Compliance Auditor Job at Help At Home
Help at Home, LLC, is the nation's leading provider of high quality care and support solutions. Our goal is to enable the highest level of personal independence and meaningful lives for our clients. Help at Home is committed to delivering a gold standard in care through our attentive and well-trained staff who support making it possible to keep people comfortably and safely within their homes and communities.
Compliance Tasks
Investigations and Reporting
Nursing Compliance
Chart Audits
Marketing and Development
Compliance Tasks
- Review all returned customer satisfaction surveys from Compliance Specialist and take proper measures to respond to compliance issues (sent quarterly - typically low return rate)
- Review Quarterly Compliance Reports from compliance team and follow up with compliance team/nursing staff/administrative staff on serious issues
- Direct Compliance Specialist to notify compliance team of missing compliance reports no fewer than 15 days before end of each quarter to ensure all homes with members receive compliance visits
Investigations and Reporting
- Download Manual Updates at the beginning of each quarter and send to South Operations Manager to send to home providers
- Handle compliance calls, complaints, issues and respond to members\families\homes providers\case managers as directed by Compliance Investigation Protocol
- Update PAR (Performance Analysis Report) monthly on Y Drive - entry items include complaints/grievances, HFRD incidents reported, medication errors, individual rights violations, charts reviewed, licensure citations reported, missed nurse visits (avoidable and unavoidable), compliance visits, homes leaving for higher pay, homes terminated for poor quality and homes closed. Information submitted by Compliance Specialist, North and South Operations Managers and QA Director.
- Assist home providers with state surveys and other inspections including writing plans of correction and assisting with the appeal process
- Coordinate monthly in-service training for home providers and other training required to remain in compliance with state rules and regulations
- Monitor and assist with maintenance of electronic client and home provider files
- Act as a liaison with case management agencies, Georgia Department of Community Health (Waiver Section and Healthcare Facility Regulation Division)
- Send written communication to DCH Representatives on home closures and other compliance related issues
Nursing Compliance
- Review CV Schedule Manager on the 3rd of each month and send out reminder emails to nurses to finish notes with a copy to the ALS-F Director. Notes should be finished within 24-48 hours of making visits.
- Review Clinical Notes Manager monthly to ensure all notes are completed and signed off by Branch Manager with a copy to the ALS-F Director.
- Complete random monthly review of nurse narratives to ensure narrative meets criteria
- Audit monthly nursing paperwork for the north area to ensure all quality standards are met
- Ensure monthly paperwork is received and audited by Compliance Specialist for the south area
- Notify Operations Manager for any avoidable missed visits (day program, physician appointments, etc unless the nurse did not properly schedule the visit) in order that a CIF is sent to accounting
- Craft and send letter to home provider for any avoidable visits
Chart Audits
- Ensure that 8.3% of members on the program each month receive a chart audit using the Crocodile Tool
- Ensure that approximate dates and results are entered on the Results Quarterly Chart Audit Spreadsheet
- Ensure that all new admissions charts are audited by Compliance Administrative Assistant
- Ensure that all discharged members charts are audited
- Assist with retrieval of missing documents by reaching out to the home provider and compliance officer or nurse (whichever may see the home next)
- Remove all recovered or outdated (over 18 months) from the Results Quarterly Chart Audit Spreadsheet
- Ensure that the level of care and care plan review reports are generated by the Compliance Specialist and that the list is actively worked to recover missing documents
Marketing and Development
- Work with the Marketing and Referrals Contractor in the north area and the South Operations Manager to register new homes with the EDWP and ICWP waivers by gathering, vetting and submitting all paperwork to the Georgia Department of Community Health
- Assist new home providers with the personal care home application process through the Georgia Department of Community Health
- Provide technical assistance and education to new and potential home providers
- Conduct educational seminars on assorted topics
- Represent the company in community relations
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