It’s not unusual for a home health agency to have written a plan of correction for something in a surveyor’s report that seems ridiculous and unnecessary; but in many cases, it’s easier to implement a plan of correction than to appeal the survey. But what happens if your survey report is full of inaccuracies and crosses the boundary of typical standard-of-care expectations? Are you prepared to appeal?
"Most agencies wait until they receive a condition-level deficiency or a report that they consider unfair before they find out what their rights are," points out Virginia Wright Caudill, JD, an Indianapolis-based attorney. This is too late, she says. "Even if you are gathering information and planning an appeal, you still have a set amount of time in which to file your plan of correction," she adds.
The best time to find out how your state or federal survey organization handles appeals, and what rights you have, is well before any survey takes place, Caudill says. "If you go to your state’s web site and find the agency that regulates home health, you will, in nine out of 10 cases, find a section on your administrative procedure rights that spells out what rights you have to appeal," she says.
Another area in which you need to be knowledgeable is your state’s public records statute, Caudill suggests. "Even if you believe your survey report is unfair, you must get access to the surveyor’s notes as well as the original complaint to be able to address inaccuracies," she says. If you question some of the findings in your survey, be prepared to write to request all formal and informal notes and documents related to the survey, in addition to the original complaint, she recommends.
The time frame for receiving these documents varies, with worst case usually 30 days following the receipt of the request, but you need to know what the statute requires, so you can plan your actions to respond to the survey.
Because you may have to wait for the public records you’ve requested, you still need to work on your plan of correction. "In most states, you can request an extension to the 10 days you are normally given for the plan of correction, but make sure you know what your options are within your state," Caudill says.
Even if you have to submit a plan of correction prior to receiving the information you’ve requested, you can place a statement at the beginning of your plan of correction that indicates you do not agree with the findings of the surveyor, but you have prepared the best reply to the alleged deficiencies with the information you currently have, she suggests.
Once you have gathered more information or you have initiated an informal dispute resolution or appeal, you can submit an amended plan of correction that includes the statement, "I have received additional information that has enabled me to more knowledgeably address the issues in the report, and I have amended the plan to better serve my patients."
What happens if your survey report is full of inaccuracies and crosses the boundary of typical standard-of-care expectations? Are you prepared to appeal?
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