Make your regulatory compliance process smooth.

Navigating the tangled web of regulation can be sticky. Managers of organizations today are expected to comply with numerous laws and rules that are often unique to their industry or type of organization. CRI professionals work closely with regulators and industry groups and continuously share their training, knowledge, and experience with our clients. This expertise allows our clients to develop their internal processes to address the strands of various regulatory requirements.

We believe that span between current processes and compliance offer opportunities to help our clients adapt, change, and grow – making for a strong, flexible safety “web” of controls. We don’t dangle any team in front of our clients. Rather, we find the team that best matches our clients’ needs and prospects. Our approach to compliance is fortified by and centered on four steps: appraisal, planning, execution, and monitoring. We then add the necessary radials to capture the various aspects of compliance that might be buzzing around your organization.

Solutions Simplified

Down-to-earth descriptions of our services.
HIPAA Risk Analysis

The Health Insurance and Portability Accountability Act (HIPAA) details the steps that covered entities must take when handling sensitive patient information, such as electronic health records. Covered entities must demonstrate compliance through written policies, as well as tangible processes, that are part of daily operations. CRI’s team members understand the aspects of entities’ responsibilities – including required policies, procedures, systems, and controls. While a successful HIPAA risk analysis identifies potential weaknesses in processes and in IT systems, our approach also pinpoints the most economical ways to mitigate the identified risks. There is no one-size-fits-all solution to improve business processes; we tailor proposed solutions to specific client needs.

Medicaid Cost Reports

Medicaid social health programs are jointly funded by the Federal and state governments, but they are ultimately managed by each state. Medicaid providers are generally required to submit cost reports that conform to each state’s reporting guidelines.

CRI is knowledgeable in the Medicaid systems of a number of states. In assisting with cost report preparation, we strive to help our clients obtain the maximum Medicaid reimbursement to which they are entitled within the laws and regulations of their state’s Medicaid system. We accomplish this goal by staying current on regulations and statutes that affect Medicaid reimbursement systems and maintaining a good working relationship with the states.

Medicare Cost Reports

Medicare-certified providers are required to submit an annual cost report to the Centers for Medicare & Medicaid Services (CMS). Cost reports contain provider information such as facility characteristics, utilization data, cost and charges by cost center, Medicare settlement data, and financial data. Applicable reports include the:

  • Hospital Cost Report,
  • Skilled Nursing Facility Cost Report,
  • Home Health Agency Cost Report,
  • Renal Facility Cost Report,
  • Health Clinic Cost Report,
  • Hospice Cost Report, and
  • Community Mental Health Center Cost Report.

CRI has extensive experience helping clients gather necessary data and prepare cost reports. We can also aid clients in analyzing the specific costs of providing services. This analysis can enable clients to maintain positive cash flows and improve patient care.

OMB Uniform Grant Guidance

The Federal Office of Management and Budget’s (OMB) Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards were implemented in December 2014. The framework introduced in the Uniform Guidance aims to reduce the administrative burden on award recipients and, at the same time, guard against the risk of waste and misuse of federal funds. The knowledgeable CRI team is available to guide you through the compliance steps inherent in grants awarded by the federal government.

Payroll-Based Journal Reporting

The Affordable Care Act (ACA) requires skilled nursing facilities to submit direct care staffing information based on payroll and other auditable data to the Centers for Medicare & Medicaid Services (CMS). (Note: CMS has identified staffing as one of the vital components of a nursing home’s ability to provide quality care.) CRI team members understand the Payroll-Based Journal (PBJ) reporting requirements and can assist with developing strategies to collect accurate information. We can also guide clients in implementing processes and identifying software solutions that not only satisfy compliance requirements, but also provide valuable information to foster efficiently staffed facilities.

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