Clinical Services

Roush & Associates is committed to supporting and guiding the efforts of providers to achieve clinical excellence. R&A is an experienced leader in providing quality improvement services to healthcare providers operating under challenging regulatory mandates. To promote and sustain quality of care and regulatory compliance, R&A offers the following services:

Quality Improvement and Educational Training Programs

We begin by touring a facility to observe departmental practices and quality of care and quality of life issues. To assess facility compliance, we review established clinical management programs, facility policies, current standards of practice and documentation requirements. Examples of training programs offered by our team include RUGs III application, case management systems, all aspects of the comprehensive MDS assessment process, care plan development, survey readiness and quality assurance activities.

Clinical Records Reviews

Our audits are intended to detect weak documentation and deficient practices and to offer corrective solutions. We utilize the entire clinical record including pre-admission data and review the interdisciplinary services provided to residents throughout their stay. The comprehensive assessment process is the driving force for our reviews. These clinical record reviews are also included in all pre-survey assessments.

Pre-Survey Assessment

Survey readiness is a constant process and involves proactive approaches by all members of the interdisciplinary team to attain and maintain compliance. We assist providers in the achievement of substantial compliance by conducting quality assurance reviews. These "mock surveys" are keyed to the potential regulatory "hot spots" relating to facility quality indicator reports, survey investigative protocols and current acceptable standards of clinical practice. A facility is provided with a comprehensive report of all negative findings with the assignment of "scope and severity" to areas of weakness. We offer recommendations and provide assistance with corrective measures to address compliance issues.

Medicare and Medicaid Reimbursement

R&A identifies documentation methods and systems used in the determination of eligibility requirements for Medicare and Medicaid programs. In addition, we help providers develop strategies for successful operation under the current reimbursement systems.