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Show Me The Reg

Many times when I talk to new agencies I find that surveys, or surveyors, have the owners nervous and biting their nails. If they haven't been through their first one, they're worried that the surveyor is going to come in and just rip them apart.

If you have this fear of your survey or surveyor, consider this. What they're going to be giving you is a helpful To-Do List. It's basically a free audit. A mock-survey can be costly, but a bad state survey can be much more so! You want to be prepared, so it's always good to have an external person review your records and operations to determine that you're doing everything correctly.

The surveyors and the state are out to help you ensure quality care for your clients. They actually want to help you; not get you! It may not always feel like that, but in the initial survey, they tend to be more lenient. States set up these rules and regulations for the same reason you started your agency: to help ensure the quality of care and protect your clients.

They often tell you what to do in these rules and regulations, but not how to do it, and that's where it can start to get a little tricky. Rules are left open to your interpretation on how to accomplish whatever they're telling you. Rules are also open to the surveyors' interpretations. Surveyors are humans, not robots. In some situations they may think there's only one way to do something. But in many situations, they understand and know that the protocols you put in place for your business and clients are going to vary from agency to agency.

If you can accept the process for what it is, and be willing to go into the survey process with an open mind and an open heart with a willingness to learn, you'll yield more from the survey than just a helpful To-Do-List. You may be given the chance to fix or improve something before the final report is made. You will likely have opportunities to explain your policies or protocols and even time to correct some small discrepancies.

This is an important part of the exit interview. Ask for clarification. I always say, "Show me the reg. Can I see the regulation that ties to what you might cite us for? Maybe my interpretation is just different than yours." There's nothing wrong with taking some time to ask some deeper questions. This shows the surveyor that you want to do what is right and that you're on their team.

The goal is to do what is best for our clients. If something is incorrect, let's take this opportunity to learn. You will do better going into your survey with that kind of attitude. Be welcoming as they come into your office and just be ready for what's coming; not out of fear but more so out of curiosity.

Stay open. Could you be doing anything better or did you interpret something differently? Keeping an open mind may even help you convince them that perhaps your interpretation of a specific regulation is also right. You could accomplish having a cite removed!

Above all else, always respect the surveyor and don't forget to respect yourself. You've worked hard and come far! You've had to take care of clients for a long time to get to this point so do not discount that. Also, you do not have to assume that anything they say is always right. When dealing with regulations, they can be convinced to recognize that there is always more than one way to approach what may be a misinterpretation. Remember that everyone is human and may not see things from your perspective right away. Take the time to explain the reasoning behind your approach, and it may make all the difference. They may just say, "Oh, I just didn't see it that way!" Why? Because they're human just like you.

To sum it up remember these points on survey day:

  1. Don't forget to say, "Show me the reg" and stand up for yourself.

  2. You don't have to go in for a fight.

  3. Be open and respectful; letting them know you're on the same page.

  4. Ask them to show you what you're trying to learn.

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