Provider balks at JCAHO fees

ABINGTON, Pa. - JCAHO is threatening to pull the accreditation of a provider who has resisted paying $6,000 in additional fees that he characterizes as too excessive. JCAHO billed C&H Medical (now doing business as Flagship Medical) $3,500 for a March 2002 follow-up survey to his July 2001 triennial survey and $2,500 for another follow-up survey in August 2002. Tim Black, president of Flagship, doesn't dispute the need for the follow-ups. But, given the nature of the follow-ups, he's having trouble reconciling the associated costs. Each of the two follow-up surveys took three-four hours, according to Black, and pertained to five specific paperwork requirements that didn't pass muster in his 2001 triennial. While he doesn't quibble over paying travel expenses for the first follow-up surveyor, who came in from Detroit, he still can't understand why reviews that largely involved paperwork should cost so much. “My problem is that the original survey which took two people three days, [cost] $3,500,” said Black. For “the next two visits, which were half-days, I was charged $6,000 additional.” JCAHO says the charges are routine. “They know at the time they sign up for accreditation that if they go conditional there will be additional survey fees assessed,” said a JCAHO spokesman, Mark Forstneger. “It's also in the accreditation manual. It's not a pay-as-you-go set up.” Although the first follow-up surveyor went out with a Flagship driver, Black contends that the rest of the follow-up work was mere paperwork. He can't understand why that couldn't have been done via mail. That's how paperwork follow-up is routinely done at the Accreditation Commission for Home Care in Raleigh, N.C. “Unless there is some clinical operation issue we need to physically observe, we usually have processes in place where we have a surveyor evaluate info that is submitted to us in writing,” said Sherry Samuels, ACHC's vice president of accreditation. ACHC charges $1,000 plus expenses for follow-ups that require additional site visits. For a single location company that generates about $2 million per year in revenues, ACHC charges about $5,000 for a triennial survey. In early January, JCAHO told Black they were sending him a certified letter demanding payment. At press time, Black didn't know how he'd respond. He still can't figure the math. “A guy literally drives down here two hours from Jersey, and they're charging me $2,500 for that,” he said. “I feel like they've got a gun to my head.” HME