EHRs and Survey
Providers are allowed to use whatever system of medical records best suits their needs. This includes paper and/or electronic systems. There is not one required electronic system that providers must use.
However, a provider must grant access to any medical record, including access to EHRs, when requested by the surveyor. If the facility is unable to provide direct print capability to the surveyor, the provider must make available a printout of any record or part of a record upon request in a timeframe that does not impede the survey process. Undue delays in the production of records are unacceptable.
To expedite the survey process, CHC recommends that you have common requests such as the personnel list ready before your Surveyor arrives for Initial Licensure surveys. If you plan to produce it when your Surveyor arrives, practice generating a report of the personnel list (and all other reports likely in their request) to ensure the correct information can be provided in a timely manner. If you are unfamiliar with how to print the information, contact your software vendor before the survey.
CMA Home Health Survey
The Center for Medicare Advocacy’s mission is to advance access to comprehensive Medicare coverage, health equity, and quality health care for older people and people with disabilities by providing exceptional legal analysis, education, and advocacy.
In a recent report, CMA states that "Home health services as authorized by Medicare law, regulations, and policies are too often unavailable in practice."
For example, for patients who meet qualifying criteria, Medicare law authorizes up to 28 to 35 hours a week of home health aide personal hands-on care and nursing services combined, as well as therapies and medical social services. Unfortunately, patients can rarely access this level of Medicare-covered care.
In a recent study by the Center for Medicare Advocacy, access problems are especially true for beneficiaries with chronic and longer-term conditions who need services to maintain or slow decline.
The Center inquired about home health services available from each agency for a hypothetical patient with an authorized practitioner’s order certifying one hour of physical therapy per week, one hour of skilled nursing per week, and 20 hours of home health aide services per week.
All agencies indicated that they would be able to provide one hour of physical therapy per week, and 99% said they could provide one hour of skilled nursing care per week.
Responses about home health aide services, however, were very different. 15% of agencies did not provide a clear answer regarding available home health aide services. Those that did provide an answer demonstrated overwhelmingly that home health aide services are not available in an amount even approaching the benefit as defined by Medicare law. This trend was present in rural and urban areas across all 20 surveyed states.
An agency is not required to accept a patient if it can’t meet the patient’s medical needs. However, a Medicare-certified home health agency must provide the patient with all the home care identified in the plan of care, including staff services and medical supplies. The agency may do this through its own staff, through an arrangement with another agency, or by hiring someone else to meet your needs. This includes nurses, therapists, home health aides, and medical social service counselors.