Sunday, July 29, 2012

Ten Tips to Survive your next Medicare or Medicaid Survey

By Stephen Tweed

It's the call you dread.  "The surveyors are in the lobby."  Responding to a state survey is one of the most difficult and intimidating experience a new agency administrator faces.  But it doesn't have to be an intimidating experience.  There are some things you can do to get ready, and some things you can do during the survey to make it a positive experience for you and your agency.

Whether or not you agree with the Federal, State, and local laws regarding home health care and hospice, or the standards for accreditation set by The Joint Commission, CHAP, or ACHC, they are mandated and must be followed.  Surveys are designed to determine whether or not patient needs are being met, and whether or  not your agency is meeting the Conditions of Participation for Medicare or Medicaid.

You can make the survey process an asset for your agency by meeting and exceeding the standards.  Use the survey process as a tool to make your agency more productive, more patient centered, and more profitable.

Our good friend, Nancy Allen, CEO of Solutions for Care in Jacksonville Beach, Florida gives us ten specific steps you can take to survive the survey experience:

1.  Remove the Fear ... Start off on the right foot!  Educate your receptionist and office staff about the nature and purpose of a survey.  Remember that a pleasant greeting is the best way to start every survey visit.

2.  Act as if you have had a survey before.  In other words, follow the words of the great sales trainer who teach, "Fake it until you make it."  Develop a focused plan to be ready for the survey when it happens.  It's inevitable.  Put together a "Survey Binder" with all of the information you will need to respond to the surveyor. Keep it up to date.

3.  Hospitality 101:  The Proper Care and Feeding of Surveyors.  Have a place set aside for the surveyors when they come.  Make sure they are comfortable and have the resources they will need for their day (s) in your office.

4. Remove the Mystery.  Ask what type of survey is being conducted.  Be prepared for each type of survey ... State Licensure, Medicare Survey, Medicaid Survey, Complaint Survey, Follow Up Survey, Accreditation Survey.

5.  Who's Looking? Information about your organization that has been reported to Medicare or Medicaid is readily available to surveyors.  Be familiar with the information that is available about your agency.

6.  Study the Regulations.  The time invested in getting to know the regulations backwards and forwards is time well spent.  Since these rules are constantly changing, it's important that you have at least one member of your team whose job is to keep up to date with all federal, state, and local regulations as well as accreditation standards.

7.  There's Always Room for Improvement.  View the surveyor as someone who can be helpful in providing input for your quality management team.  Your agency and the surveyor have many of the same goals; ensuring that patients receive the highest quality care, and meeting the COPs.

8.  Avoid the Easy Deficiencies!  The best way to be deficiency free is to have systems in place to make sure that you are always ready to meet the regulations and standards.  Without solid systems in place, things fall through the cracks.

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9.  Control your Growth.  It is not unusual to see out-of-control behavior in home health agencies that want to grow quickly.  While growth is a good thing, controlling the rate of growth is important to make sure you do not outpace the capabilities of your people and your processes.

10.  Find your Niche.  Think outside the box.  Don't do what everyone else is doing in your local marketplace.  Look for opportunities to stand out from the crowd, and focus in the specific needs of a narrow segment of the market.  

For more tips, techniques, and strategies to survive the surveyor, you will want to order a copy of the 3rd edition of Nancy's book, Survivor!  Ten Practical Steps for Survey Survival.  


  1. Nancy's book is easy to read and fun with simple solutions that you can use immediately. A must read for anyone contemplating a survey.


  2. Dennis Heide8:01 AM

    Nancy's book does a great job of breaking down the needs for good survey prep. Basic, simple and straight forward instruction to prepare and maintain your agency in a state of survey readiness.

  3. Nita Fowler11:02 AM

    Don't wait until you hear the dreaded words "the surveyor is here", get prepared and stay prepared. One of the best ways to do this is by reading and following the advice found in Nancy's Book.

  4. This is one of the best books for understanding just how to work through the survey process in a practical manner. In her book, Nancy Allen presents the survey process information in an easy to read and easy to understand way. I recommend that agencies buy one for every staff member and make it a "must read" during an orientation process at the Agency.

  5. Deborah Barker1:56 PM

    The most important part of being surveyed is knowing that you have prepared everything well. Nancy's book does exactly that for you. If you read it, follow it step by step, you will be prepared. Nancy's book is easy to read, includes practical information to help you succeed, and should be read by every home health agency. It is extremely helpful.

  6. Melody Nizam10:40 PM

    Surveys can make you nervous and anxious wondering what are they "really" looking for. Feeling like you just don't want to be there.
    Well after reading this book the understanding I obtained was priceless.
    Nancy left no stone unturned in this step by step how to prepare for a survey. For any office wanting a deficiency free survey this is the book to read.
    I did and we Passed !!!

  7. Russell Ward9:10 PM

    I found Survivor! insightful and easy-to-understand. This is a unique,practical book written by Nancy Allen, a seasoned surveyor veteran. With healthcare guidelines constantly changing it is important to find a book (now in its 3rd Edition) that speaks to current industry standards. This is a unique one-of-a-kind book that lays out the step-by-step process to feel confident to complete a successful survey. You will glean nuggets of
    information you can't find anywhere else - no matter your level of

  8. This book is worth its weight in gold! We had a survey and I immediately gave the surveyor the Survey Binder. She was so impressed and commented on how other agencies should do the same. There is nothing more relieving than to start a survey off right!

  9. An essential for all home health supervisors and directors. Easy and quick to read. A perfect step by step guide to ensure your success with any survey. It helps to keep the survey process in perspective. I recommend this book often to all levels of home health managers. Jen