes

3. Reduces risk

4. Builds consistency in care processes and across locations

5. Focuses performance improvement efforts

6. Enhances staff competency and education

7. Increases referrals

8. Opens access to contracts

9. Access to coverage or discounts with liability insurance providers

10. Differentiates from the competition

10 Ways Joint Commission Accreditation Helps Your Business Thrive


https://www.jointcommission.org/accreditation-and-certification/liability-insurers/

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Serving the Continuum of CareComprehensive Accreditation / Certification Services

Helpful

Tips & Resources

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− One of the most important tools is the Joint Commission’s electronic standards manual, the E-dition

− Service profile allows you to view standards relevant to the services you provide

− Organizations new to the Joint Commission can request free 90-day trial access online via our website, or through your Business Development representative.

− Organizations that are in process or are already accredited have permanent access via their Connect extranet portal

Helpful Tips & Resources

E-dition

Tip: Contact Staff or Click Here to Request E-dition

http://pages.jointcommission.org/OME-EditionRequest_FormLP.html

http://pages.jointcommission.org/OME-EditionRequest_FormLP.html

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About the Application

− Web-based ‘extranet’ platform

− Data drives survey length and surveyor complement

− YOU designate survey ready date and black-out dates

− Deposit is required to activate

the scheduling process; pay

deposit online

Tips for Expediting

− Submit your application 6 months prior to your desired accreditation goal date

− Submit your deposit

− Choose realistic ready date


Application for Accreditation/Certification

Get-Ready Resource: Request Application

https://www.jointcommission.org/accreditation-and-certification/health-care-settings/home-care/home-care-application-request/

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Personalized page to access pertinent accreditation documents and resources:

− Application

− E-dition

− Survey Activity Guide

− Important notifications

− The Joint Commission

Perspectives® - official monthly

e-periodical


Joint Commission ConnectTM (Extranet)

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Seminars, Webinars, Software

− Home Care Executive Briefing: August 12, 2020

− Home Care Accreditation Essentials: October 20-21, 2020

E-books

− Home Care Compliance Assessment Checklist

− Toolkit for New Accreditation

Professionals

− Big Book of Checklists


Joint Commission Resources

Get-Ready Resource: Joint Commission Resources

https://store.jcrinc.com/home-care-executive-briefing-august-12-2020/?_ga

https://store.jcrinc.com/home-care-accreditation-essentials-october-20-21-2020/?_ga

http://www.jcrinc.com/

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Our WebsiteThe Joint Commission has launched a new website designed to put the breadth and depth of our resources at your fingertips, including: patient safety portals, FAQs and more.

View our newly updated website at www.jointcommission.org/homecare

http://www.jointcommission.org/homecare

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Business Development

− Contact our Business Development teamat [email protected]

− Initial questions on accreditation and eligibility

− Gain access to trial version of the standards and the application

Account Executive

− Dedicated point-of-contact, from application submission onward

− Update changes to demographic information

Standards Interpretation Group (SIG)

− For questions related to compliance of Joint Commission standards

− Access FAQ’s and submit your own questions via online form.

− Visit jointcommission.org/standards


Dedicated Support Staff

mailto:[email protected]

https://www.jointcommission.org/standards_information/standards.aspx

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As we conclude…

─ Contact Us!Phone: 630-792-5070 Email: [email protected]

─ Web: www.jointcommission.org/homecare

─ Follow us on social media!

http://www.jointcommission.org/homecare

https://www.facebook.com/pages/The-Joint-Commission/104533371063

https://twitter.com/TJCommission

https://www.linkedin.com/company/home-care-accreditation---the-joint-commission

Thank you!

Complimentary Webinar...STEP 7. Work with a dedicated account executive to schedule your survey....

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