Long-Term Care Survey Alert

Long-term care accreditation for nursing facilities will be a lot easier when the Joint Commission on Accreditation of Healthcare Organizations moves to a new "one day" survey option that doesn't duplicate state surveys.

"The new option will rely significantly on state agency certification results to demonstrate compliance with JCAHO's long-term care standards," explains Marianne Grachek, executive director for JCAHO's long-term care and assisted living programs. Surveyors will begin using the new model in January 2003.

To develop the abbreviated survey, JCAHO culled its 384 long-term care standards to 112 that don't cross walk to Medicare/Medicaid conditions of participation for nursing facilities.

The 112 standards focus on key areas that JCAHO views as hallmarks of accreditation: (1) resident safety; (2) credentialing and privileges of physicians and other licensed independent practitioners; (3) resident education; (4) pain management; and (5) organizational performance improvement.

During the document review time, JCAHO surveyors will examine the state survey report and the facility quality indicator profile to evaluate how the organization has used the information to establish its "performance improvement priorities."

The cost of the new SNF/NF certification-based accreditation survey is $4,300 for a three-year accreditation award, regardless of the facility's size. Currently, a comprehensive accreditation good for three years would cost a 100-bed facility about $6,400 with costs increasing depending on the number of residents.

JCAHO's decision to offer the streamlined survey process can be chalked up to a decreased demand for long-term care accreditation over the last several years. The Medicare prospective payment for SNFs, for example, decimated subacute SNFs, which often sought the JCAHO stamp of approval to participate in managed care.

"And many nursing facilities no longer have the resources for voluntary activities such as accreditation," Grachek adds.

In spite of the changing payment landscape, managed care organizations in several states still only contract with accredited long-term care facilities, Grachek says. "And managed care companies are expressing interest in the one-day survey option for their contracted providers," she says. That means your MCO might let you opt for the SNF/NF certification-based accreditation option.

Facilities should thus check with their health plan contracts to see if the new long-term care accreditation option will be accepted in lieu of the comprehensive accreditation product.