Thoughts on HRSA Site Visits

Posted on: August 9th, 2013 by Norm

Okay, you’ve had your HRSA site visit and you know there are going to be Conditions (Yes, that’s conditions with a capital “C”).  Worse than the Conditions, though, are the “suggestions” made by the surveyors. Many of you have no doubt received input that offers a dim view about the way you have been operating for the last 20 years or questioned things that your Board has enjoyed doing for the last 30 years. crawl test . Ultimately, you may have found yourself wondering if the surveyor is actually serious about what he or she is saying. Are these suggestions with a capital “S” or simply propositions that you can brush off?

Before digging myself too deep of a hole here, I should pause to point out that, in many cases, these suggestions are so obviously good that, upon receiving them, you may wonder if you’re brain-dead. “How,” you may ask yourself, “did I not think of that?” However, because you’re not brain-dead, you will implement these kinds of suggestions, all the while wishing that you had thought of them yourself.

But let’s go back to the suggestions you thought were stupid.

The chances are slim that you’ll get the 1 in 100 Project Officer who actually has had experience in a community health center or really understands what goes on in one. So, once you’ve heard the suggestions, are you now saddled with doing something that should be reconsidered?  Or, is what was suggested so poorly considered that you feel it is best to simply ignore and quickly forget it? In either case, you’re in a difficult position, with few good options. Either you’re going to have to convince your Project Officer that you seek to defy the gods and do something else or, worse, do nothing at all.

In my Army days, a “suggestion” to attend Happy Hour at the Officers’ Club could easily be regarded as an order if it was made by a commanding officer. Yes, looking back on my years in the military, I can think of many suggestions and orders that were patently ridiculous and plenty of others that were on the mark and well worth immediate action. In some cases, both could have seriously impacted my life expectancy. Kazakhstan Unfortunately, in the Army, orders, both the inanely stupid and the absolutely brilliant, came fast and hard, and I had very little choice in carrying them out and doing them well.

Obviously, it’s easy to define and separate a condition from a suggestion. However, what lingering obligation do you have to implement a suggestion recorded in a Project Officer’s report and maintained in a site visit narrative?

I’ll leave you to ponder over that question and suggest that you check out HRSA’s Health Center Site Visit Guide if you’re preparing for a site visit.

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