Compliance and CMS Ratings Articles

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 inc…

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.

All Articles

Hospital Swing Bed Services: Overview and FAQ

What is a hospital swing bed program? We’ll discuss the CMS rules that apply and address common questions about this stage of medical care.

What Is the Needlestick Safety and Prevention Act? Overview and FAQ

The Needlestick Safety and Prevention Act makes employee safety an issue of compliance. Here’s an overview of the regulation with answers to FAQs.

California On Call Laws and Healthcare Facilities: FAQ

Need help understanding how California on-call laws apply to your healthcare facility? Our FAQ covers the essentials so you can remain in compliance.

Choosing a HIPAA Compliant Email Service for Your Facility (2025)

Getting the right HIPAA compliant email service is vital for productive, safe engagement with patients, so we did the research to help you choose.

What Is Negligence in Nursing? Overview and FAQ

Negligence in nursing is an increasing concern. We’ll discuss the components of medical negligence charges, and provide answers to common questions.

What Is The Red Flags Rule in Healthcare?

What is the red flags rule and how does it impact your healthcare facility? Learn how to comply with these federal identity theft regulations.

Top 10 Most Common Denial Codes in Medical Billing

Want to optimize your healthcare revenue cycle? Learn about the 10 most common denial codes in medical billing and how to prevent them.

What Is Compliance in Healthcare? Overview and FAQ

Ensuring compliance in healthcare is essential to providing safe patient care. Discover how certain laws and regulations could impact your facility.

CMS Plan of Correction: Template and FAQ

Does your facility need to address deficiencies cited by CMS? Here are five key elements to include in your Plan of Correction, template language, and more.

Setting Up a HIPAA Compliance Audit: Step-by-Step Checklist

Looking to set up a routine HIPAA compliance audit at your facility? This step-by-step checklist will help you streamline the process.

How Do Hospital Inspections Work? FAQ for Facilities

Not sure what to expect during state and federal hospital inspections? Learn more about this process in this helpful FAQ.

Credentialing With Insurance Companies: 5 Mistakes to Avoid

Not sure if your practice credentialing with insurance companies properly? Avoid these five mistakes to make the process as smooth as possible.