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

Appeals and Grievances: CMS Guide for Facilities

Learn about the process for appeals and grievances CMS provides to better navigate Medicare billing at your facility or residence.

Medicare Billing Codes: A Guide for Healthcare Facilities

Unclear about Medicare billing codes? Learn about what Medicare billing codes are, why they’re essential, and the varying types.

CMS Nursing Home Visitation Guidelines and Resources

Curious about the latest CMS nursing home visitation regulations? Find out how the recent changes from CMS impact your facility.

Preparing For a DOL Audit of Your Workforce: FAQ

Being prepared for a DOL audit is the best way to avoid one. Use this overview and FAQ guide to help keep your facility compliant.

5 Ways to Improve CMS Compliance for Your Facility

Learn about the background of CMS compliance and discover some tips to improve compliance in your facility or residence.

Durable Medical Equipment Billing Guide

This durable medical equipment billing guide walks through what DME is, how to order it, and finally how to bill for it.

Medicare Reimbursement Rates: Examples and FAQ

Explore the basics of Medicare reimbursement rates so you can understand how your facility will be compensated for its services.

How to Bill Medicare as a Provider: Explanation and FAQ

Learn how to bill Medicare as a provider to ensure your facility or residence is receiving payments and maintaining compliance.

How to Improve Your CMS 5 Star Rating: 5 Tips

Learn how to improve your facility’s CMS 5 Star Rating by understanding the rating methodology and using our helpful tips.

How Does the Resource-Based Relative Value Scale (RBRVS) Work?

Learn about the resource-based relative value scale (RBRVS) and how it is used to calculate payments for healthcare services.

CMS Certification Process: A Guide for Healthcare Facilities

Find out how to stay compliant with federal standards by reading this guide for the CMS certification process.

What Does SNF Mean? Explanation and FAQ

What does SNF mean? Explore the meaning of this medical acronym as it relates to healthcare facilities, nursing professionals, and levels of care.