Healthcare Management Solutions, LLC

Surveyor

• Conduct on-site Initial, Recertification, Revisit and/or Desk Audit, Complaint, Focus, and Pilot surveys of long-term care and non-long-term care medical facility programs throughout the United States and Territories
• Conduct surveys in accordance with the State Operations Manual
• Complete deficiency reports in accordance with the Principles of Documentation and the HMS Master Writing Guide
• Maintain client-established deadlines and timeframes
• Clearly link identified deficient practices with associated regulations
• Document survey findings accurately using laptop or tablet computer technology
• Report Immediate Jeopardy Condition-level findings and Substandard Quality of Care findings to appropriate Quality Assurance staff
• Coordinate with Quality Assurance staff to ensure findings are adequately documented and defensible before submission to CMS or SSA
• Submit documentation according to established deadlines
• Maintain current knowledge of CMS and HMS policies and procedures, Medicare regulations, and CMS QSO memoranda
• Identify opportunities for improvement in the survey process and communicate them to leadership staff
• Accept survey assignments as needed and as directed by CMS and HMS

Medical Facility Surveyor

• Complete surveys of hospitals, ambulatory surgical centers, rural health clinics, critical access hospitals, home health, and hospice facilities
• Conduct surveys in accordance with the State Operations Manual (SOM)
• Prepare deficiency reports in accordance with the Principles of Documentation (PoD) and the HMS Master Writing Guide
• Communicate survey findings through the approved Quality Assurance process
• Identify opportunities to improve the survey process
• Communicate improvement opportunities to appropriate leadership staff
• Accept survey assignments as needed and as directed by CMS and HMS
• Travel extensively to survey facilities

Medical Facility Surveyor – Acute and Continuing Care Programs

Reviewer

• Review and audit clinical data submitted to the STS Congenital Heart Surgery Database against source medical record documentation
• Validate case selection, procedure coding, outcomes, and registry variables for completeness and accuracy
• Identify and document matches, mismatches, and potential data quality concerns using HMS audit tools
• Review operative reports, progress notes, diagnostic studies, discharge summaries, and other relevant medical records
• Participate in initial and ongoing reviewer training activities
• Meet established productivity, quality, and inter-rater reliability standards
• Escalate questions regarding data definitions, documentation interpretation, or audit findings through established channels
• Participate in adjudication activities and documentation review when sites respond to preliminary audit findings
• Provide clear, professional documentation regarding audit determinations and supporting rationale
• Maintain confidentiality and comply with HMS security, privacy, and data protection requirements
• Participate in team meetings and project calls as needed
• Perform other duties as assigned

Medical Facility Surveyor

Medical Facility Surveyor – Acute and Continuing Care Programs

Congenital Heart Surgery Database Reviewer