A New Day: Accreditation for Dialysis Facilities Presented By Curt - - PowerPoint PPT Presentation

A New Day: Accreditation for Dialysis Facilities

Presented By Curt Anliker, CEO To

Florida Renal Association

2019 Annual Educational Conference · July 18-19, 2019

Today’s Topics

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Accreditation by an Accreditation Organization (AO) vs. Certification by the state agency

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Overview of NDAC’s team and service commitment

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Value of accreditation

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Future predictions

What’s the Difference in Accreditation and Certification?

►

Accreditation is awarded to a facility that meets the standards of the AO

►

CMS awards certification based on the successful completion of an initial survey

• By a state agency, or
• By an AO with deemed status

►

Certification allows for payment for care of Medicare beneficiaries

Are AOs CMS Contractors?

► No - All AOs are private companies ► If an AO chooses to offer “deemed status”

for a provider type, they must apply for and be approved by CMS

► AOs seeking deemed status must follow

CMS direction

• AO Standards must be equal or more stringent
• AO Survey process must be equal or more stringent

Currently Two AOs Have “Deemed Status” for ESRD

► NDAC - Approved January 4, 2019 ► Accreditation Commission for Health Care

• Approved April 11, 2019

How Does the Accreditation Process Differ from a State Survey?

► A facility or provider company chooses to contract

with an AO and pay for a survey under the AO standards

► The AO standards must be equivalent to the CMS

regulations

• May be similar to ESRD Conditions for Coverage
• May include additional requirements
• May be written in a different way

► AO surveys are expected to be unannounced

How Does Accreditation Differ from a State Survey?

► AO survey process: May differ from state survey

process, but must be equivalent

► Survey team size:

• State teams vary from 1 to 4+;
• AO teams may vary from 1 to several surveyors

► Successful AO survey = recommend accreditation

and deemed status for certification

► Successful state survey = recommend certification

How Does Accreditation Differ from a State Survey?

► AO survey process: May differ from state survey

process, but must be equivalent

► Survey team size:

• State teams vary from 1 to 4+;
• AO teams may vary from 1 to several surveyors

► Successful AO survey = recommend accreditation

and deemed status for certification

► Successful state survey = recommend certification

Only CMS Awards Certification!

What About Findings and Corrective Action?

► AOs develop statements of findings much like

the state reports

► Corrective action is required within similar

timelines as the state survey

► If serious findings are identified, one or more

revisits may be required to verify correction

What About Complaints?

► The AO will investigate any complaints it

receives directly and referrals from the state, CMS or the Network

► CMS must authorize the state to do

federal complaint investigations in dialysis facilities with deemed status

► The state will investigate complaints

received by the state or CMS if the allegations indicate a serious threat to patient health and safety

AO Services Provided

✔

Geographic coverage includes entire U.S. and its territories

✔

Maximum accreditation period = 3 years

✔

Re-survey required to continue accreditation

• Initial / DeNovo
• Re-Surveys & Expansion
• Life Safety Code
• Complaint Response

Expansion of Service Surveys

August 2018 CMS Guidance Letter revised some processes:

► Allows relocations, adding stations and

some services to be done by “desk” review (by state or AO)

► On-site survey required to add home

training or to add in-center dialysis to a home only facility

• Not included in the law or the memo
• 90 Day rule does not apply….. Survey may be

delayed in some states

What About Resurveys? Why Stay with an AO?

► Predictable re-survey window in 33-36 months

What About Resurveys? Why Stay with an AO?

► Predictable re-survey window in 33-36 months ► An AO is customer-focused: prompt response to

questions and clear communication

What About Resurveys? Why Stay with an AO?

► Predictable re-survey window in 33-36 months ► An AO is customer-focused: prompt response to

questions and clear communication

► Standardization and centralized review of every

survey

• Thwarts “rogue citations”
• Ensures consistency across the country (not

just within a state)

What About Resurveys? Why Stay with an AO?

► Predictable re-survey window in 33-36 months ► An AO is customer-focused: prompt response to

questions and clear communication

► Standardization and centralized review of every

survey

• Thwarts “rogue citations”
• Ensures consistency across the country (not

just within a state)

► Surveyors experienced in ESRD ► Focus on what is important for patient safety

Meet NDAC

► NDAC management and surveyors

have dialysis experience

► Survey process similar to the CMS

survey process

► NDAC standards closely mirror the

Conditions for Coverage

• Exception: cultures and endotoxin

levels reflect current AAMI standards

NDAC Executive Team

► Glenda Payne:

Chief Compliance Officer

40+ years in nephrology with regulatory and compliance expertise

► Jennifer Vavrinchik:

Chief Operating Officer 30+

years in nephrology with clinical

• perations expertise

► Curt Anliker:

Chief Executive Officer

~ 20 years as a dialysis provider

NDAC Advisory Board

• Interdisciplinary Team
• Patient
• Physician
• Nurses
• Bio-Medical
• Dietitian
• Social Worker

Every voice is heard!

NDAC Commitment

► Surveyors who know dialysis ► Focus on what’s important

• Identify serious issues
• Educate to our standards

► Identify non-compliance and require

correction

► Prompt response and turn-around

Is a $14,500 Accreditation Fee Worth It?

Is a $14,500 Accreditation Fee Worth It?

Is a $14,500 Accreditation Fee Worth It?

TIME = $$

78 Days (2.6 Months) Average Time Savings =

• Reduced fixed costs: Rent, utilities, insurance, capital carry costs, Med Dir fee, etc.
• Reduced variable costs: Staffing + benefits, treatment supplies/drugs, labs, EMR,

water and machine maintenance, social worker/dietitian

• Faster Medicare reimbursement: (2.6 mo) x (12 tx/mo) x ($240/tx) = $7,500

($7,500) x # patients = $$ INCREMENTAL REVENUE

The Future of Accreditation

► Two AOs are approved to offer this service;

• thers may apply

► Provider interest is high ► Uptake of AO services partially depends on

CMS and states’ ability to meet the mandate for prompt initial surveys

► Long-term: likely to be widely adopted ► Likely adoption/integration by payor

community as accredited clinics grow

Thank you! For more information

www.ndacommission.com

Questions?