Achieving 100% Audit Rate for PACE Plan at a Leading CCRC through AI-Powered Solutions

Overview

Founded in 1899, our client is a leading Continuing Care Community focused on providing holistic quality care to its residents. They aim to build a care community offering top-notch care to people of all faiths, encompassing various services like home and community-based care, skilled nursing, rehabilitation, hospice, and more. This positions them as a vital cornerstone in the realm of healthcare services.

Business Challenge

  • Striving for a 100% audit rate for the PACE plan.
  • Ensuring strict adherence for quality checks and compliance.
  • Keeping track of participant action items and intensive information.
  • Operational Inefficiencies
The organization encountered significant challenges in attaining 100% audit rates for the PACE plan, while ensuring compliance with state and federal regulations. Tracking time-sensitive information and action items for participants was another hurdle. Furthermore, due to delays in approvals, inefficient scheduling, and inadequate goal tracking, their operational efficiency and client service suffered, impacting their ability to address residents' essential needs, compounded by limited visibility into resident data.

NuAIg Solution

After a comprehensive assessment of organization’s intricacies, we successfully crafted a roadmap tailored for our client.
AI-enabled analytical dashboards were developed to facilitate quick decision-making and prevent compliance breaches. These dynamic dashboards promptly supplied insights into pivotal and time-bound matters, empowering stakeholders to take swift and informed measures, thereby elevating transparency within the system.
Additionally, AI bots were strategically implemented to capture vital participant information, streamlining the generation of crucial Audit and CMS reports. This deployment significantly contributed to the organization’s accomplishment of a 100% audit goal for all PACE participants..

Impact

100%

Compliance
Achieved 100% compliance in timely completion of initial and reassessments.

100%

Audit Goal
Successfully met the 100% Audit goal while adhering to the highest quality standards for participant assessments. 

24/7

Availability
24*7 real time tracking of Problems, Goals, and Interventions, facilitating timely reviews and updates to Care Plans. 

24/7

Surveillance
Real-time monitoring and tracking of participant’s Service Delivery Request (SDR)s, with automated alerts to ensure compliance.

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