Medicare audit response
A tracker for TPE, ADR, SMRC, and UPIC notices — status workflow, document storage, and due-date countdowns — so the corrective-action chain is documented rather than reconstructed under deadline.
Product
Four integrated modules. One canonical record.
Charts flow in from the agency EHR through purpose-built integrations and
are organized around hospice clinical and regulatory concepts. Four
modules share the same canonical record, the same audit findings, and the
same attributable history of every action.
Module 01
Chart audit.
Every chart, every day, against the citations surveyors use.
The problem
Plan-of-care deficiencies under 42 CFR §418.56 are consistently among the most cited findings in hospice surveys, alongside vague certification narratives under §418.22 and missed 14-day aide supervisory visits under §418.76. Traditional sample-based internal audit reviews only a fraction of charts, leaving the remainder unexamined until a surveyor arrives.
How Hospice Helper addresses it
Hospice Helper applies a library of audit checks — each mapped to a specific CMS citation — to the entire active census, continuously. Findings appear on a clinical worklist linked to the precise chart, visit, or document that triggered them, while the issue remains correctable.
- Each audit check is tagged to a Condition of Participation citation, a severity level, and an applicable accreditor scope (ACHC, CHAP, TJC, or all).
- Every finding links directly to the underlying record and to the original EHR payload preserved at ingest, providing complete provenance.
- Resolutions and waivers are documented with rationale and recorded in an attributable, append-only history.
- Repetitive findings across a cohort — for example, missed §418.56(b)(4) fifteen-day plan-of-care reviews — can be remediated in a coordinated workflow rather than chart-by-chart.
- Per-chart PDF export supports IDG packets, surveyor requests, and accreditation evidence.
Module 02
HOPE and HQRP.
Timepoints tracked to the day, in the agency's own time zone.
The problem
HOPE replaced the Hospice Item Set on October 1, 2025. HUV1 (days 6–15), HUV2 (days 16–30), and Symptom Follow-Up Visits within two calendar days of moderate or severe symptoms must be tracked, completed by a registered nurse, and submitted to iQIES on a strict schedule. Submission of fewer than ninety percent of required records within thirty days reduces the Annual Payment Update by four percentage points — for FY 2026, a swing from a 2.6% increase to a 1.4% decrease.
How Hospice Helper addresses it
Hospice Helper monitors HUV1 and HUV2 windows in the agency's local time zone, arms Symptom Follow-Up Visits automatically when J2051 records a moderate or severe symptom, scaffolds iQIES submission, and tracks measure performance for the Comprehensive Assessment, HVLDL, the Hospice Care Index, and CAHPS.
- HUV1 (days 6–15) and HUV2 (days 16–30) tracked precisely in the agency's primary time zone — never against a server-local clock.
- Symptom Follow-Up Visits armed within two calendar days when a moderate or severe symptom is recorded on J2051, consistent with HOPE specifications.
- iQIES submission scaffold for HOPE records, with submission status and on-time percentage visible on a continuous basis.
- Live dashboards for the Comprehensive Assessment (CBE 3235), Hospice Visits in the Last Days of Life, the ten Hospice Care Index indicators, and CAHPS.
- APU exposure surfaced as a managed indicator — the four-percentage-point reduction is observable in advance, not at year end.
Module 03
QAPI workspace.
QAPI drawn from the same record surveyors will examine.
The problem
42 CFR §418.58 requires an effective, ongoing, agency-wide, data-driven QAPI program. In practice, many agencies maintain QAPI artifacts separately from clinical operations, producing reconstruction work at the annual evaluation and inconsistencies between QAPI documentation and the underlying chart record.
How Hospice Helper addresses it
Hospice Helper draws QAPI documentation directly from the audit and quality engines, ensuring that the annual evaluation, Performance Improvement Projects, IDG attendance, and IDG meeting documentation reflect the same record surveyors will examine.
- Annual evaluation populated continuously from audit findings, not reconstructed at year end.
- Performance Improvement Projects with measurable goals, defined owners, documented interventions, and outcome tracking.
- IDG attendance and meeting-cadence reporting consistent with §418.56 requirements.
- Performance reports formatted for ACHC, CHAP, and TJC survey review.
Module 04
Survey readiness.
Evidence that is always current, never assembled under deadline.
The problem
Under 42 CFR Part 488 Subpart M, certified hospice programs are surveyed on a recurring basis, with surveyors guided by the L-tags published in Appendix M of the State Operations Manual. Evidence assembly typically begins only when a survey is announced, compressing weeks of preparation into days.
How Hospice Helper addresses it
Hospice Helper maintains a continuously current, accreditor-scoped record of every applicable Condition of Participation, every audit finding, every resolution, and every access record — available on demand in the formats surveyors and accreditors expect to receive.
- On-demand readiness report scoped to ACHC, CHAP, TJC, or the applicable state survey agency.
- Sortable by citation, by patient, by clinician, and by date range.
- Inclusive of full resolution history and the underlying access trail — not solely the finding itself.
- Snapshot exports for board reporting, accreditation cycles, and change-of-ownership transactions.
Also in the platform
Built for how agencies actually operate.
Multi-location roll-ups
Agencies operating multiple branches see compliance posture and findings rolled up by branch, with branch-scoped reporting for leaders accountable to a single location.
Role-based administration
Invite users by email, assign roles, and enforce MFA — every administrative action recorded in the same attributable audit trail as the clinical record.
Next step
Deploy it for your organization.
We will scope the deployment with you, starting with a walkthrough on a sanitized sample of your data, or on a fully synthetic dataset.