Issued in 2008, the Center for Medicaid Services’ (CMS) version 3.5 of the HCBS waiver template requires states to provide specific information on the Quality Management Strategy used to ensure compliance with waiver assurances. Rushmore offers customized software solutions that facilitate systematic data gathering and performance measures reporting as specified in a state’s waiver application and as needed to monitor service quality. Participant file reviews are the central focus of the user-friendly, web-based application that enables data reporting essential to root cause analysis and benchmarking improvement. Other features of the system include functions that support:

•  Remidiation of identified issues;
• Re-reviews to ensure inter-rater reliability;
• Corrective action planning and monitoring;
• Survey of provider qualifications; and
• Review of level of care determinations.
   

The Rushmore Group has over a decade of distinguished experience in the design, development, implementation, and ongoing support of automated review systems for county and state human services agencies.  Rushmore understands the challenges faced by states in designing systems that produce meaningful information for decision making. Wanda Seiler joined the Rushmore team in 2008 bringing 20 years of state government experience including eight years leading a state developmental disability agency. Her knowledge and expertise have been applied to Rushmore’s automated review systems to create a product that supports data discovery, remediation and improvement of home and community based waiver services.  Collectively the Rushmore team has created an inimitable solution for states seeking to align existing quality assurance and improvement processes with federal reporting requirements while concurrently producing meaningful information for systemic improvement.