OUR SERVICES

With experience as a DADS surveyor, DON of a large home health agency and finally a consultant with a well known company, Pamela Pryor RN, BSN used her accumulated knowledge and experience to found Accurate QA Solutions. Accurate QA Solutions began January 3, 2011 with the goal of providing affordable regulatory compliance in consulting and QA products for Home Health, Hospice and PAS agencies. Accurate QA Solutions is a regulatory driven, full service consulting and QA company whose products evolve to meet the compliance needs of agencies in a complex and ever changing regulatory environment.
Our Services
  • Superior QAPI services – audits/reports – Onsite or Remote(monthly, quarterly, bi-annually
  • Agency Education – Nurse documentation – Administrator responsibilities – HR Compliance
  • Accreditation Preparation:
    • L&C Home Health & Hospice
    • CHAP Home Health & Hospice Home Health & Hospice
    • ACHC Home Health & Hospice
    • PHC Consultation and Quarterly Reports
  • ADR, Redetermination, Reconsideration, ALJ Analysis – Palmetto GBA, RAC, MAC and ZPIC Compliance Assessment/Mock Surveys.
  • Plans of Correction (Survey Response)
  • Applications
  • Annual Agency Evaluations & Annual Documents
  • QA of all Clinical Documents, Nursing, PT, OT, ST, MSW and HHA
  • Manuals with guidance in Applications

We provide compliance driven guidance on all agency documents. We are proud of our Compliance Specialists, who audit all agency administrative documents to ensure optimal compliance. We audit business profile, emergency preparedness manuals, HR files, Admission/Discharge Forms, OIG compliance, Agency logs and physical site for HIPAA Compliance.

Consultant Services

The CoP’s state “The HHA must develop, implement, evaluate and maintain an effective, on-going, HHA wide, data driven QAPI program.”
Is your agency ready for the new CoP requirements for QAPI? Do you have a program customized specifically to address your agency outcomes? Can you read and analyze your CASPER reports? Can you show the surveyors your analysis as required? Are you able to complete 5% chart audit of your agency’s census each month with findings and analysis?
If you answered NO to the above questions, call Accurate QA Solutions today. Our all inclusive, new and totally compliant QAPI Audit, Analysis with Plan meets all Medicare requirements for an agency specific QAPI program. Our QAPI program has been audited by STATE and TJC with excellent reviews. Do not settle for a cookie cutter QAPI plan that will cost you in survey deficiencies. Call today!

We are accepting on-site consultant appointments in Texas and states beyond. We provide an in-depth audit of your agency’s clinical documents and compare our results to Medicare Standards, State Regulations, Accreditation agencies and your state’s Nurse Practice Act. We assist you in pulling the relevant CASPER reports and Home Health Compare reports. Then, using the M numbers from the OASIS, our consultant will instruct you on exactly how your agency earned its current Home Health Compare Star rating and what you need to do to improve or maintain it. If we find a problem with your clinical documentation, including SN, PT, OT, ST, MSW and aide or attendants, we have the resources to assist you to assist the clinicians into improved compliance.
Accurate QA Solutions has been providing QAPI analysis and reports for 8 years. Our work has passed all regulatory and accreditation surveys. And, we always price our work based on your agency census.

(Although the new CoP’s do not designate a time frame for audits, we recommend continuing the quarterly schedule. It is important to catch problems before they become unmanageable. And, this gives us a timeframe for comparison for measuring outcomes with future quarterly’s).

On-site Consulting audits/reports include:

  • Audit of active/discharge charts (prefer problematic charts).
  • Audit/trending of mandatory logs (infection, complaints, occurrences, patient satisfaction surveys).
  • Audit of personnel charts (Q six months or more often if needed).
  • Audit Emergency Preparedness manual/Business profile/In-service manual.
  • Audit of Policy and Procedure manuals.
  • Audit of contracts and forms.
  • Review of marketing materials.
  • Inspection of physical plant for compliance with accreditation agencies/DADS requirements
  • Production of Quarterly Report (every third month):
    • Compliant with regulatory requirements
    • Includes solution for every deficiency found
    • Guide for agency improvements
    • OASIS analysis current/past with outcome trends
    • Review and analysis of CASPER reports, comparison with Hospice/Home Health Compare and strategies for controlling outcomes via OASIS analysis

Quarterly services include the above audits and reports with additional OASIS analysis current/past with outcome trends, review and analysis of CASPER reports with comparison to Hospice/Home Health Compare and review and analysis of CAHPS surveys. All audits and reports are completed before the consultants leave your agency. Cost is based upon agency census:
FEE BASED UPON AGENCY CENSUS:

  • 1- 20 patients – $850.00a day.
  • 21 – 50 patients – $1,100.00 a day.
  • 51 – 80 patients – $1,700.00 a day.
  • 81 -110 patients – $2,200.00 a day.
  • 111 and above – will discuss each Contract individually.

Expenses:

  • Your Agency is asked to provide lunch so our auditors can work non-stop.
  • If your Agency is further than 75 miles from Dallas/Fort Worth, you will be charged mileage.
  • If your Agency is further than 75 miles from Houston, you will be charged mileage.
  • If your agency is further than 75 miles from McAllen, you will be charged mileage
  • Hotel charges may be required if your agency is not close to the Dallas/ Fort Worth area.

All audits and reports are completed before the consultants leave your agency. We ask the agency to provide lunch so our auditors do not have to leave the agency and can work relatively uninterrupted.

Remote Consulting /Chart audits

In 2018, the new Conditions of Participation will require each agency administrator/Governing Board to be more actively engaged in the agency’s QAPI program. Our highly flexible remote audit services can be seamlessly incorporated into this new process, with your agency guiding the audits for the results required to meet the new regulations.
This product requires agency participation in the data collecting process. We provide the audit tools for the administration aspects of the agency business, and your agency provides the data. For the clinical side of the QAPI, your agency provides access to your software and we provide the chart audits with findings. For the CASPER analysis, we provide the “how to” and calendar for CASPER reports and your agency provides the selected reports. Together, we compile a regulatory compliant quarterly report that accurately reflects your agency’s strengths and deficiencies.
For first time remote users, we will compile a QAPI audit, analysis and plan for your approval with the first remote QAPI audit ordered. A small, onetime fee of $250.00 will be due for this report in addition to your quarterly fee.

Level 1: Complete quarterly report compiled by our experts.

Includes:

  • Audit of 15% agency active patient census with report of findings
  • 6 discharge and transfer charts with report of findings
  • Proof of audit document with the clinical indicators for 2018. If you do not wish to use our pre-designed clinical indicators, the audits and proof of audit can be customized to your agency’s specific needs.
Our indicators for 2018 include:
  • Plan of Care will be followed per MD orders
  • Upon admission, the patient’s diagnoses, as recorded in the SOC OASIS will correlate to the Face to Face form, Admission order and MD visit note/Hospital H & P
  • The OASIS RN will validate all diagnoses, assessments and services with supporting documentation and clearly establish medical necessity in each OASIS.
  • Therapy documentation will meet regulatory standards
  • All patients with a diagnosis of Diabetes II will have a HgA2c value in their chart at SOC or within 30 days and every 90-120 days thereafter
  • Re-certification orders will be written per the 42 CFR 424.22(b)(2) regulation and will include home bound status, specific diagnosis(es) to be addressed and approximate date for end of services.
  • CASPER analysis with outcomes reviewed and reported with Home Health Compare scores
  • Personnel files (audits completed by your staff) with report of findings (we recommend these audits are performed during an on-site visit every other quarter)
  • Review of Indicators (tallied by your staff) Infections, Complaints, Occurrences, Patient satisfaction surveys
  • Emergency Preparedness manual (audit sheet completed by your staff)
  • Business Profile (audit sheets completed by your staff)
  • Quarterly analysis and report with Proof of audit with 6 clinical indicators and FOCUS INDICATORS (derived from the QAPI audits, analysis and plan) current indicators

Remote Quarterly Pricing – $600.00 – $1,500.00 per quarter (based on Census).

  • 1-30 Census up to 3 patient charts – $600.00
  • 31-60 Census up to 6 patient charts – $900.00
  • 61-90 Census up to 9 patient charts – $1200.00
  • 91- 125 Census up to 12 patient charts – $1500.0
  • >125 census will be negotiated per contract

Please note: If your agency has both paper and electronic documents, we ask you to upload documents into your software in order to provide complete chart audits.

Level 2: Your agency completes the quarterly report. Includes:
  • Unlimited number of active chart audits: $85.00 each chart. We provide a complete analysis of the clinical chart findings in an easy to use Word document.
  • Audit of 15% agency active patient census with report of findings
  • 6 discharge and transfer charts with report of findings
  • Proof of audit document with the clinical indicators for 2018. If you do not wish to use our pre-designed clinical indicators, the audits and proof of audit can be customized to your agency’s specific needs.
  • Our indicators for 2018 include:
    • Plan of Care will be followed per MD orders
    • Upon admission, the patient’s diagnoses, as recorded in the SOC OASIS will correlate to the Face to Face form, Admission order and MD visit note/Hospital H & P
    • The OASIS RN will validate all diagnoses, assessments and services with supporting documentation and clearly establish medical necessity in each OASIS.
    • Therapy documentation will meet regulatory standards
    • All patients with a diagnosis of Diabetes II will have a HgA2c value in their chart at SOC or within 30 days and every 90-120 days thereafter
    • Recertification orders will be written per the 42 CFR 424.22(b)(2) regulation and will include home bound status, specific diagnosis(es) to be addressed and approximate date for end of services.
  • Unlimited number of discharge chart audits: $25.00 each chart. We provide a complete analysis of the clinical chart findings in an easy to use Word document.
  • List of findings provided in an easy to use Word document with each discipline (SN, PT, OT, ST, HHA, MSW) reviewed and reported separately.
  • Thank you for your consideration!

Remote QA of Clinical Documents

Before we begin to QA your company’s documents we provide instruction on the standards and regulations we follow in performing the QA process. We offer on-site in-services for a nominal fee with handbooks for each clinician. Or, you may choose just the handbooks, which we will supply to your agency at no additional cost. It has been our experience through the past 6 years that clinicians prefer on-site instruction as it allows them time for questions and speeds up document submission time.

Remote QA: Notes/OASIS/485

Notes – How it works:

  • Your agency designates a contact person to work with our QA supervisor who will provide access for the QA nurses and give our supervisor your agency’s preferences in QA.
  • Our QA supervisor will make assignments by the alphabet. Before starting to QA the nurses’ notes, our QA nurses will review your OASIS, 485, communication notes and orders. The QA nurse will review these documents for completeness and consistency.
  • The QA nurse will then begin to QA your notes. The nurse will compare all notes to the 485 for functional limitations, homebound status and to ensure all ordered assessments are completed. The QA nurse will monitor teaching to ensure it is from the 485 or meets an immediate need and to ensure there is no duplicate/repeated teaching. If the note is approved, it will be passed. If there are corrections to be done, the note will be returned to the nurse. There is no additional charge for the QA nurse checking the note when returned to ensure corrections are completed.

OASIS QA AND CODING – How it works:

  • The patient list is checked daily for submitted documents. Our goal is to have all OASIS reviewed and returned if needed within 48 hours.
  • OASIS are coded and audited vertically, within the same document, and horizontally between previous certifications. OASIS are audited for supporting information for primary and secondary diagnoses, therapy, MSW and HHA; M numbers (using our copyrighted M number audit tool); Medication profile; orders; supportive assistance; teaching (per regulations and is measurable); supervision. We also focus on rehab potential and if the RN validated the need for therapy.
  • We will make corrections to spelling and grammar, add supporting phrases if the agency so desires and correct small narrative errors. We will review the coding for appropriateness with home care diagnoses.
  • As with the notes, if the form is approved, it will be passed. If it requires corrections, we will return the form. There is no additional charge for checking the form when returned to ensure corrections are completed.

Plan of Care – How it works

  • The patient list is checked daily for submitted documents. Our goal is to have all 485/POC’s reviewed and returned within 48 hours.
  • Our QA staff will review the OASIS, orders, 60 day summary, H & P, and communications notes prior to QA’ing the form.
  • The 485/POC will then be QA’d based upon the review. We then QA for all Medicare required elements which include: ensuring the functional limitations are consistent with OASIS; DME consistent with OASIS; Diet consistent with OASIS; Mental status is consistent with OASIS; orders and goals are patient and disease specific; orders and goals are not repeats of earlier 485/POC’s; number of orders match visit frequency.
  • Wound care orders/IV/Foley changes are QA’d using the standards established by the WOCN and the Nurse Practice Act for your state
    The medication profiles are QA’d to ensure: generic and brand names are not interchanged; there are no duplicates; antibiotics and other intermittent medications are discontinued in a timely manner and spelling is correct.
  • We assign specific QA nurses to your account. This allows the QA nurses to get to know your field nurses which has proven to be a help for both the field nurse and the QA nurse. Also our QA nurses are a ‘neutral’ voice and personality problems are eliminated.

The registration will provide:
  • Personal consulting by one of our clinical documentation specialists to ensure we follow your agency’s specific requests as well as all applicable regulations and standards.
  • Our assessment tool for OASIS RN’s, “Questions to Establish Medical Necessity”, that clearly documents patient/caregiver knowledge deficits and greatly reduces the risk for Medicare denial of OASIS forms
  • Guidance for your RN’s on OASIS assessments for all M numbers
  • Our Word document “Phrases that Support Medical Necessity” to guide your RN’s in effective OASIS comments.

We provide proof of audit for you to review; we will instruct you on how to review us at no charge, so you may be confident you are receiving exactly what you are paying for.

For the 1st 30 days, we return documents as many times as needed at no charge. This allows the QA nurse and the field nurse to work together to bring all documents into regulatory compliance. There is no charge for telephone and e mail conferences with our staff. We want to help your nurses submit only billable documents. There is no charge for the review of returned document; this is included in the original hourly charge.

Agency/Staff Education

My first nursing passion is for nursing documentation and the education of nurses in compliant, accurate and timely documentation. My staff and I educate with every audit we perform. The Accurate QA Solutions prime directive to our staff is to educate and empower agencies. We do not believe in fostering agency dependence on our knowledge. We customize our documentation in-services to your agencies staff, software and needs. Every attendee receives a bound booklet to use later as a resource manual. We provide instruction on the Nurse Practice Act of your state, State Home Care Regulations, Medicare/Medicaid regulations and Accreditation standards. Using your view screen or our projector, we work through your agency’s software for the hands on experience for your staff. We can accommodate one on one instruction up to full auditoriums.
We also offer instruction to train your staff for in-house QA of all agency documents. Your staff is provided the same instruction materials we provide to our staff of highly competent document auditors.

Survey Response

The staff at Accurate QA Solutions works tirelessly to ensure your surveys are answered completely and in a timely manner. If for some reason, your survey is not accepted, we work at no additional cost to you to make the changes required to get your survey accepted. We work on State, TJC and CHAP surveys.
We charge $75.00 an hour. We generally can complete 2 deficiency responses per hour for State surveys and 1 per hour for TJC and CHAP surveys.

ADR’s and Appeals

While we do not guarantee success in your episodes passing Medicare audit, we do guarantee an in-depth episode audit with a findings report and a well written argument for the episode passing. Before we accept an episode for audit, we check to ensure the episode has a potential for acceptance. If for example we find the plan of care was signed after the last day of the episode, we will not accept the work. The late signing of the plan of care is reason for immediate denial and there is nothing our auditors can do to change the outcome. We do not charge for work we do not think has a chance to pass Medicare audit.

We can deal with

ON SITE QAPI CONSULTING SERVICES
REMOTE QAPI CONSULTING SERVICES
REMOTE CHART AUDITS
REMOTE QA OF ALL NURSING DOCUMENTS
AGENCY/STAFF EDUCATION
SURVEY RESPONSES
ADR AND APPEALS
POLICY AND PROCEDURES