Compliance and CMS Ratings

Healthcare compliance is always top-of-mind when you’re operating a nursing care facility. After all, one major misstep could put your facility in poor standing with state and federal regulators or even land you at the center of a featured news story. Even worse, it could lead to an adverse incident involving a resident or a staff member, with all of the litigation that usually ensues.

Having a strong compliance strategy in place not only protects you, your facility, and your personnel, it also gives you the assurances you need to bring in more residents and staff, expand your operations, and ultimately grow your business.

With ever-changing regulations and requirements, it’s important to have a source of information to help guide you through the compliance process. This section is designed with that in mind and covers topics ranging from credentialing and ratings through the Centers for Medicare & Medicaid Services (CMS) to healthcare billing requirements and procedures.

Healthcare Compliance Overview

Whether you’re starting your first nursing care facility or you’re scouting locations to open your next one, understanding what’s required of you is always the best starting point. Having a good handle on current compliance requirements from the outset means better planning, improved budgeting, and ultimately better outcomes for you, your staff, and your residents.

What can you expect to find in this section? Here you’ll get a better handle on topics that have a direct impact on your facility, such as:

• Preparing for CMS visitations.
• Implementing healthcare compliance training programs.
• Updating policies to reflect relevant regulations.
• Improving your star ratings and what this means for your facility.
• Understanding billing codes and terminology, and procedures for reimbursement.
• Appealing adverse findings or decisions.
• Establishing course accreditation for continuing education requirements.
• Building a culture of compliance at your facility.

Building a Facility Centered on Healthcare Compliance

Ensuring that your facility is aligned with legal requirements, industry standards, and public expectations is no easy task. The good news is that this section has resources to help you along the way. Whether you’re focused on assisted living compliance or nursing home compliance, this section will provide answers to many of your compliance questions, but will also go one step further by providing you with links to trusted authorities, so you can get the information directly from the source.

When it’s done right, compliance can end up having several positive, cascading effects for your facility and help you stand out – for all the right reasons.