Compliance Monitoring and Oversight

We help manage compliance issues concerning: 

  • Licensed Home Care Services Agency (LHCSA) – New York State Department of Health (NYSDOH) Title 10, New York Codes, Rules and Regulations (NYCRR) Article 7.

  • Certified Home Home Health Agency (CHHA) – Code of Federal Regulations (CFR) Title 42, Title 10 New York Codes, Rules and Regulations (NYCRR), 42 CFR 440.70 and Part 484.

Standards for Accreditation

  • Community Health Accreditation Partner (CHAP)
  • Commission on Accreditation for Home Care (CAHC) 
  • The Joint Commission Accreditation
Accreditation leads to two things: Better quality care. Better business performance.

We aim to support the home healthcare industry to be in full compliance, increasing quality of care. Are your policies in alignment with the state regulations? Often during an audit, we identify policies that inadvertently create non-compliance due to misinterpretation. It can be a quick fix such as your current paperwork is not designed to meet standards. At times, we identify “extra” steps in the processes which in turn results in a negative impact on onboarding, yearly employee requirements as well as clinical visits. Is it time to invest in automation and integration? Compliance at the forefront will increase value, quality and decrease cost.

An audit will reveal what you should be doing is being done, and if not, it provides a framework to enable improvements to be made.

We assist companies in preventing compliance citations by auditing clinical and personnel files; identifying errors and recommending improvements to documents, focusing on processes, and ending inappropriate staffing.

We conduct internal monitoring and auditing. Utilize the collection of data to identify risk, provide training and communication, control activities, and implement corrective action plans. Update and maintain policies and procedures and ensure interdepartmental cohesion.

We will obtain sufficient audit evidence for forming an opinion on financial statements, whether they reflect the true and fair view of the company’s financial position.

We assist and provide you with the following. 

  • Audit Planning and Preparation.
  • Audit Execution and Fieldwork.
  • Audit Reporting and Review.
  • Corrective and Preventive Action. 

Audits are effective in identifying any breaks in processes. 

Corrective action plans will include compliance workflows that will display the granular steps that need to be taken to ensure that the company is in line with the internal controls set forth by management as well as the external regulations implemented by governing bodies. Identify misinterpretation of guidelines and regulations which result in waste and operational obstacles to increasing efficiency. 

A compliance audit is a comprehensive review of a company’s adherence to regulatory guidelines. Audit reports evaluate the strength and thoroughness of compliance preparations, security policies, user access controls and risk management procedures over the course of a compliance audit. Assess risk, identify risk, control risk, review controls. We identify both clinical and financial risk to the company. Areas where problems have been encountered in practice. We will recommend and implement improvements to documents and processes. 

A clinical audit provides the framework to improve the quality of patient care in a collaborative and systematic way. 

Through this audit we can identify emerging trends, which enables us to identify risks and implement actions before it becomes a bigger issue.

A personnel file audit is the periodic and systematic review of your personnel files to assess whether the documents in each employee’s personnel file are accurate, up to date, and complete. The audit helps ensure legal compliance, identifies Human Resources (HR) process weaknesses and highlights HR successes.

With the trends that are identified, we prepare a workflow design ensuring all aspects of the company are in cohesion. Improve clinical outcomes, increase federal and state compliance for services provided, physician orders, decrease omissions, established trends, and identify gaps in processes.

A workflow audit will assist you in identifying the gaps and alter the workflow to suit the current process or team goals. Workflow audits also help identify bottlenecks in the operations and address the root cause.

Is your company doing what you said you would do?

This is a vital monitoring role, and identifies risk within the business where policy, process or procedure is not being implemented or followed correctly.You cannot ensure that processes will be compliant over a period of time if you do not look out for changes.  So the compliance function must look at your past, present activity and into the future, so that potential change is identified as early as possible.  In this way it can help the business adapt to that change as smoothly and in the most cost effective way as possible.

Decrease waste and increase compliance by identifying outliers which include non-revenue generating cases, non-compliant cases, efficiency in billing, and true census growth. Maintain compliance and maximize billing by oversight of timely documentation, return of orders, and meeting visit frequency. 

We will review the impact of a break in communication within the different departments. This data is utilized to ensure staff are being productive and working in real time as well as patient outcomes are being met. We will identify where there is a clear potential for improving service delivery, high risk or high cost, in which improvements can be made.

Utilize the information that has been gathered to drive procedure development.

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