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Frequently Asked Questions
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Questions about CMS-Certified providers: |
| Q: What does it mean to be certified by CMS? |
| In order to receive federal dollars through the Medicare or Medicaid programs, providers must meet a set of minimum conditions and standards specified in federal regulations. |
| Q: How does CMS ensure that providers are meeting the minimum conditions and standards? |
MS, through the state survey agencies, conducts regular onsite surveys (inspections) of the providers to ensure that they are meeting all minimum conditions and standards. A provider may also choose to hire a private, CMS-approved accrediting organization to conduct those surveys. CMS reviews the results of the accrediting organization surveys and, if the survey results warrant it, may deem the provider to be in compliance.
In addition, state survey agencies and accrediting organization investigate complaints made by patients and the public as well as incidents that providers report. |
| Q: What are the different reasons for a survey? |
A state survey agency may survey a provider for the following reasons:
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1.Recertification: The provider is not deemed and is being re-certified as part of the normal re-certification cycle. This comprehensive survey checks that the provider is in compliance with all federal regulatory conditions and standards.
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2.Complaint Investigation: These are specific investigations of complaints filed by the public or incidents reported by the provider.
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3.Full Survey after Complaint: During a complaint investigation, the state survey agency discovers enough evidence of noncompliance and deficient practice to warrant a full survey evaluating all minimum conditions and standards.
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4.Validation: For deemed providers, the state survey agency conducts a full evaluations of all minimum conditions and standards within 60 days of a full survey by an Accrediting Organization. The purpose of this survey is to assess the quality of the accrediting organization’s survey.
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| Q: What is a Survey Report? |
When surveyors cite a deficient practice, they provide a narrative to explain what regulation was deficient and why it was deficient. This information is captured as the statement of deficiencies on the CMS form 2567.
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| Q: What surveys does the QCOR website show? |
QCOR displays all state survey agency surveys of providers that have occurred in the last six months and that resulted in a substantial deficiency (specifically a Condition of Participation) being cited. In the case of validation surveys of deemed providers, only immediate jeopardy citations are identified.
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| Q: What does it mean when a survey has an “Immediate Jeopardy Situation”? |
While on survey, a surveyor may identify a practice that puts patients in immediate jeopardy for harm or death. This is considered one of the most severe findings that can occur and requires the provider to fix the situation quickly or risk being cut off from Federal money.
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| Q: How do we know the deficiencies have been corrected? |
After the survey, the surveyor provides the provider with the statement of deficiencies. The provider responds with a plan of correction, explaining how it plans to correct the deficiency. For surveys with substantial deficiencies, the state survey agency returns to the provider to ensure that the deficiency is corrected. If the survey agency returns to the provider and determines that the original deficiencies have not been corrected or discover a new deficiency then they will cite the uncorrected and new deficiencies. State survey agencies continue to revisit the provider until the all deficiencies are corrected or the provider is cut off from Federal money.
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| Q: Can I get a copy of the Plan of Correction from the provider? |
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