Now more than ever, your sleep facility needs to pay close attention to the commitment, performance, and quality you achieve to ensure you are addressing your market's needs. Accreditation can help to your sleep center to reach this important goal.

Many markets seek accreditation since it is mandated by the third party payers, and it is how you get reimbursed for your services. Even a number of Medicare Local Coverage Determinations now require sleep centers to be accredited to receive reimbursement. Yet, there are other great reasons to strive for and complete accreditation.

Successful accreditation is a recognized benchmark to demonstrate quality review and adherence with quality standards. It provides insurance companies, physicians, and patients evidence of adherence with national regulatory standards. It documents that all staff meet defined educational standards, and the sleep center measures performance improvement through a standardized quality assurance plan and achieves compliance with effective treatment outcomes.

Accreditation also ensures there is active involvement of a medical director who makes sure standardized clinical practice parameters are integrated and evidence-based protocols are implemented.

In addition, being accredited gives your team the benefit to achieve higher professional goals and accomplishments. There is pride in working with an accredited sleep center, which is focused on effectively treating sleep dysfunction and providing life-changing sleep services to their patients.

Many Steps
Let's start at the beginning of the accreditation process. Review the insurance contracting and your regional LCD to identify which regulatory entity you need to use for accreditation. Next, research the requirements for each of the accreditation options -- American Academy of Sleep Medicine (AASM), The Joint Commission (TJC), and Accreditation Commission for Health Care (ACHC). Complete a self-assessment to determine if your program can be compliant with the required standards.

AASM accreditation is required by a number of third party payers. However, many insurance companies provide the option to complete accreditation through TJC as an alternative to the AASM. This is often completed by hospitals during the overall TJC hospital accreditation site visit. Some payers may not consider the hospital-wide accreditation acceptable and require a more specific sleep lab accreditation visit. ACHC has recently expanded into providing accreditation for sleep centers and is accepted by a growing number of payers.

Remember, you have to start early on with accreditation. Be realistic as completion of the application requires attention to detail, time to compile data, and the efforts of dedicated staff.

Begin by reviewing all the applications, which are posted on the agent's respective website. Complete a self-assessment for compliance with each standard. Take time to discuss with your team and medical director. If you are already struggling to complete your work, engage an experienced accreditation consultant to help prepare the sleep team to ensure the potential for your success.

After finishing the self-assessment, compile a list of the tasks with completion dates and make assignments. Select one person to be the leader who keeps the momentum going and on a defined timetable. Some challenges in this process are often associated with collating the data required for completion of the application: all demographic data, referral network, discharge diagnoses, and types of studies completed. You also will need the data demonstrating the involvement of the medical director: the number of consults, return visits, and studies completed.

The need to demonstrate the referral to multidisciplinary consultants for treatment is necessary. There must be a defined performance improvement quality plan for indicating adherence to quality standards such as inter-scorer correlation with scoring standards. Quality outcomes demonstrating the effectiveness of all treatments is required. It is imperative to be able to demonstrate effective compliance with positive airway pressure therapy for all patients.

The time required to complete your preparation for the site visit depends on a number of factors, including: leadership capacity, timely cooperation of medical director and staff, whether a consultant is used, and experience with the accreditation process. It is not unusual to take three to six months to complete if your data are organized and sleep team members commit to focused completion of their assignments.

Now, take time to review the sleep center's technical policies and procedures to ensure they are updated with the most current protocols. The standards for practice published on the AASM website are essential to integrate. Review the procedures to confirm that all diagnostic testing is performed in accordance with the practice parameters. For instance, RIP belts are required for monitoring breathing dysfunction. Capnography is required when performing pediatric sleep studies. When scoring respiratory-impaired breathing, define which rule for scoring hypopnea you are using with each diagnostic test.

Read your policies to ensure they include all the required elements. For instance, with each environmental emergency plan, you must include the nuts and bolts to implement the plan: who calls emergency services, who attends to the patients, who unlocks the doors, who calls the supervisor, medical director, and the building manager, what is the central location to meet if evacuation is required, and who is in charge?

You will face challenges and delays to complete the entire project in an efficient manner without a digital database with accurate query functionality to provide required information for the accreditation packet. A second pitfall in this process is failing to complete and maintain a comprehensive quality improvement plan measuring outcomes for improvement. A third barrier is not enlisting experienced knowledge of the accreditation process. As well, failure to have support from key people such as the medical director or the administrator is another reason your application process will take a longer period of time to complete.

Accreditation secures third party reimbursements, expands market opportunities to attract more physician referrals, and increases your center's financial health. With a well done accreditation process and a successful accreditation, your center will increase the benchmark for patient care and will experience greater respect in your market. Accreditation remains one of your highest patient service, professional, and business priorities.

Kathryn Hansen, BS, REEGT, CPC, is executive director of the Kentucky Sleep Society and has been involved in sleep medicine for three decades.