Types of Reviews
A routine review is conducted by DODD/OSSAS, Council of Government agency (COG), or County Board of Developmental Disabilities within the first year of billing for newly certified providers and once every certification span. Providers are notified at least 90 days before a routine review is conducted.
Routine reviews of licensed facilities are conducted once per license term and are only conducted by DODD/OSSAS.
Routine reviews of county boards, called accreditation reviews, are completed at least once every three years and are only conducted by DODD/OSSAS. Accreditation reviews result in either a three-year accreditation, a one-year accreditation, or the county board is not in compliance and works with the department to develop a plan of action to come into compliance within 90 calendar days. During this time, the county board cannot enroll people with developmental disabilities onto home and community-based services waivers.
A special review is conducted by DODD/OSASS, Council of Government agency (COG), or County Board of Developmental Disabilities. A special review is conducted when there is a complaint made or Major Unusual Incident concerns regarding a provider. Advance notice is not required for special reviews.
An abbreviated review may only be conducted by DODD/OSSAS. An abbreviated review may be available upon request to providers who are accredited by a national accrediting entity. Providers are notified 90 days before the review will occur.
Preparing for Your Review
It is important to take time to prepare for your compliance review by careful review of all information in this section. Being fully prepared at the start of the review helps make the process go more smoothly for you as the provider and for the review specialists. Any information that is not available at the time of the review may lead to a provider citation. Make sure to contact the reviewer with any questions while preparing for the review.
- Directions on how to assign designee in RDS
- Review Tools: The review tool is the same document used by reviewers to conduct your review. The review tool is your guide to the requirements the reviewers will be looking at for compliance. Not all parts of the review tool will apply based on the services you provide.
- Required Documents List: The required documents list tells you what records the reviewers will need to see during the review. Not all parts of the required documents list will apply based on the services you provide.
- Individual and Staff Sample Keys: The review will include a sample of individuals and for agencies, a staff sample. Sample keys will be provided by the reviewer and will be available in the portal. Refer to the required documents list for what documents will be needed for the review.
Review Tool and Required Documents List by Type of Provider
Agency Provider (including licensed waiver settings)
The results of the review will be sent within 7 calendar days of the review. If citations are issued, a plan of correction or appeal will be required.
Submitting a Plan of Correction (POC) or Appeals for Citations
After the report of citation(s) is sent to the provider, the provider has 14 days to submit a plan of correction or an appeal for each citation.
Plan of Correction (POC) in MyPortal: The provider should write very clearly how they plan to correct the current citation, how they will prevent the citation from happening again, and the date the POC will be implemented.
Appealing Citations in MyPortal: The provider should write very clearly why they are appealing the citation. The provider needs to attach evidence in the portal to support why the citation should be rescinded.
Plan of Correction (POC) Response
The reviewer has 20 calendar days to approve a POC. If a reviewer is not able to approve the POC, an explanation will be provided and a revised POC will be required.
Plan of Correction Verification (POC-V)
A Plan of Correction Verification (POC-V) is the last step of the review process and occurs within 90 days of POC approval. The reviewer will need to see evidence that the provider has implemented their approved POC.