Home Health & Hospice

When the surveyor knocks on your door: What NOT to do!

Homecare Insider, December 3, 2012

We often discuss what you should do when a surveyor comes knocking, but less often do we tackle what you shouldn’t do.

Here are some helpful tips. During a survey, never do the following:

  • Immediately agree that you are wrong. You may not be.
  • Change anything because the surveyor simply wants or prefers it a certain way. You are abiding by regulation, not personal choice.
  • Allow a surveyor to go out alone with staff on a home visit. Always send a supervisor or management representative with them. If a home visit goes bad, you don’t want it to be one staff member’s word against the surveyor. Furthermore, if the staff member being observed has a question at any time, it can be addressed immediately. This is especially important with new staff or staff who has never enjoyed the pleasure of a survey. They may be nervous and uncomfortable. The presence of a supervisor may put them at ease.
  • Let the surveyor make his or her own copies. Agency staff should make any copies and they should always make two—one copy for the surveyor and one for the agency so that you are always aware of what the surveyor has from the record.
  • Be argumentative or defensive. This is the worst thing you could do. If you disagree, do so respectfully. If you meet a regulation, show the surveyor how you meet it. If you don’t meet a regulation, be prepared to accept the consequences and correct the deficient practice.
  • Volunteer trivial information. Simply answer the surveyor’s questions. Educate your staff to also follow this simple guideline.
  • Say “I don’t know” or make something up. If a staff member is asked a question that they don’t know the answer to, educate them that an appropriate response would be “I am unsure, but I will check with my supervisor” or “I need to look that up to refresh my memory.”

Operating a homecare agency is a stressful task. Do not allow a survey to further frustrate you. Simply prepare so that when it occurs, you and your staff are ready to handle it. Citations happen and sometimes they are outside of your control (e.g., during a home visit, a home health aide or clinician doesn’t follow appropriate hand washing procedures). In those instances, all you can do is address and correct the issue and move on.

On occasion, you may have a surveyor who is inexperienced in home health. There is a great deal of turnover in some states and surveyors often move from hospital or skilled nursing facility to homecare survey. When that happens, those surveyors tend to be slower and more inquisitive because they are learning, too. Be patient and keep in mind that you were once new to the industry.