1. Ober, Stacey BSN, JD
  2. Craven, Gloria BSN, MSN
  3. Craven & Ober Policy Strategists, LLC

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Established back in 1988, The Joint Commission's (TJC's) Home Care Accreditation Program accredits more than 4000 organizations that offer a variety of patient homecare services. The Hospice Association of America's 2008 Hospice Facts and Statistics Report confirms that Medicare-certified hospices have grown from 31 in 1984 to more than 3000 as of January 2008, serving more than 950,000 patients annually. On March 27, 2009, the Centers for Medicare & Medicaid Services (CMS) issued a final rule extending TJC's deeming authority for certification of hospice organizations for the maximum 6-year term.1

Figure. Stacey Ober,... - Click to enlarge in new windowFigure. Stacey Ober, BSN, JD; Gloria Craven, BSN, MSN

In order for a home health agency or hospice to participate and receive payment from CMS, it must be certified as complying with the program's standards, Conditions of Participation. Although accreditation is a voluntary process, seeking "deemed status" via an organization's Joint Commission accreditation is an available option to confirm that a healthcare organization has met CMS hospice certification requirements. For those organizations pursuing Medicare approval, they may choose to be surveyed either by an accrediting body such as TJC or by a state survey agency on behalf of CMS to verify that they are in compliance with Medicare's Hospice Conditions of Participation. CMS has partnered with TJC to ensure the quality of hospice services for terminally ill patients and their families and will continue to honor TJC's standards for hospice as meeting or exceeding those established by the CMS program. Any healthcare organization subsequently accredited by TJC may also request TJC, as a "deeming authority," to conduct a survey confirming it to have met the Medicare and Medicaid certification requirements.


The Joint Commission's 2009 guide to understanding the home health and hospice deemed status and state recognition process is a useful tool.2 According to TJC, accreditation and deemed status provide a recognized nationwide "seal of approval" for your organization. The deemed status option may prove to be a way of combining compliance activities and reducing duplicative regulatory surveys.2 Deemed status surveys are unannounced surveys that typically take a day or two longer than a traditional accreditation survey. Answers to questions about the accreditation process itself, how a deemed status survey differs from a regular TJC survey, who will survey your organization, what should be included in your accreditation report, and whether your organization is eligible for a deemed status survey option and estimates of the cost are all available. If your organization is contemplating moving forward with a deemed status survey, it is advisable to assemble a small team of key staff who can review all requirements and spot any that the organization does not currently fulfill. If you have questions about what the standards are, you can contact TJC's Standards Interpretation Group at (630) 792-5900 or online via their Web site,, where you can use the online standards form to send your questions by e-mail.




1. The Joint Commission. CMS recognizes The Joint Commission for continued hospice deeming authority [press release]. April 9, 2009. Accessed April 10, 2009. [Context Link]


2. The Joint Commission. Understanding Joint Commission's home health and hospice deemed status option: a Q & A guide covering federal deemed status and state recognition 2009. Accessed April 10, 2009. [Context Link]