Quality Oversight

Ridgeview is committed to continuous quality improvement and relies on both internal and external resources to accomplish this goal.

Internally, monitoring activities are performed and evaluated by the staff of the Quality Management Department and by each program and service director. These activities include treatment record audits, which focus on compliance with standards and best practices, high risk, high priority, high volume or problem prone areas, utilization activity, clinical supervision, complaints and grievances, patient satisfaction surveys, MD quality assurance, pharmacy and therapeutics, infection control, and safety. All of this data is reported to the Ridgeview Board of Directors on a monthly basis. Quality teams are formed on an as needed basis to address areas that are identified for improvement.

Externally, Ridgeview is audited by the following organizations:

The Joint Commission on Accreditation of Healthcare Organizations (Joint Commission)

This involvement is voluntary and based on comparing Ridgeview to nation-wide standards developed specifically for Behavioral Health Organizations. Joint Commission surveys are generally unannounced, however at the three year survey cycle, Ridgeview is given a one week notice of their arrival.

The Centers for Medicare and Medicaid Services (CMS)

All surveys are unannounced.

The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS)

TDMHSAS audits on two levels: the first level addresses all state contracted grant funded programs and these audits are scheduled in advance on an annual basis; the second level of oversight comes from the Department's Office of Licensure. These surveys are all unannounced, can occur at any time, and focus on all of Ridgeview’s licensed sites.

The Disability Law & Advocacy Center of Tennessee

All audits are unannounced.

United Healthcare Community Plan

This Managed Care Organization (MCO) audits all of Ridgeview’s contracted TennCare services provided for them, under their contract with TennCare. All audits are scheduled.

Volunteer State Health Plan

This MCO audits all of Ridgeview contracted TennCare services provided for them, under their contract with TennCare.

 

Ridgeview staff respect and appreciate the role each of these outside entities and organizations play in preserving and enhancing Ridgeview’s commitment to continuous quality improvement and as result, all audit results are shared with the Ridgeview Board of Directors and program staff.