Surviving a Bad Survey: Tips for Advising Health Care Providers
- May 31, 2024
- Liz LaFoe Frederick , Husch Blackwell LLP
- Katey Hinz , Husch Blackwell LLP
It is no secret that health care is a heavily regulated industry. It should be. The lives of patients are literally in the hands of health care providers. To participate in Medicare and Medicaid, health care entities must maintain substantial compliance with applicable regulatory requirements (conditions of participation). The survey process is designed to assess whether a provider is in substantial compliance with those requirements, with the overarching goals of ensuring patient safety and quality of care at health care entities, including long term care facilities, hospitals, and home health agencies. This is accomplished through regulatory oversight—specifically, the citation of deficiencies and imposition of penalties for alleged regulatory violations, as well as an opportunity for the implementation of corrective measures and a revisit to ensure that regulatory violations have been corrected and no new violations exist. The Centers for Medicare & Medicaid Services (CMS) contracts with state survey agencies (SSAs) (through the state departments of health) to accomplish this, although CMS also has its own (federal) surveyors as well, and conducts federal surveys at times.
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