Site Review

​​​​​​​​Contracted primary care provider (PCP) sites are reviewed as a condition of participation in our provider network. A site review is conducted during the initial provider credentialing process. Additional site reviews will be conducted at minimum every three years to assure each provider continues to meet the standards set forth by local, state, and federal regulations. A registered nurse, using the California Department of Health Care Services (DHCS) approved review tools, conducts the review. The site review consists of the Facility Site Review and Medical Record Review.  In addition, a Physical Accessibility Review Survey (PARS) is also conducted at the time of the site review. Other contracted provider sites, including OB/GYN and Substance Use Disorder providers, will also have an initial Facility Site Review conducted.

What is a Facility Site Review?

It is an assessment of the facility’s physical site (includes building, accessibility, equipment, and policies/procedures) for PCPs, OB/GYNs, and freestanding Substance Use Disorder centers at the time of initial credentialing and at minimum three years thereafter for PCPs. This assessment is conducted by a registered nurse, who is a DHCS-certified site reviewer. The DHCS approved site review tool is used to determine compliance in meeting the standards in the following areas:

  • Accessibility/Safety
  • Personnel
  • Office Management
  • Clinical Services
  • Preventative Services
  • Infection Control  

Facility Site Review Tools

Click here for Facility Site Review Tools and Guidelines
Click here for OB/GYN Site Review Tools and Guidelines
Click here for Behavioral Health/Substance Abuse Site Review Tool and Guidelines
Click here for Site Review Preparation Best Practices
Click here for Frequently Asked Questions (FAQs)

 

What is a Medical Record Review?

A Medical Record Review is conducted at primary care provider sites, three to six months after an initial Site Review has been completed, and at minimum every three years thereafter. The DHCS approved tool and guidelines used by the DHCS-certified nurse reviewer​ will be sent prior to the review as well as a list of patients whose records will be reviewed. Typically, a medical record review may take up to approximately three hours for ten records. Your site can operate as usual during the review. A staff person may be needed to get the reviewer acquainted with the electronic health record layout (only a few minutes) if applicable. ​The specific areas being reviewed are:

  • Format
  • Documentation
  • Continuity of Care
  • Pediatric Preventive Care
  • Adult Preventive Care
  • OB/CPSP Preventive Care (if applicable)

Medical Record Review Tools

Click here for Medical Record Review Tool and Guidelines
Click here for Medical Record Preparation Best Practices
Click here for Staying Healthy Assessment (SHA) Information​
Click here for Frequently Asked Questions (FAQs) 

Contact Us​​

Southern Phone: (707) 863-4620

Southern Fax:  (707) 863-4316

Northern Phone: (530) 999-6813

Northern Fax: (530) 999-6950