Everest Services
- Traditional Assessment
- Recruitment
- Monthly Consulting
- Management Support Solutions
- Acquisition
- Interim Facility Management
- Clinical Reimbursement
- Managed Care Contracting
- EHR Optimization
- HUD Dilligence and Oversight
- Quality of Care
Reach Your
Peak Performance
Everest Management Solutions is a Seniors Housing Strategy Development Firm specializing in enhancing organizational culture, operating practices, talent development, resource optimization, strategy innovation, and tactical execution that positions clients to achieve targeted business performance outcomes. With a curated team of interdisciplinary professionals, Everest has created a best-in-class organization composed of industry experts focused on supporting clients to achieve optimal performance.
We provide services in a variety of fields, that can be of great use to your company and your goal, as we make helping our clients navigate the industry to reach peak performance our priority.
Align Objectives
Improve Accountability
Increase Revenue
Buy-In Accelerate
Change Management
Traditional Assessment
- Overview
- Operational Support
- Clinical Insights
- Business Development Support
- Financial Assessment
- Identification of workflow efficiencies
- Evaluate regulatory compliance
- Analysis of department goals, talent, and performance plans
- Center best practice for PDPM rate capture and general understanding
- Labor management and financial strategies for decreased spend
- Review of all systems tied to budget achievement
- Current status with individualized performance development
- Center specific and regional coaching for sustainability
- Routine Ops reviews with center NHA on identified KPIs
- Monthly calls with weekly engagement in critical areas to ensure execution
- Direct training to center NHA on management practices in the following areas: PPD expense control, PPD staffing best practice, labor management strategies for decreased spend, pharmacy cost review, QAPI effectiveness, environmental excellence tied to survey readiness, departmental spend down, AR reviews and collection effectiveness, AP reviews, PDPM understanding and CMI management (*if applicable to state)
- General Culture assessment and recommendations for improvement
- Identification of workflow efficiencies
- Evaluate regulatory compliance
- Analysis of department goals, talent, and performance plans
- Center best practice for PDPM rate capture and general understanding
- Labor management and financial strategies for decreased spend
- Validation of Phase 1 findings
- Infection prevention emphasis in daily business practice at the direct care level
- Review of existing tools, systems, and processes tied to competency
- Participation in all clinical meetings to drive effectiveness and efficiency
- Assessment and enhancement strategy for the growth and development of clinical leadership both center and region team specific
- Evaluation of current clinical programming related to market analysis and referral source need
- Partnership in any necessary P&P rework tied to improvement trends
- Quality Measure/5-Star review and collaboration in the creation of center specific improvement plans
- PCC utilization support tied to key performance indicators such as: 72-Hour Care Conferencing, Length of Stay, MCR Meeting Effectiveness, D/C
- Planning, and At-Risk Meetings including weight, nutrition, skin, and falls
- Survey result review and trend mapping for strategy development
- Business development strategy assessment
- Competitive landscape mapping for market insights
- Function analysis: internal to external gap analysis on processes tied to referral generation and admissions conversion
- Assess team’s strategic alignment with physicians, hospitals, payers, etc.
- Review of current BD tools, orientation, and training, to provide improvement recommendations designed to drive census performance.
- BD Meetings/BD Plans/Data Analysis/Field and Facility Sales Processes/Referral and Intake P&P
- Direct talent development coaching and training to center BD representative
- Create BD plan based on market nuance, patient movement data and performance trends
- Center specific niche and clinical programming
- Direct support in executing plans
- Managed care contractual relationship review and growth plan recommendation
- Delivery of elevated business development plans for each center
- Cost Management Effectiveness
- Ancillary and Consolidated Billing Practice
- Vendor Cost Efficiency Review
- Staffing and FTE Management Practice
- Immediate Revenue Pick Up Analysis
- Industry Comparison: Portfolio vs. test group representative of industry trends.
Recruitment
In addition to assigning a dedicated recruiter for critical position placement, Everest will provide the client with evaluation, assessment, and solutions tied to strengthening each location’s market position and recruitment practice standards. The engagement goal is to identify current practices and seek solutions that allow the client’s locations to optimize their market position in terms of staffing and labor-related business functions. Everest’s monthly support will catalyze a thorough analysis of the client’s current market position and provide solutions to optimize the location’s competitive strategies in recruiting and retaining staff. The Everest team will assess the client’s resources and value proposition associated with recruiting, such as their reputation as an employer, each location’s online presence, and the end-user experience of a job seeker and employee. The review will include assessing key market employers and deep dive into the tiers of competitors to identify ideal relationships to target or “sell” against.
Our Recruiting Expertise
A preview of the recent positions and specialties we have provided placement and recruitment.
-
Director of Nursing (DON)
Substance Abuse Clinic
Skilled Nursing Facility -
Registered Nurse
Substance Abuse Clinic
Skilled Nursing Facility -
Assistant Director of Nursing (ADON)
Skilled Nursing Facility
-
Licensed Practical Nurse
Substance Abuse Clinic
Skilled Nursing Facility -
Nurse Practitioner
Substance Abuse Clinic
-
Recruiting Coordinator/Talent Acquisition Specialist
Substance Abuse Clinic
Skilled Nursing Facility -
Registered Nurse Supervisor/ Unit Manager
Skilled Nursing Facility
-
Certified Nursing Assistant/Geriatric Nursing Assistant
Substance Abuse Clinic
Skilled Nursing Facility
Monthly Consulting
Everest provides cross-functional monthly interdisciplinary support to clients to help them achieve positive results. Whether layering indirectly with regional teams or direct-to-center, Everest crafts training and engagement pathways to help build sustainable processes for operational improvement. Agreements range from 3-12 months.
Monthly consulting will be included with every service option provided. If you have any questions further regarding the scope of what monthly consulting will or should entail, please fill out our contact form.
Our Consulting Expertise
We tailor our proposals to match our clients dynamic and changing needs. This is a sample of a proposal.
Due to the increasingly competitive nature of the industry’s operating environment, SNF providers are tasked with accountability to local/federal levels of stringent regulatory guidelines. In the current and future healthcare landscape, SNF providers are defined by clinical performance metrics and outcomes datasets that quantify their value and are used as performance scorecards that ultimately determine the viability of success in a given market. Furthermore, to attain and sustain regulatory compliance and simultaneously achieve business performance objectives tied to cost-containment and revenue generation, skilled nursing providers must coordinate their operations and clinical functions. The emphasis on outcomes tied to clinical components have not only changed the duties and responsibilities of providers, their processes, and the workflow of direct care, administrative teams in centers, but it has also amplified the involvement of owners and asset managers in their approach in driving accountability and performance within their portfolios. As the industry shifts into risk-based payment models, data demonstrates a providers’ value. However, the overall effectiveness of clinical programs, policies, and procedures expand beyond audits of critical datasets. Everest embraces the narrative behind the data and leverages the analytics as insights to support providers across the care continuum. Everest partners with clients to optimize their workflow through robust analysis of outcomes in concert with a comprehensive understanding of workflow processes at the bedside, resource development, tool optimization, and training.
For clients seeking to elevate its clinical management platform, Everest Management Solutions provides support in optimizing current business practices, positioning the portfolio for success, and improving performance at the center level. The partnership between Everest Management Solutions and our clients is to aid in your mission to position skilled centers to reach peak clinical performance. The Everest team will identify solutions that effectuate the changes necessary to optimize the SNF portfolio’s performance and ultimately position our clients as the post-acute care leader within the markets they serve. Ultimately, the objective of the collaboration between Everest Management Solutions and our clients is to catalyze the center’s success in terms of short and long-term gains in clinical practices through leveraging comprehensive performance analytics, industry insights, and field support to plan and drive the strategies and tactics necessary for the portfolio’s achievement of specific metrics and deliverables.
Management Support Solutions
- Overview
- Asset Performance Management
- Clinical Insights
- Clinical Informatics
- Clinical Informatics Support Offerings
- Asset Performance Management (APM) + Clinical Insights
The scope of work can include but is not limited to, any or all of the following.
- Quarterly Portfolio Recommendations
- Multilayered advisory support to guide stakeholders
- Access to Everest Management Solutions Clinical Specialist to provide guidance on the portfolio processes and behavior changes necessary to effectuate change
- CMS data and trends on 15,000+ homes
- High-level portfolio risk management aggregated data
- Competitor compares (local, state, national)
- Path to next star analysis for improving ratings
- Occupancy, SFF, Abuse, VBP & QM details
- Penalty, DOP & Payouts
- Easy links directly to CMS tech
- Ownership & Management Analysis
- Survey drill downs and citation history
- Covid performance compares to county rates
The scope of work can include but is not limited to, any or all of the following.
- Includes All of the Clinical Insights Data plus additional data sets to include:
- PDPM Forecaster with Quick Rates
- Staffing simulator using real PBJ data
- Real-time Staffing HPPD & Star Ratings via PCC link
- Real-time Quality & QRP measures via PCC link
- Staffing implementation
- Monthly CMS Data Push
- Individual Center Action Plan Design – Quarterly unless otherwise identified
- Electronic Health Record Optimization
- Partnership to align center and organizational stake holders with optimal clin-ops practices
- Everest Management Solutions Support Specialists to provide guidance on the processes and behavior changes necessary to install change management procedures as identified.
- Everest Management Solutions support to include training and joint process development or refinement to “quick start” change management based on assessment findings and client needs.
- Everest Management Solutions governance to act as an escalation point for issues or barriers in optimization that include but are not limited to; repeat onsite support for workflow alignment, outcomes review and trend analysis for tactic refinement to catalyze success and position for sustainability.
- Everest Management Solutions will adopt a corporate success partner approach to introduce findings and implement best practices to Aurora stakeholders for sustainability at the conclusion of Everest Management Solutions engagement
*It is important to note that Interdisciplinary Service includes Clinical, Business Development & Operations, or Clinical Only.
Acquisition
Every senior care and living organization faces unique challenges related to capital planning. Everest, in partnership with Plante Moran, is a uniquely qualified group of experts called upon to answer tough development and feasibility questions. We provide unrivaled, unbiased advocacy and support to senior living operators, owners, and developers from concept to completion.
Interim Facility Management
The Interim Facility Management Partner offering deploys Everest’s full team of cross-functional industry experts, tools, systems, and analytic resources to support clients. This service offering allows clients to benefit from a high-level organizational strategy actualized by the Everest team’s boots on the ground perspective and supplemental leadership to guide performance optimization at regional and center levels. This service offering is ideal to position clients for success when clients are seeking to divest assets, change tenants during the process of new tenant selection, support the integration of a new tenant or less experienced operator as the Interim Facility Management Partner service positions Everest to partner with clients in lockstep to have side-by-side leadership, support, and resource as assets are moved towards profitability.
Clinical Reimbursement
- PDPM Audits
- Gap Analysis
- Outcome Benchmarking
- Guided Implementation
Our PDPM Audits are a complete medical record review that will offer you verification or opportunities with the following services.
- HIPPS Code Trends
- Diagnosis coding
- Case Mix Group coding
- GG coding
- Section K coding
- Interview and assessment documentation (BIMS, PHQ9, etc)
- Therapy documentation
- Nursing documentation
- Non-Therapy Ancillary (NTA) documentation and coding
Managed Care Contracting
- Overview
- Additional Service Offerings
- Liaison Services
- Case Management Services
- Benefit and Eligibility Check
- Prior Authorization
- Updates
- Appeals/Peer to Peer Review
- Part B Authorization/Custodial Authorization
- Billing
- Clinical Case Management Services
- AR Collection Services
Our Contracting Expertise
Everest helps to expand your network of managed care contracts through our expertise in navigating contract negation and compliance. Our managed care contract focus includes, but is not limited to, the following networks:
-
Humana
-
Medstar
-
Amerigroup
-
United
-
Carefirst BCBS
-
TriCare
EHR Optimization
- Observation
- Action Planning
- Execution Support
- Run and Review PCC Utilization Report and Scorecard
- Create baseline strategy on usage gaps
- Desk review of site documentation practices
- Real-time audit of documentation practice in each module compared to 90 day look back
- Host center and regional layer conference calls to facilitate QA and assess items to include the following:
- Center/Organizational/Disciplinary philosophy
- Site/Regional understanding of modules
- Site/Regional expectations on daily practice
- Completed and on-going training methods
- Educational Platforms
- Performance goals
- Virtual observation of key Skilled Nursing Meetings
- Morning Meeting
- Weekly Medicare Meeting
- At Risk Meeting(s)
- Business Development Meetings
- Length of Stay Meeting with 3rd party providers
- Care Conferences
- QAPI
- Grievances
- Return to Hospital Case Review
- Develop In-Center Engagement Roadmap
- Virtual Center tour and QA with direct-care and department head staff on PCC component areas
- Assess PCC culture and growth appetite
- QA with licensed staff, dietary, admissions, social work, activities, and business office
- Establish center onsite presence and tone for behavior change expectations
- Establish cadence for improvement in PCC critical areas that will set the tone for future discussions
- Individual discipline break-out session and in-depth review of findings:
- Review causes for current gaps
- Discuss training and education options
- Develop PIP to be completed with PCC use participation
- Introduce best practice in center meetings
- Finalize PIP with timeline for improvement
- Exit debrief with facility and leadership
- Train the trainer: Everest Management Solutions train client’s Regional Team
- Biweekly review of progress with center and regional team
- Dial in participation in critical meetings at 30-day mark
HUD Quality of Care Risk Management and Diligence
- Overview
- Risk Assessment
- Quality of Care Risk Management Program
The scope of work and Clinical/Regulatory Due Diligence will include:
- Interviews with facility leadership
- Evaluation of Risk Management practices and systems
- Discussions regarding regulatory history
- Review of any open survey findings and POC
- Review of clinical practice model and processes
The scope of work will include:
- Real-Time Electronic Incident Reporting System
- Real-time incident notification of Key Leadership
- Tracking and Trending Report at facility and corporate levels
- RN clinical specialists to review and ensure appropriate facility staff training occurs
- RN clinical specialist follow up on high-risk incidents
- Assist in development, implementation, and maintenance of relevant risk initiatives
- Clinical Oversight of Risk Management Program
Quality of Care
- Risk Assessment
- Quality of Care Risk Management Program
- Interviews with facility leadership
- Evaluation of Risk Management practices and systems
- Discussions regarding regulatory history
- Review of any open survey findings and POC
- Review of clinical practice model and processes
- Real-Time Electronic Incident Reporting System
- Real-time incident notification of Key Leadership
- Tracking and Trending Report at facility and corporate levels
- RN clinical specialists to review and ensure appropriate facility staff training occurs
- RN clinical specialist follow up on high-risk incidents
- Assist in development, implementation, and maintenance of relevant risk initiatives
- Clinical Oversight of Risk Management Program
Reach Your
Peak Performance
Everest Management Solutions is a Seniors Housing Strategy Development Firm specializing in enhancing organizational culture, operating practices, talent development, resource optimization, strategy innovation, and tactical execution that positions clients to achieve targeted business performance outcomes. With a curated team of interdisciplinary professionals, Everest has created a best-in-class organization composed of industry experts focused on supporting clients to achieve optimal performance.
We provide services in a variety of fields, that can be of great use to your company and your goal, as we make helping our clients navigate the industry to reach peak performance our priority.
Align Objectives
Improve Accountability
Increase Revenue
Buy-In Accelerate
Change Management
- Traditional Assessment
Traditional Assessment
- OverviewOur team of skilled nursing experts are ready to deliver a comprehensive analysis of the centers to recommend practical solutions to reach peak performance moving forward. The portfolio assessment includes interviews with key members of each center team and virtual participation in pertinent operational meetings to assess leadership competency, center utilization of organizational and industry best practices, as well as technology utilization for operational efficiency.
- Operational Support
- Identification of workflow efficiencies
- Evaluate regulatory compliance
- Analysis of department goals, talent, and performance plans
- Center best practice for PDPM rate capture and general understanding
- Labor management and financial strategies for decreased spend
- Review of all systems tied to budget achievement
- Current status with individualized performance development
- Center specific and regional coaching for sustainability
- Routine Ops reviews with center NHA on identified KPIs
- Monthly calls with weekly engagement in critical areas to ensure execution
- Direct training to center NHA on management practices in the following areas: PPD expense control, PPD staffing best practice, labor management strategies for decreased spend, pharmacy cost review, QAPI effectiveness, environmental excellence tied to survey readiness, departmental spend down, AR reviews and collection effectiveness, AP reviews, PDPM understanding and CMI management (*if applicable to state)
- General Culture assessment and recommendations for improvement
- Clinical Insights
- Identification of workflow efficiencies
- Evaluate regulatory compliance
- Analysis of department goals, talent, and performance plans
- Center best practice for PDPM rate capture and general understanding
- Labor management and financial strategies for decreased spend
- Validation of Phase 1 findings
- Infection prevention emphasis in daily business practice at the direct care level
- Review of existing tools, systems, and processes tied to competency
- Participation in all clinical meetings to drive effectiveness and efficiency
- Assessment and enhancement strategy for the growth and development of clinical leadership both center and region team specific
- Evaluation of current clinical programming related to market analysis and referral source need
- Partnership in any necessary P&P rework tied to improvement trends
- Quality Measure/5-Star review and collaboration in the creation of center specific improvement plans
- PCC utilization support tied to key performance indicators such as: 72-Hour Care Conferencing, Length of Stay, MCR Meeting Effectiveness, D/C
- Planning, and At-Risk Meetings including weight, nutrition, skin, and falls
- Survey result review and trend mapping for strategy development
- Business Development Support
- Business development strategy assessment
- Competitive landscape mapping for market insights
- Function analysis: internal to external gap analysis on processes tied to referral generation and admissions conversion
- Assess team’s strategic alignment with physicians, hospitals, payers, etc.
- Review of current BD tools, orientation, and training, to provide improvement recommendations designed to drive census performance.
- BD Meetings/BD Plans/Data Analysis/Field and Facility Sales Processes/Referral and Intake P&P
- Direct talent development coaching and training to center BD representative
- Create BD plan based on market nuance, patient movement data and performance trends
- Center specific niche and clinical programming
- Direct support in executing plans
- Managed care contractual relationship review and growth plan recommendation
- Delivery of elevated business development plans for each center
- Financial Assessment
- Cost Management Effectiveness
- Ancillary and Consolidated Billing Practice
- Vendor Cost Efficiency Review
- Staffing and FTE Management Practice
- Immediate Revenue Pick Up Analysis
- Industry Comparison: Portfolio vs. test group representative of industry trends.
- Recruitment
Recruitment
In addition to assigning a dedicated recruiter for critical position placement, Everest will provide the client with evaluation, assessment, and solutions tied to strengthening each location’s market position and recruitment practice standards. The engagement goal is to identify current practices and seek solutions that allow the client’s locations to optimize their market position in terms of staffing and labor-related business functions. Everest’s monthly support will catalyze a thorough analysis of the client’s current market position and provide solutions to optimize the location’s competitive strategies in recruiting and retaining staff. The Everest team will assess the client’s resources and value proposition associated with recruiting, such as their reputation as an employer, each location’s online presence, and the end-user experience of a job seeker and employee. The review will include assessing key market employers and deep dive into the tiers of competitors to identify ideal relationships to target or “sell” against.
Our Recruiting Expertise
A preview of the recent positions and specialties we have provided placement and recruitment.
-
Director of Nursing (DON)
Substance Abuse Clinic
Skilled Nursing Facility -
Registered Nurse
Substance Abuse Clinic
Skilled Nursing Facility -
Assistant Director of Nursing (ADON)
Skilled Nursing Facility
-
Licensed Practical Nurse
Substance Abuse Clinic
Skilled Nursing Facility -
Nurse Practitioner
Substance Abuse Clinic
-
Recruiting Coordinator/Talent Acquisition Specialist
Substance Abuse Clinic
Skilled Nursing Facility -
Registered Nurse Supervisor/ Unit Manager
Skilled Nursing Facility
-
Certified Nursing Assistant/Geriatric Nursing Assistant
Substance Abuse Clinic
Skilled Nursing Facility
-
- Monthly Consulting
Monthly Consulting
Everest provides cross-functional monthly interdisciplinary support to clients to help them achieve positive results. Whether layering indirectly with regional teams or direct-to-center, Everest crafts training and engagement pathways to help build sustainable processes for operational improvement. Agreements range from 3-12 months.
Monthly consulting will be included with every service option provided. If you have any questions further regarding the scope of what monthly consulting will or should entail, please fill out our contact form.
Our Consulting Expertise
We tailor our proposals to match our clients dynamic and changing needs. This is a sample of a proposal.
Due to the increasingly competitive nature of the industry’s operating environment, SNF providers are tasked with accountability to local/federal levels of stringent regulatory guidelines. In the current and future healthcare landscape, SNF providers are defined by clinical performance metrics and outcomes datasets that quantify their value and are used as performance scorecards that ultimately determine the viability of success in a given market. Furthermore, to attain and sustain regulatory compliance and simultaneously achieve business performance objectives tied to cost-containment and revenue generation, skilled nursing providers must coordinate their operations and clinical functions. The emphasis on outcomes tied to clinical components have not only changed the duties and responsibilities of providers, their processes, and the workflow of direct care, administrative teams in centers, but it has also amplified the involvement of owners and asset managers in their approach in driving accountability and performance within their portfolios. As the industry shifts into risk-based payment models, data demonstrates a providers’ value. However, the overall effectiveness of clinical programs, policies, and procedures expand beyond audits of critical datasets. Everest embraces the narrative behind the data and leverages the analytics as insights to support providers across the care continuum. Everest partners with clients to optimize their workflow through robust analysis of outcomes in concert with a comprehensive understanding of workflow processes at the bedside, resource development, tool optimization, and training.For clients seeking to elevate its clinical management platform, Everest Management Solutions provides support in optimizing current business practices, positioning the portfolio for success, and improving performance at the center level. The partnership between Everest Management Solutions and our clients is to aid in your mission to position skilled centers to reach peak clinical performance. The Everest team will identify solutions that effectuate the changes necessary to optimize the SNF portfolio’s performance and ultimately position our clients as the post-acute care leader within the markets they serve. Ultimately, the objective of the collaboration between Everest Management Solutions and our clients is to catalyze the center’s success in terms of short and long-term gains in clinical practices through leveraging comprehensive performance analytics, industry insights, and field support to plan and drive the strategies and tactics necessary for the portfolio’s achievement of specific metrics and deliverables.
- Management Support Solutions
Management Support Solutions
- OverviewThe Everest approach is designed for impact and focused on results. All engagements are tailored to the client portfolio’s needs to provide high-level optics to optimally manage their assets and to catalyze the behavior change management necessary to yield performance improvements.
- Asset Performance ManagementAsset Performance Management (APM): The objective of Everest’s APM model is to provide consultation designed to pivot usage practices and drive performance- enhancing solutions with client assets. The method for accomplishment is via remote and on-site collaboration with the organization’s regional and center supervisory teams.
- Clinical InsightsEverest’s analytic capabilities allow us to quickly understand the SNFs to provide an assessment and recommendations that will produce the highest return. Everest will look at the client portfolio holistically and analyze individual centers, individual markets, and industry benchmarks to optimize field-level and portfolio efficiencies. Analytics are leveraged to increase awareness of both the opportunities in the current state and in what future elevation could provide to aid in continued regulatory alignment critical to clinical/operational success.
- Clinical InformaticsFor your use “on-demand” coupled with quarterly portfolio recommendations from the Everest team to guide your key stake holders. With this option you also have access to the Everest SNF Specialists to review data and get opinions on strategy at any time.
- Clinical Informatics Support Offerings
The scope of work can include but is not limited to, any or all of the following.
- Quarterly Portfolio Recommendations
- Multilayered advisory support to guide stakeholders
- Access to Everest Management Solutions Clinical Specialist to provide guidance on the portfolio processes and behavior changes necessary to effectuate change
- CMS data and trends on 15,000+ homes
- High-level portfolio risk management aggregated data
- Competitor compares (local, state, national)
- Path to next star analysis for improving ratings
- Occupancy, SFF, Abuse, VBP & QM details
- Penalty, DOP & Payouts
- Easy links directly to CMS tech
- Ownership & Management Analysis
- Survey drill downs and citation history
- Covid performance compares to county rates
- Asset Performance Management (APM) + Clinical Insights
The scope of work can include but is not limited to, any or all of the following.
- Includes All of the Clinical Insights Data plus additional data sets to include:
- PDPM Forecaster with Quick Rates
- Staffing simulator using real PBJ data
- Real-time Staffing HPPD & Star Ratings via PCC link
- Real-time Quality & QRP measures via PCC link
- Staffing implementation
- Monthly CMS Data Push
- Individual Center Action Plan Design - Quarterly unless otherwise identified
- Electronic Health Record Optimization
- Partnership to align center and organizational stake holders with optimal clin-ops practices
- Everest Management Solutions Support Specialists to provide guidance on the processes and behavior changes necessary to install change management procedures as identified.
- Everest Management Solutions support to include training and joint process development or refinement to “quick start” change management based on assessment findings and client needs.
- Everest Management Solutions governance to act as an escalation point for issues or barriers in optimization that include but are not limited to; repeat onsite support for workflow alignment, outcomes review and trend analysis for tactic refinement to catalyze success and position for sustainability.
- Everest Management Solutions will adopt a corporate success partner approach to introduce findings and implement best practices to Aurora stakeholders for sustainability at the conclusion of Everest Management Solutions engagement
*It is important to note that Interdisciplinary Service includes Clinical, Business Development & Operations, or Clinical Only.
- Includes All of the Clinical Insights Data plus additional data sets to include:
- Acquisition
Acquisition
Every senior care and living organization faces unique challenges related to capital planning. Everest, in partnership with Plante Moran, is a uniquely qualified group of experts called upon to answer tough development and feasibility questions. We provide unrivaled, unbiased advocacy and support to senior living operators, owners, and developers from concept to completion.
- Interim Facility Management
Interim Facility Management
The Interim Facility Management Partner offering deploys Everest’s full team of cross-functional industry experts, tools, systems, and analytic resources to support clients. This service offering allows clients to benefit from a high-level organizational strategy actualized by the Everest team’s boots on the ground perspective and supplemental leadership to guide performance optimization at regional and center levels. This service offering is ideal to position clients for success when clients are seeking to divest assets, change tenants during the process of new tenant selection, support the integration of a new tenant or less experienced operator as the Interim Facility Management Partner service positions Everest to partner with clients in lockstep to have side-by-side leadership, support, and resource as assets are moved towards profitability.
- Clinical Reimbursement
Clinical Reimbursement
- PDPM Audits
Our PDPM Audits are a complete medical record review that will offer you verification or opportunities with the following services.
- HIPPS Code Trends
- Diagnosis coding
- Case Mix Group coding
- GG coding
- Section K coding
- Interview and assessment documentation (BIMS, PHQ9, etc)
- Therapy documentation
- Nursing documentation
- Non-Therapy Ancillary (NTA) documentation and coding
- Gap AnalysisA comparison of Everest’s clinical reimbursement practice standards to the current written client’s policy, procedure, and competency process. Assess each center’s execution of those items to provide a GAP Analysis and roadmap the center-specific focus areas for reimbursement improvement. In addition, Everest will seek to review the previously provided EHR and PDPM recommendations regarding PCC configuration and clinical documentation processes to champion a work plan around the identified organizational opportunities.
- Outcome BenchmarkingThe Everest team will host and complete training and education pathways for the center and region teams to impact key performance areas identified in the gap analysis mentioned above. The training pathway will prioritize center FTE education while creating skillset sustainability via enhanced cross-functional onboarding tools. This approach will allow the creation of strategic recommendations for the client to scale across the complete portfolio and replicate the positive performance produced.
- Guided ImplementationPartner with center and regional leaders to establish center-specific and engagement portfolio KPIs tied to the identified improvement areas. Provide a 30-day evaluation of performance via Medicare Claims Data reviews to ensure the focus items yield relevant results. Establishing this process in tandem with corporate support will ensure consistency in both messaging and focus areas for the centers. The Everest team will also provide a risk audit post 30 days of completed training pathways to mitigate risk tied to reimbursement appeals and denials and compare them to national averages.
- Managed Care Contracting
Managed Care Contracting
- OverviewOur Managed Care experts are ready to deliver a robust analysis of the portfolio’s current state and recommend practical solutions to reach peak performance moving forward. The consulting services that might be secured from Everest Management Solutions in Phase I MCO Fundamentals Package of Everest’s payer innovation and services are: MCO Strategic Positioning, Contracting Service, Contract Optimization. Upon completion of the engagement, the Everest team will perform a final review with the client Operators’ team. During the review, Everest will guide the client through the relationship established, contracts obtained, and the two tools provided (the MCO guide and contract quick guide). Everest’s review will ensure the client’s readiness and ownership of the payer relations moving forward.
- Additional Service Offerings
- Liaison Services
- Case Management Services
- Benefit and Eligibility Check
- Prior Authorization
- Updates
- Appeals/Peer to Peer Review
- Part B Authorization/Custodial Authorization
- Billing
- Clinical Case Management Services
- AR Collection Services
Our Contracting Expertise
Everest helps to expand your network of managed care contracts through our expertise in navigating contract negation and compliance. Our managed care contract focus includes, but is not limited to, the following networks:
-
Humana
-
Medstar
-
Amerigroup
-
United
-
Carefirst BCBS
-
TriCare
- EHR Optimization
EHR Optimization
- Observation
- Run and Review PCC Utilization Report and Scorecard
- Create baseline strategy on usage gaps
- Desk review of site documentation practices
- Real-time audit of documentation practice in each module compared to 90 day look back
- Host center and regional layer conference calls to facilitate QA and assess items to include the following:
- Center/Organizational/Disciplinary philosophy
- Site/Regional understanding of modules
- Site/Regional expectations on daily practice
- Completed and on-going training methods
- Educational Platforms
- Performance goals
- Virtual observation of key Skilled Nursing Meetings
- Morning Meeting
- Weekly Medicare Meeting
- At Risk Meeting(s)
- Business Development Meetings
- Length of Stay Meeting with 3rd party providers
- Care Conferences
- QAPI
- Grievances
- Return to Hospital Case Review
- Develop In-Center Engagement Roadmap
- Virtual Center tour and QA with direct-care and department head staff on PCC component areas
- Assess PCC culture and growth appetite
- QA with licensed staff, dietary, admissions, social work, activities, and business office
- Establish center onsite presence and tone for behavior change expectations
- Establish cadence for improvement in PCC critical areas that will set the tone for future discussions
- Individual discipline break-out session and in-depth review of findings:
- Review causes for current gaps
- Discuss training and education options
- Develop PIP to be completed with PCC use participation
- Action Planning
- Introduce best practice in center meetings
- Finalize PIP with timeline for improvement
- Exit debrief with facility and leadership
- Execution Support
- Train the trainer: Everest Management Solutions train client’s Regional Team
- Biweekly review of progress with center and regional team
- Dial in participation in critical meetings at 30-day mark
- HUD Dilligence and Oversight
HUD Dilligence and Oversight
- OverviewThe Everest team of industry experts deploys strategies and tactics that identify potential risk areas to develop center-specific HUD risk management plans that indicate the course of action for performance improvement based on clinical performance and relevant risk. Everest’s risk management assessment plans are comprehensive and drive accountability to positive performance by aligning operators with best practices to yield positive outcomes that meet HUD requirements.
- Risk Assessment
The scope of work and Clinical/Regulatory Due Diligence will include:
- Interviews with facility leadership
- Evaluation of Risk Management practices and systems
- Discussions regarding regulatory history
- Review of any open survey findings and POC
- Review of clinical practice model and processes
- Quality of Care Risk Management Program
The scope of work will include:
- Real-Time Electronic Incident Reporting System
- Real-time incident notification of Key Leadership
- Tracking and Trending Report at facility and corporate levels
- RN clinical specialists to review and ensure appropriate facility staff training occurs
- RN clinical specialist follow up on high-risk incidents
- Assist in development, implementation, and maintenance of relevant risk initiatives
- Clinical Oversight of Risk Management Program
- Quality of Care
Quality of Care
- Risk AssessmentThe scope of work and Clinical/Regulatory Due Diligence will include:
- Interviews with facility leadership
- Evaluation of Risk Management practices and systems
- Discussions regarding regulatory history
- Review of any open survey findings and POC
- Review of clinical practice model and processes
- Quality of Care Risk Management ProgramThe scope of work will include:
- Real-Time Electronic Incident Reporting System
- Real-time incident notification of Key Leadership
- Tracking and Trending Report at facility and corporate levels
- RN clinical specialists to review and ensure appropriate facility staff training occurs
- RN clinical specialist follow up on high-risk incidents
- Assist in development, implementation, and maintenance of relevant risk initiatives
- Clinical Oversight of Risk Management Program