Posted by: Robert Markette
August 31, 2006

I have to confess that I am a little tardy with this post, but I saw an article in last weeks Home Health Line that I had to mention. The article mentions an effort by the U.S. Senate to require agencies to pay for a resurvey, if an agency were to nee one. This is being presented as an effort to save the government money, but overlooks a few issues.

The most obvious is that you are required to respond to findings with a plan of correction. As has repeatedly been pointed out by the Courts, you do not have the right to appeal a survey unless you are going to be decertified (or lose your license). If there are findings in a survey report, even if you disagree with them, you submit the required plan of correction and, if accepted, you await a resurvey. Which may result in additional findings.

I have argued that a survey report should be subject to review for some time. This proposal would make the poc and resurvey process even more onerous, because you would be forced to pay the state for the privilege of having a surveyor come out and check your compliance after the POC. In some cases, this may happen more than once.

If they do charge, what will the fee be? Is it a flat fee similar to a filing fee or will it be directly related to actual costs. This could result in rural agencies paying more for a resurvey. It could also result in agencies being put in an awkward position because of the cost of a resurvey. The resurvey fear would end up being an annual cost an agency would have to pay, because many agencies are resurveyed each year.

This additional fee will be well received, especially with agencies rising costs and the failure of Medicare or Medicaid to increase reimbursement rates to keep up with costs. This potential new fee will simply be one more item to further narrow agencies already narrow margins.

Given the limited rights an agency already has vis-à-vis the survey process and the costs inherent in preparing and submitting a plan of correction, an agency should not have to pay an additional fee to be resurveyed. Charging an agency for a resurvey would place a heavy burden on the exercise of this right. I think the

Finally, if the Federal Government starts doing this, you can guess that the states wont be too far behind. (For those agencies who are licensed and certified, you should only pay one fee, since you have one survey for two agencies, but if a state figures there is money to be made, there could be a separate state fee.) This could potentially add even more costs to an agencys survey. It strikes me that there must be some other way to address this issue than piling more burdens on home health providers.

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