Established in 1988, The Joint Commission’s Home Care Accreditation Program accredits more than 4,000 organizations. The services are provided directly or through a contracted individual or organization. The primary services accredited under the Home Care Accreditation Program are:
- Home Health—professional health care services such as nursing; physical, speech or occupational therapies; medical social work; and nutrition/dietetics.
- Personal Care and/or Support—assistance with activities of daily living, management of household routine and personal care by paraprofessional personnel.
- Home Medical Equipment—Organizations are eligible to be surveyed under The Joint Commission’s standards for HME (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) when they provide medical equipment, prosthetics, orthotics and/or supplies to patients in their place of residence either directly or through the mail. All organizations may also be eligible for HME accreditation if they bill Medicare Part B DMEPOS, regardless of where the services are provided.
- Clinical Respiratory—services provided by respiratory therapists and/or other health care professionals to patients in their home, and associated with the provision of medical equipment.
- Rehabilitation Technology—equipment services that enhance the lifestyle of physically challenged individuals through custom medical equipment and supplies, and ongoing evaluation by trained rehabilitation technologists or orthotics/prosthetics technicians.
- Hospice—services provided and coordinated by an interdisciplinary team to meet the needs of terminally ill patients, including 24-hour access to care, utilization of volunteers and bereavement care.
- Pharmacy—the preparation and dispensing of medications and medication-related devices and supplies by a licensed pharmacy.
- Pharmacy dispensing—dispensing of medications, medication-related supplies and equipment and other related services by a licensed pharmacy.
- Clinical/Consultant Pharmacy—services provided by a qualified pharmacist to optimize outcomes of medication therapy and minimize the adverse effects of medications.
- Long Term Care Pharmacy—pharmacy dispensing services provided to patients residing in a nursing home or other long term care facility, such as assisted living or rehabilitation facility.
- Freestanding Ambulatory Infusion—dispensing and administering drug therapy by infusion or inhalation, and related services, to ambulatory patients in a room or office at an organization’s site that is not an extension of a physician’s office, hospital or part of a larger ambulatory organization.
Eligibility
In addition to accrediting home care organizations throughout the United States, The Joint Commission offers accreditation to home care organizations located outside the U.S. that are operated by the U.S. government or under a charter of the U.S. Congress or that meet certain criteria. For information about specific eligibility requirements for the primary services accredited under the Home Care Accreditation Program, 'How to become accredited'.
Benefits of accreditation
- Demonstrates a commitment to the highest level of patient safety and patient care.
- Eases access to managed care contracts and third party payment, and encourages patient referrals.
- Nationally acknowledged benchmark of quality.
- Increases competitive edge.
- Provides constructive educational opportunity.
- Experienced surveyors offer valuable insights and compliance tips.
- Dedicated Account Representatives offer organization-specific services.
- Enhances ability to attract and recruit top quality staff.
Standards
The Joint Commission’s standards address the home care organization’s performance in specific areas, and specify requirements to ensure that patient care and services are provided in a safe manner. The Joint Commission develops its standards in consultation with health care experts, providers and researchers, as well as measurement experts, purchasers and consumers. The 2009 standards-based performance areas for home care organizations are:
- Emergency Management
- Environment of Care
- Equipment Management
- Human Resources
- Infection Prevention and Control
- Information Management
- Leadership
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- Life Safety
- Medication Management
- Performance Improvement
- Provision of Care, Treatment and Services
- Record of Care, Treatment and Services
- Rights and Responsibilities of the Individual
- Waived Testing
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Accreditation process
The Joint Commission’s accreditation process concentrates on operational systems critical to the safety and quality of patient care. To earn and maintain accreditation, a home care organization must undergo an on-site survey by a Joint Commission surveyor periodically (within a range of 18-30 months). The objective of the survey is not only to evaluate the organization, but to provide education and guidance that will help staff continue to improve the home care organization’s performance. Surveys are conducted by professionals with at least five years of experience in home care. They include registered nurses, pharmacists, respiratory therapists, rehabilitation technologists, orthotists, prosthetists and medical equipment experts. The background and experience of the surveyor who will review an organization are related to the types of services that the organization provides, the volume of services provided, and the ownership or management structure of the home care organization. All surveyors are extensively trained and certified and receive continuing education to keep them up-to-date on advances in quality-related performance evaluation. Following the on-site survey, the organization will receive an accreditation report that outlines the survey findings and any follow-up requirements, requirements for improvement, supplemental findings and organizational strengths. Before it can be accredited, the organization must address all requirements for improvement.
Survey process
The survey process focuses on evaluating actual care processes by tracing patients through the care, treatment and services they received. In addition to these patient “tracers,” surveyors conduct patient systems tracers to analyze key operational systems that directly impact the quality and safety of patient care. Through the Priority Focus Process, surveyors use pre-survey information to conduct a more organization-specific and consistent survey.
Medicare recognition
- Home Medical Equipment: In November 2006, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services granted The Joint Commission deeming authority to accredit durable medical equipment, prosthetics, orthotics and supplies as provided by the Medicare Modernization Act of 2003. The designation means that DMEPOS suppliers accredited by The Joint Commission are “deemed” as meeting Medicare requirements which include the published Quality Standards.
Deemed status relationships
- Hospices: The Centers for Medicare & Medicaid approved The Joint Commission’s application for hospice deemed status in June 1999. Hospice deemed status surveys must be unannounced. The deemed status option is open to organizations seeking Medicare payment for hospice services as well as those already Medicare certified. Organizations choosing this option are evaluated against both Joint Commission standards and Hospice Medicare Conditions of Participation.
- Home Health: The federal deemed status option for Joint Commission-accredited home health agencies became effective in June 1993. Surveys to be used for deemed status must be unannounced. Survey intervals, which may be one, two or three years, are determined using CMS’ criteria. More frequent surveys may be necessary for an accredited home health agency that, for example, has had a change of ownership. CMS retains the authority to conduct random validation surveys and complaint investigations in all certified home health agencies.
Accreditation remains voluntary and seeking deemed status through accreditation is not a requirement for Medicare certification. Qualified home health agencies and hospices should notify The Joint Commission of their interest in using accreditation for Medicare certification purposes prior to applying for a survey. To speak with someone about the deemed status option, call (630) 792-5771.
Cost of accreditation
The Joint Commission uses an annual subscription billing process. For most home care organizations, the annual fee is approximately 20 percent of the total survey fee. In addition, in the year of survey, organizations pay the remaining 40 percent after the survey has been conducted. An organization’s survey fees are based on the type of services provided, the number of patients served (average daily census), the number of offices or sites and the distance from the main site included in the survey. Additional fees may apply to home health deemed status surveys. Pricing information for 2009 will be available after January 1. For more information, contact the Survey Pricing Unit at (630) 792-5115. Staff can also determine whether there are additional fees for branch offices or sites.
Home care information available to the public
Information about the safety and quality of accredited home care organizations is available to the public at Quality Check®, www.qualitycheck.org. This comprehensive listing includes each accredited home care organization’s name, address, telephone number, accreditation decision, current accreditation status and effective date, and its most recent Quality Report. These reports include detailed information about a home care organization’s performance and how it compares to similar home care organizations. In 2007, Quality Check® was expanded to include organizations that are not accredited by The Joint Commission to provide consumers with more information about where to go for their health care needs. However, Quality Reports are only available for Joint Commission accredited organizations.
For questions about standards, contact the Standards Interpretation Group at (630) 792-5900 or complete the online form For more information about the Home Care Accreditation Program, call (630) 792-5771