Services

Kaplan Health Innovations is an independent resource for health care compliance, clinical advice and guidance to assist you with your organization’s transformation to the new health care delivery paradigm.

Services include:

Evaluating federally qualified health centers through site visits to ensure administrative and clinical compliance with federal regulations.

Through extensive document review and interviews with leadership, staff, and the board of directors, Ms. Kaplan provides objective assessment and verification of health center compliance with the statutory and regulatory requirements of HRSAs Health Center Program. 

This includes:

ADMINISTRATIVE REQUIREMENTS

• Needs Assessment — define the “catchment” service area and have the ability to address the needs of the medically underserved population;
• Accessible Locations and Hours of Operation — ensure service sites are accessible to patients where they live or work and have hours that are responsive to patient needs;
• Key Management Staff — maintain sufficient trained and experienced staff to carry out health center activities;
• Collaborative Relationships — make reasonable efforts to establish relationships with other health care providers and institutions that provide additional care within the catchment area;
• Board Authority — ensure the governing board understands and addresses its responsibilities for oversight of the program, including operational and fiduciary responsibilities;
• Board Composition — make certain that members meet the stringent requirements contained in the legislation.

CLINICAL REQUIREMENTS

• Required and Additional Services — provide the required primary health services in a culturally sensitive manner, while serving those with limited English-speaking ability;
• Clinical Staffing — use appropriate staff that is qualified by training and experience;
• Coverage for Medical Emergencies During and After Hours — have staff trained in basic life support and ensure that operating procedures are in place to respond to medical emergencies during and after hours;
• Continuity of Care and Hospital Admitting — ensure there are relationships with hospitals to treat patients on an emergency and inpatient basis and have mechanisms in place to follow-up with patients post-hospitalization;
• Quality Improvement/Assurance — ensure that (QI/QA) programs support high-quality patient care and address patient satisfaction and grievances, patient safety and adverse events, and QI/QA assessments and oversight;
• Federal Tort Claims Act Deeming Requirements — review and evaluate risk and claims management activities.

Reviewing deeming applications for the Federal Tort Claims Act (FTCA) medical malpractice coverage program.

The FTCA program provides federally qualified health centers immunity from lawsuits alleging medical malpractice. As a reviewer, Ms. Kaplan makes deeming recommendations based on a substantive review of the center’s application. Information includes review and assessment of credentialing and privileging procedures, risk management assessments, quality improvement and quality assurance operating procedures and assessments, and claims management.

As part of the qualifications to become a reviewer, Ms. Kaplan has received secret clearance status from the U.S. Department of Justice.

In addition to reviewing deeming applications, Ms. Kaplan also conducts site visits to evaluate health center program compliance.

Providing technical assistance guidance, including virtual and in-person mock operational site visits and audits.

Ms. Kaplan reviews and assesses the clinical and administrative program requirements to ensure they are in alignment with the HRSA Compliance Manual and Site Visit Protocol. Similar to an operational site visit, all pertinent administrative and clinical policies and procedures are reviewed. Areas needing improvement are identified, and recommendations are made to achieve compliance, as non-compliance could lead to a condition on the grant.

Performing compliance research, analysis, and evaluation services for health care practices, using evidence-based health care strategies.

Depending on the project, Ms. Kaplan collects, analyzes, and evaluates quantitative and qualitative clinical data. She researches trends and develops strategies and interventions for improving access to and quality of health care operations.

Confidentiality

Services are available through telephone, video chat, and in-person consultations. All conversations are strictly CONFIDENTIAL. Ms. Kaplan personally performs all audits, reviews, and evaluations. She also works with a select group of vetted and experienced consultants to provide additional review of a health center’s financial and administrative requirements, when necessary.

Current Clients

Call us at 503-341-0593 to see if Kaplan Health Innovations can provide the quality services your organization deserves.