Accreditation: Prevent avoidable denials

Q. How can I protect my business accreditation from being denied or revoked in the new era of 100% compliance? 

A. When CMS overhauled the DMEPOS accreditation process, the agency reinforced the mandatory 100% compliance with all standards supplied by their accreditation organization (AO). Every standard must be met at the time of your onsite survey. No exceptions. If not, and depending on the infraction, a corrective action plan (CAP) and process is required before you can move forward. 

However, accreditation may be denied or revoked if certain mandatory requirements are missing. Fortunately, the top three issues causing denials/revocations are entirely preventable.  

State licensure 

Facility and product-specific licenses must be current and accessible on the day of your survey. If a surveyor cannot verify a required license is current for the applicable state onsite, accreditation is denied/revoked and reported to CMS. If the license relates to a specific product line, those products would be removed as non-accredited and could impact your billing if not corrected before your expiration date. 

Staffing during posted hours 

Your surveyor arrives unannounced. If your posted hours say 9:00 a.m. and no one is on-site at 9:30, you’re facing automatic denial/revocation - plus the cost of a repeat onsite survey visit. Ensure staff are present for every minute of your posted business hours. No exceptions. This is considered non-operational by CMS. 

Facility accessibility 

Beneficiaries must be able to access your facility during business hours. That means accessibility-compliant entry, no obstructions and, if you use locked doors, gates or keypads, a clearly available way for visitors to enter. If a surveyor can’t get in, you’re denied/revoked. 

The era of 100% compliance is here. As a provider, you can avoid common pitfalls by focusing on operational basics. A small investment of time today in licensure tracking, staffing discipline, and facility access can protect your accreditation, your cash flow, and your patients’ access to care. 

Sandra Canally, RN, is founder and CEO of The Compliance Team.