Operational Assessments


Harmony Healthcare International (HHI) offers a complex approach to Operational Assessments as it relates to Medicare and Medicaid products as well as Clinical Operations. Operational Assessments include a review of general operations, an analysis of all billing services, an evaluation of reimbursement structure, and recommendations for revenue enhancements and cost reductions based on current utilization. The goal of the assessment is to provide the facility Leadership Team with a road map to the achievement of both an ethical and profitable business model.

Potential Risks to Providers:

Nursing homes still face significant risks that have their basis in the current regulatory system, reimbursement programs and market forces. Harmony (HHI) identified the following risks that pose the biggest challenge to any nursing home operator:

  • Census Fluctuations which could be influenced through caseload management
  • Compliance Problems e.g. Regulation Inspections
  • Receivable Management Problems due to untimely or lack of payments
  • Inaccurate Reimbursement due to MDS under coding or Claim Denials secondary to insufficient documentation

How Can Harmony Healthcare International (HHI) Help?

The Harmony Healthcare International Operational Assessment review include:

  • Interviews with facility Leadership Team including NH Administrator,  Department Managers, Therapy Management
  • Accuracy of patient billing (PPS, Case Mix, Medicare Part B, UB-04)
  • Identification of revenue losses due to MDS errors, insufficient documentation or inadequate treatment strategies
  • Financial review and findings interpretation strategies (RUG and Medicare Part A Review)
  • Admissions Process Review
  • Average Daily Census Analysis
  • Review of specific ADL Coding strategies
  • Discharge Process Review
  • Work flow and time study assessment (Therapy and Nursing)
  • Therapy Staffing Analysis (other disciplines available upon request)
  • Review of Clinical Policies and Procedures

HHI's aim is to improve and optimize nursing homes performance, customer satisfaction, case mix, occupancy, clinical operations, regulatory compliance, and financial results.

Free Resources - Case Mix by State, Federal Rates, RUGs Analysis & More!