Specialty Practice Accreditation Fact Sheet

What is a Specialty Practice Accreditation?

Specialty Practice accreditation is for non-sleep medical practices (e.g., cardiology practices) that manage its patients by screening for sleep apnea and performing home sleep apnea tests (HSATs). Treatment and management of the Specialty Practice patients sleep disorders is facilitated by a related AASM-accredited Sleep Facility.

Personnel Requirements

Medical Director: One designated physician who is licensed in the state where the Specialty Practice is located.

Technical Staff: Specialty Practices must maintain appropriately trained, supervised, and, where required by law, licensed personnel.

Technical staff must be trained on the proper use of HSAT devices including:

  • Device operations, application of sensors, use, maintenance, warnings, and safety
  • Instruction of patients in the use of HSAT devices
  • Troubleshooting of HSAT problems
  • Infection control

Any staff member who performs the above duties is considered technical staff.

Scorers: RST, RPSGT, CPSGT, respiratory therapists with the sleep disorders specialist certification (either CRT-SDS or RRT-SDS), or medical staff members/PhDs board-certified in sleep medicine.

Patient Management (Related AASM-accredited Sleep Facility)

The Specialty Practice must maintain a written agreement with an accessible AASM-accredited Sleep Facility that will provide both full diagnostic testing as well as treatment and follow-up to the Specialty Practice patients.

  1. The written agreement should describe the services and responsibilities of the AASM-accredited Sleep Facility:
    1. In-center testing
    2. Follow-up treatment and management
    3. Data gathering (i.e., when treatment was initiated, treatment compliance, and ongoing treatment assessments/outcomes)

Diagnosis: The diagnosis must be performed by a board-certified sleep specialist. If the diagnosis is not performed by a board-certified sleep specialist, then the diagnosis must be reviewed by a board-certified sleep specialist. The diagnosis must remain the responsibility of an appropriately licensed physician or APRN, at the Specialty Practice or the related AASM-accredited Sleep Facility as appropriate.

Quality Improvement

The Specialty Practice must have a QA program for HSAT that addresses two process measures and one outcome measure for OSA. The Specialty Practice must establish minimal thresholds for the quality assurance metrics. Quarterly, the Specialty Practice’s medical director must attest to the effectiveness of quality improvement efforts and address plans for remediation of metrics that do not meet the minimal threshold.

Documentation of process and outcome measures may involve gathering data from the AASM-accredited Sleep Facility. Examples for efficiently gathering data between the Specialty Practice and the AASM-accredited Sleep Facility include:

  • Utilizing a data collection form at follow-up visits to be a part of the medical record and provided to the Specialty Practice monthly/quarterly.
  • Developing a means to access the Accredited Sleep Facilities EMR to pull data as needed.

Depending on the outcome measure chosen, the Specialty Practice may opt to provide a post assessment at the Specialty Practice clinic after the patient has received treatment by the AASM-accredited Sleep Facility. This may eliminate the need to gather data from the AASM-accredited Sleep Facility for the chosen outcome measure.

Please see the Quality Assurance Fact Sheet for more detailed information on QA.

Key Things to Keep In Mind

  • This program is eligible for non-sleep medical practices only (e.g., cardiology practices).
  • Only Specialty Practice patients can be tested. Direct referrals cannot be tested by the Specialty Practice.
  • Independent Sleep Practices and Independent Diagnostic Testing Facilities (IDTFs)/entities that solely test patients are not
  • Services may be subcontracted through a related AASM accredited facility or HSAT provider to meet certain standard requirements e.g.,
    • Equipment/Device
    • Scoring
    • On-Call /Troubleshooting
  • There must be a written agreement outlining the responsibilities of the related AASM-accredited facility:
    • In-center testing
    • Follow-up treatment and management
  • Data gathering (i.e., when treatment was initiated, treatment compliance, and ongoing treatment assessments/outcomes)
  • The diagnosis must remain the responsibility of an appropriately licensed physician or APRN, at the Specialty Practice or the related AASM-accredited Sleep Facility as appropriate.
  • The Specialty Practice must maintain evidence of the services provided from related AASM-accredited Sleep Facility or HSAT provider to demonstrate compliance.
  • Scoring personnel are required to maintain continuing education (CEC) in Sleep Medicine.
  • Any staff member who provides training on proper use of HSAT devices is considered technical staff.
  • It is important for the Specialty Practice and AASM-accredited Sleep Facility to collaborate and maintain open communication regarding ongoing care and treatment of each patient to ensure improvement in the patients’ overall health.