DNV Healthcare is now the second Accrediting Organization (after The Joint Commission) to receive deeming authority from CMS for psychiatric hospitals to participate in the Medicare or Medicaid programs. CMS granted deeming authority to DNV in July 2020. CMS’s approval followed a rigorous review to evaluate DNV’s survey process and how closely its standards align with the CMS Conditions of Participation (CoPs) for Hospitals including the Special CoPs for Psychiatric Hospitals.
Who is DNV?
DNV (formerly DNV-GL) is an international accredited registrar and classification society headquarted in Hovik, Norway. The company provides services for healthcare as well as the maritime, oil & gas, energy, electrification, and food & beverage industries.
DNV has had CMS deeming authority for acute care hospitals since 2008. In 2010, they gained deeming authority for critical access hospitals. Currently, there are over 600 DNV-accredited hospitals nationwide.
What is Deeming Authority?
In order for hospitals to receive Medicare or Medicaid reimbursement, they must be certified to meet the CMS Conditions of Participation. Hospitals can achieve that certification in two ways.
First, they can undergo a survey by the State Survey Agency – typically the State Dept. of Health. Alternatively, they can gain accreditation by a CMS-approved Accrediting Organization. If they achieve this accreditation, they are “deemed” to have met the CMS CoPs. As a result, they are eligible to participate in the Medicare and Medicaid programs.
CMS currently gives deeming authority for acute care hospitals to the following Accrediting Organizations:
- The Joint Commission
- Healthcare Facilities Accreditation Program
- DNV Healthcare
- Center for Improvement in Healthcare Quality
TJC is the foremost Accrediting Organization. It accredits approximately 88% of U.S. hospitals.
TJC Deeming Authority for Psychiatric Hospitals
TJC has had deeming authority for acute care hospitals since 1965. In 2011, TJC received deeming authority for psychiatric hospitals as well.
As a result, psychiatric hospitals no longer had to undergo certification surveys by the State Survey Agency in order to obtain CMS deemed status. They could choose the Joint Commission accreditation route. Indeed, that is what the majority of psychiatric hospitals do.
Since 2011, TJC has been the only Accrediting Organization to have deeming authority for psychiatric hospitals. CMS’s approval of DNV means there’s a new player on the field.
The DNV Survey Process
A major difference between the DNV survey process and TJC surveys is that DNV conducts annual surveys. During these annual surveys, they focus on progress made on deficiencies cited in the prior survey.
In addition, another difference is that DNV standards integrate the principles of the ISO 9001 Standards.
These standards focus on the hospital’s Quality Management System. They cover areas such as customer focus, leadership, engagement, process improvement, and evidence based decision making.
The DNV survey teams for psychiatric hospitals will have at least one team member with a background in behavioral health. In contrast, the TJC survey teams for psychiatric hospitals consist wholly of professionals with behavioral health experience.
Similar to TJC surveys, the DNV surveys will be unannounced. This is a CMS requirement.
Feedback on DNV Surveys
DNV has been surveying acute care hospitals for several years. So, there is some feedback from the field on their survey process.
Several hospitals report that DNV surveys are less robust than TJC surveys; i.e. “easier.” Also, that the DNV surveys are less clinically focused than TJC.
Lastly, several hospitals have commented that the DNV surveys are heavily focused on the hospital’s quality management program and less on clinical service delivery.
It’s too early to predict what impact DNV will have on the psychiatric hospital industry. It will be interesting to see how many of the nation’s 600+ psychiatric hospitals make a move to DNV accreditation. Rest assured we’ll keep you posted on this topic and and any developments in the field.
Related Info on Deemed Status
Remember, if CMS removes your deemed status, you must notify TJC. See our post Deemed Status for Psychiatric Hospitals: You Must Notify TJC If CMS Removes Your Deemed Status
Also, CMS issues an annual Report to Congress on their oversight of the various Accrediting Organizations. It’s interesting reading. You can see the Disparity Rate between TJC surveys and the CMS validation surveys including psychiatric hospitals.
Barrins & Associates Consultation
We offer CMS Compliance Support Services for psychiatric hospitals. We’re now also conducting our Mock Surveys and Continuous Readiness Consultations both virtually and onsite.
We’ve incorporated all the new 2021 standards and surveyor tools. As always, we’re prepared to support your ongoing compliance and survey readiness even in these challenging times.