During the COVID-19 pandemic, hospital Medicare and Medicaid compliance has been constantly changing and becoming harder to maintain with the influx of patients, and the furloughs of employees. Healthcare facilities all over the country undergo rigorous compliance measures and surveys from regulatory agencies to keep their buildings and patients safe. The Centers for Medicare & Medicaid Services (CMS), the government agency that oversees these processes, gives authority to companies like The Joint Commission to survey hospitals and their compliance with the CMS guidelines. Each hospital must pass a compliance survey and be found up to code in order to receive their Medicare and Medicaid funding each year. According to the American Hospital Association, Medicaid enrollees alone constitute one in five Americans (more than 70 million people) each year.[i].
“Medicare and Medicaid reimbursements can represent 30%-70% of a hospital’s total revenue. Hospitals stand to lose millions in reimbursement dollars from CMS if they fall short of the standards as reported by a survey.Hospitals typically run on narrow margins so having their reimbursement reduced by a failed survey, even by a few percentage points, could be catastrophic fora hospital. With so many furloughs looming and the reduction of elective surgeries, those funds are even more important in the middle of the coronavirus,” states Will Walburn, VP of Business Development for Soleran, Kansas City based compliance technology company.
Over a decade ago, Soleran built a platform (emeditrack) to streamline compliance processes for hospitals. They have helped healthcare systems like Johns Hopkins Medicine, Orlando Health, St. Luke’s Health System,Children’s Mercy Kansas City and Texas Children’s Hospital use their automated compliance management applications to wrangle the many checks and balances of the government agencies. Soleran also has free healthcare compliance apps available during COVID-19 - including an inventory app for tracking current and ordered N95 masks and other PPE.
With the ever changing circumstances, Soleran wanted to go a step further to aid hospitals pass these surveys, so they tapped into the government expertise of someone formerly on the regulatory survey front lines. They hired a seasoned veteran, former Joint Commission Life Safety Code Surveyor-Lance Woolf, to join the Soleran team as Director of Life Safety Compliance. Woolf works directly in the hospitals to prepare for upcoming CMS and Joint
Commission surveys by identifying possible problems and creating solutions through a mock survey. The mock survey process focuses on alleviating issues that consistently arise during a regulatory survey, resulting in minimizing the government’s actual evaluation. The
positive impact to the hospital is less red tape, safer facilities for all patients and, in turn, the full reimbursement of Medicare &Medicaid funds.
Woolf has worked in the health industry for over 17 years holding Senior Director, Director of Facilities and Surveyor positions. His expertise in Regulatory Compliance, Engineering, Emergency Preparedness, Safety,Security, Haz-Mat and Bio-Med has been within Acute Care Hospitals. Prior to the healthcare industry, Lance was a police officer for seven years, with expertise in emergency preparedness. He also has experience in pandemics like H1N1, SARS, Ebola, Zika, and now COVID-19. In the police department, he received FEMA training specializing in emergency response, including active shooter training and bio-terrorism.
Woolf will also help create more extensive Soleran application tools based on his knowledge of the CMS codes. Woolf is writing free, educational healthcare compliance related resources via a blog and hosting an online Q&A for the medical community. Thinking outside the box and working with their known resources is how Soleran & Woolf are giving back during this crisis.
You can follow Woolf & Soleran on LinkedIn, Twitter or online at www.soleran.com.
[i]American Hospital Association. (n.d.) Medicaid. Retrieved April 24, 2020from https://www.aha.org/medicaid