Frequently Asked Questions

An accredited facility must comply with the most stringent set of applicable standards. It must meet our strict requirements for facility director, medical specialist certification, staff credentials, and must pass a thorough survey by a qualified QUAD A facility surveyor.

To achieve QUAD A accreditation, a facility must comply with 100% of the standards in all categories.

An accredited facility must undergo re-evaluation through an annual self-survey, an onsite survey every three years, and comply with all QUAD A accreditation standards.

Once your paperwork is complete and your floor plan is approved, the QUAD A staff can usually secure a surveyor to evaluate your facility within 30 days. For Medicare accreditation, an additional Life Safety Code inspection is performed prior to the QUAD A Medicare inspection. QUAD A cannot guarantee a Life Safety Code inspection within 30 days. Statistically, most facilities fully achieve accreditation 90 to 150 days after submitting an application. For those requesting an immediate survey in a non-Medicare program, we may be able to accommodate but an additional fee would apply.

Prices vary based on program, class, facility size, and number of specialists.

QUAD A’s patient safety data reporting (PSDR) system, as required by QUAD A’s standards, requires online reporting every three months. This online reporting includes the submission of three random cases for each surgeon/proceduralist and all unanticipated sequelae. The reported cases for each surgeon/proceduralist must include the first case done by each surgeon/proceduralist per month during the reporting period for a total of three cases, plus all unanticipated sequelae. If a surgeon/proceduralist has not performed at least one case per month, cases from other months in the period may be selected for a total of three reported cases per period.

What QUAD A previously called Peer Review is a separate and distinct process from what many physicians are familiar with as a full clinical peer review process, which is performed at a physician-to-physician level. The objective data elements required during the quarterly Patient Safety Data Reporting, as part of the accreditation process, is specifically intended for medical study and the evaluation and improvement of quality care and reduction of morbidity and mortality. Such data can be entered prior to the facility conducting its peer review meetings. Revised standards manuals will be published soon and will use more distinct language to demonstrate the difference.

• An ASC must be certified and approved to enter into a written agreement with CMS. Participation as an ASC is limited to any distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of services would not exceed 24 hours following an admission.
• The regulatory definition of an ASC does not allow the ASC and another entity, such as an adjacent physician's office, to mix functions and operations in a common space during concurrent or overlapping hours of operations. CMS does permit two different Medicare-participating ASCs to use the same physical space, so long as they are temporally separated. That is, the two facilities must have entirely separate operations, records, etc., and may not be open at the same time.

• A Rural Health Clinic (RHC) is a clinic located in a rural, underserved area with a shortage of primary care providers, personal health services, or both. Currently, there are about 4,500 RHCs nationwide providing primary care and preventive health services in underserved rural areas.
  

  RHCs provide:
  

• Primary care and preventive services
• Services and supplies furnished incident to RHC practitioner services, such as taking blood pressure or administering shots
• Homebound visiting nurse services in CMS-certified home health agency shortages
• Some care management services
• Some virtual communication services, such as communications-based technology and remote evaluation services

An RHC must:

• Be in an area defined by the U.S. Census Bureau as non-urbanized
• Be in an area currently designated by the Health Resources and Services Administration (HRSA) within the last 4 years as 1 of these:
• Primary Care Geographic Health Professional Shortage Area
• Primary Care Population-Group Health Professional Shortage Area
• Medically Underserved Area
• Governor-designated and Secretary-certified Shortage Area

An RHC must:

• Employ an NP or PA (RHCs may contract with NPs, PAs, CNMs, CPs, and CSWs when the RHC employs at least 1 NP or PA)
• Have an NP, PA, or CNM working at least 50% of the time during operational hours
• Post operation days and hours

Health Care Services Requirements:

• Directly provide routine diagnostic and lab services
• Have arrangements with 1 or more hospitals to provide medically necessary services unavailable at the RHC
• Have drugs and biologicals available to treat emergencies
• Provide these lab tests on site:
• Stick or tablet chemical urine exam or both
• Hemoglobin or hematocrit
• Blood sugar
• Occult blood stool specimens exam
• Pregnancy tests
• Primary culturing to send to a certified lab
• Not be primarily a mental disease treatment facility or a rehabilitation agency
• Not be a Federally Qualified Health Center (FQHC)

• The primary purpose of a rehabilitation agency is to improve or rehabilitate an injury or disability, and to tailor a rehabilitation program to meet the specific rehabilitation needs of each patient referred to the agency. A rehabilitation agency must provide, at a minimum, physical therapy and/or speech language pathology services to address those needs of the patients. 
• The rehabilitation agency must be able to provide therapeutic procedures as well as the modalities of heat, cold, water and electricity for physical therapy treatments for the patients it accepts for service at any of its practice locations. The rehabilitation agency must also be able to provide any equipment required by the speech-language pathologist to treat patients accepted for such service.
• Occupational therapy is an optional service and cannot be substituted for either of these two services. It may be provided in addition to physical therapy and/or speech-language pathology services.

• The extension location and the primary location must have the same:

• Governing body,
• Administration; and
• Policies and procedures (e.g., housekeeping, infection control). 
• However, it is important that evacuation plans are specific to the building where the services are provided.