On April 14, the Centers for Medicare & Medicaid Services (CMS) released its proposed regulation governing Fiscal Year 2018 payments to hospitals (Medicare Program; Hospital Inpatient Prospective Payment System (IPPS) for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rates). As part of the rule, CMS proposes to require that each national accrediting organizations (AOs) applying or reapplying for CMS-approval of its accreditation program agree to post final accreditation survey reports (including statements of deficiency findings) and acceptable Plans of Corrections (PoCs) from that accreditation program on its public-facing websites within 90 days after such information is made available to the facilities for the most recent three years. This provision would include Home Health and Hospice survey findings on all triennial, full, follow-up, focused, and complaint surveys, whether performed onsite or offsite.
TAHC&H is interested in receiving feedback from you regarding the proposal to require accrediting organizations to publically post your survey reports. Your comments will help us give feedback on the rule and give accrediting organizations like the Accreditation Commission for Health Care (ACHC ) our membership insight.
ACHC plans to submit comments opposing the rule (see below).
From ACHC:
Accreditation Commission for Health Care (ACHC) supports accredited healthcare providers by opposing CMS-1677-P, which proposes that Accrediting Organizations (AOs) be required to post all survey reports and acceptable plans of correction (PoCs) from their CMS-approved accreditation programs on their websites. Contrary to the CMS position, ACHC asserts that accepting this proposal impedes healthcare consumers’ ability to make informed decisions.
ACHC stands firm with our providers in rejecting this proposal:
*Healthcare consumers should evaluate patient outcomes, not organizational deficiencies
*There is no requirement to standardize requirements between Accrediting Organizations; therefore, standards and deficiencies are not consistent
*Focuses on deficiencies found at a fixed point during a three-year period versus Medicare Compare outcomes, which are designed to continuously display organizational outcomes
*Undermines concepts of continuous quality improvement
The summary below explains the proposal, provides a link to the CMS Fact Sheet, describes why this proposal negatively affects providers and seeks a call to action.
Proposed Rule by CMS Could be Problematic - Centers for Medicare & Medicaid Services (CMS) published a proposed rule on April 28, 2017, CMS-1677-P, which would require Accrediting Organizations (AOs) to post all survey reports and acceptable plans of correction (PoCs) from their CMS-approved accreditation programs on their websites.
The CMS fact sheet on the proposed rule can be found at:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-04-14.html
This proposal impedes healthcare consumers’ ability to make informed decisions:
· Healthcare consumers should evaluate patient outcomes, not organizational deficiencies.
Healthcare consumers have an existing platform that allows them to compare outcomes of healthcare agencies. Consumers should be educated on the value of Medicare Compare sites. Transparency about an organization’s performance is best measured through the collection of data using a consistent methodology that incorporates risk adjustment and validation testing as accomplished through Medicare Compare.
· There is no requirement to standardize requirements between Accrediting Organizations.
The publishing of Summary Reports does not provide a comparison of equivalent requirements because non-CoP-based standards created by Accrediting Organizations are not comparable. Healthcare consumers are left to draw improper conclusions caused by misinterpreting data and an inability to properly comprehend the implications of the findings.
· Focuses on deficiencies found at a fixed point during a three-year period versus Medicare Compare outcomes, which are designed to continuously display organizational outcomes.
Survey results reflect deficiencies cited during a finite moment in a three-year accreditation period. This provides a snapshot in time. Conversely, outcomes such as those displayed on Medicare Compare reflect a continuous measurement of the healthcare providers’ quality of care and their commitment to maintaining compliance with the findings identified during the accreditation survey process.
· Undermines concepts of continuous quality improvement.
Organizations frequently maintain accreditation because they are committed to continuous improvement. Accreditation fosters the process of identifying gaps in compliance, creating an effective plan of correction, implementing the plan, and monitoring for ongoing compliance. If the proposed regulation is passed, agencies will not view identification of non-conformances as a means of improving performance.
· Is in opposition with regulatory requirements as stated in section 1865(b) of the Act and §488.4(b).
CFR §488.4(b) prohibits the disclosure described in the proposal for all but one provider: “With the exception of home health agency surveys, general disclosure of an accrediting organization's survey information is prohibited under section 1865(b) of the Act…”
CALL TO ACTION - Based on facts provided above or your personal insights, please submit comments by June 13 th electronically through the CMS e-Regulation website at:
https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Policies/eRulemaking/index.html.
· Click on “Submit Electronic Comments on CMS Regulations With An Open Comment Period”
· Search under regulation: CMS-1677-P
· Please note that although this regulation affects Home Health agencies and Hospices, the name of the regulation is - Medicare Program: Hospital IPPS for Acute Care Hospitals and Long Term Care…
We want to hear from our membership in order to submit comments on this issue. Please send comments to marissa@tahch.org by June 9th to allow us enough time to summarize and submit by the due date above. You may also submit comment directly. See call to action above.