Industry standards and certifications exist for a reason. These standardized measures can further ensure that a behavioral healthcare entity is aligning its practices and clinical settings with industry acknowledged best practices for the health and safety of patients. By adhering to compliance standards and regulations, the overall health of the organization, its employees, and its clinical outcomes will all benefit.
The daily activities of operating a behavioral health organization can often distract management from the evolving set of practice standards set by review boards and licensing agencies. Behavioral health professionals face increasingly burdensome compliance demands in response to ever-changing documentation, coding, and billing, determining medical necessity, and treatment planning standards.
Pinnacle Behavioral Health Systems can relieve the burden of constantly staying on top of new required standards and practices, or to assist the behavioral health provider complete licensing procedures that may have been inadvertently missed. Because governing bodies require that behavioral healthcare facilities demonstrate compliance, taking steps to identify gaps, evaluate status, and complete updates is essential.
Our compliance services include:
- Quality Assurance. Installation of ongoing quality assurance systems for clinical documentation for completeness, medical necessity, and compliance with insurance, state, and accreditation reviews. The efficiency of these systems rests on ongoing staff training and management oversight, ensuring that the procedural guidelines for meeting optimum quality assurance goals are followed.
- State Licensure and Certification. Ensure that complex guidelines for substance use disorder and mental health accreditation agencies are met, such as for the Joint Commission (TJC), and the Commission on Accreditation of Rehabilitation Facilities (CARF). A careful review of the accreditation requirements can help identify missing elements in existing licensing efforts, or guidance from start to finish for those providers embarking on the accreditation process.
- Monitoring Outcomes. Installation of ongoing outcome measurement systems for value data tracking and performance improvements. The systems provide invaluable compliance data to allow for timely adjustments, improved staff training, and fine-tuning treatment programming.
- State and federal regulatory guidance. Offer guidance and services on meeting state and federal requirements regarding such criteria as administrative structure, financial planning, human resources, staff training, and client and staff safety planning.
- Local zoning guidance. Submittal of conditional use permits and public relations assistance for local city operating requirements. For behavioral health organizations with multiple facility locations, each local entity’s specific zoning and licensure requirements will be addressed.