⚠ CMS Alert — Effective March 31, 2026: Per-day & per-instance Civil Money Penalties now apply to all nursing home enforcement cycles. Penalties go public on Care Compare starting June 24, 2026. Is your facility protected?
CMS · OIG · FCA · State Medicaid · Documentation-Based Advisory

Compliance Monitoring That Catches Risk Before It Becomes a Citation

NCRCC provides ongoing, documentation-based compliance monitoring for healthcare facilities — without the overhead of a full-time compliance officer. We identify what builds quietly between surveys.

$11K+
Max per-day CMP
per violation (2026)
Monthly
OIG required exclusion
screening frequency
27%
Of SNFs cited for
actual harm annually
2026 Active Regulatory Exposure
CMP Now Per-Day & Per-Instance
42 CFR §488 — Effective March 31, 2026. Sustained deficiencies multiply penalties daily.
OIG Monthly Exclusion Mandate
SSA §1128 + 42 CFR §1001 — One excluded employee = hundreds of individual FCA violations.
Penalties Go Public June 24, 2026
CMS Nursing Home Care Compare will display CMP data publicly — reputation risk is real-time.
SNF VBP & PDPM Audit Scrutiny
OIG auditing SNFs for PDPM upcoding, improper billing, and medical necessity gaps in 2026.
Aligned with
42 CFR Parts 483 & 484
OIG LEIE / SAM.gov
False Claims Act §§3729–3733
CMS State Operations Manual
QAPI Program Support
Confidential Data Handling
Registered U.S. Federal Contractor — SAM.gov Active
2026 Regulatory Landscape

What Changed This Year — And What It Means for Your Facility

Effective March 31, 2026
CMS Expands Civil Money Penalty Authority
Per-day and per-instance CMPs now apply to all nursing home enforcement cycles under 42 CFR §488. A single sustained deficiency can compound into massive liability.
Starting June 24, 2026
Penalties Posted Publicly on Care Compare
CMS will publicly post CMP data on Nursing Home Care Compare. Your fine history becomes visible to families, referral sources, and competitors in real time.
OIG Ongoing Mandate
Monthly Exclusion Screening Is Non-Negotiable
Under SSA §1128 and OIG 2013 Special Advisory, monthly screening is required. One excluded employee generates hundreds of FCA violations — one per claim submitted.
FY 2026 SNF PPS Final Rule
PDPM & VBP Audit Scrutiny Intensifies
OIG is actively auditing SNFs for PDPM upcoding, lack of medical necessity, and improper Consolidated Billing. Documentation accuracy is under active scrutiny.
Who We Serve

Every Facility Type Faces Compliance Risk

NCRCC works with a broad range of post-acute and community-based providers across Virginia, DC, Maryland, and nationwide.

Skilled Nursing Facilities & SNFs
42 CFR Part 483 · PDPM · 5-Star
Assisted Living Communities
State licensure · operational compliance
Home Health Agencies
42 CFR Part 484 · PDGM billing
Behavioral Health Centers
Exclusion monitoring · billing documentation review
Group Homes & Disability Services
Exclusion monitoring · documentation review
Hospice Agencies
42 CFR Part 418 · CMS audit focus
Our Service Models

Four Models. One Unified Compliance System.

Each model targets a distinct regulatory exposure area — anchored to current CMS, OIG, and federal regulatory standards — delivered as a monthly advisory service.

Model 01 — Sentinel
Exclusion & Fraud Risk Monitoring
Monthly screening of all active employees, contractors, and vendors against federal and state exclusion databases — the most commonly missed monthly compliance obligation in LTC.
OIG LEIE monthly check (SSA §1128)
SAM.gov federal exclusion database
State Medicaid exclusion cross-check
Monthly Exclusion Verification Certificate + timestamped audit trail
Regulatory anchor: 42 U.S.C. §1320a-7 · OIG 2013 Special Advisory · 42 CFR §1001 · FCA 31 U.S.C. §§3729–3733
Model 03 — Documentation Compliance
Operational Record Integrity
Systematic review of operational and administrative records to identify missing signatures, incomplete entries, and documentation patterns that could trigger survey citations.
Record completeness and signature audit
Late-entry and timestamp pattern review
Policy vs. practice gap analysis
Survey trigger identification report
Regulatory anchor: 42 CFR Part 483 (Requirements for Participation) · CMS State Operations Manual Chapters 5 & 7 (QSO-26-03-NH)
Model 04 — Dietary & Food Safety
Nutritional Compliance Oversight
Quarterly audit of food safety practices and therapeutic diet documentation — among the most frequently cited F-Tags in long-term care facility surveys.
Kitchen sanitation log review (F-Tag F812)
Therapeutic diet accuracy check (F-Tag F803)
Temperature log compliance verification
Quarterly Dietary Compliance Report
Regulatory anchor: F-Tag F812 (Food Safety) · F-Tag F803 (Menus/Nutritional Needs) · 42 CFR §483.60
Nexus Risk Modules — Expandable Add-On Services
Revenue Leakage & Denial Tracking
Monthly denied claim pattern analysis and revenue leakage identification
Add-on · Custom pricing
Incident Pattern Monitoring
Review of incident logs for repeat patterns, risk indicators, and documentation gaps
Add-on · Custom pricing
Staffing Compliance Review
Schedule vs. staffing log reconciliation and gap detection
Add-on · Custom pricing
Admission Documentation Risk
Intake file completeness and payer eligibility documentation review
Add-on · Custom pricing
QAPI Program Structure Setup
Build your QAPI framework, data tracking system, and documentation processes — aligned to CMS requirements. Program structure and administrative setup only; clinical quality measure interpretation remains with licensed facility staff.
Project-based · Custom quote
Process

How NCRCC Works — Month to Month

A disciplined monthly cycle built to create a continuous audit trail, not just a one-time snapshot.

1
Secure Document Submission
You securely share relevant records — staff rosters, billing samples, incident logs, or policy documents — aligned to your selected service models.
Confidential & secure data handling
2
Documentation Review
We conduct a structured review against current CMS, OIG, and federal regulatory standards to identify risk patterns, gaps, and exposure areas.
CMS State Operations Manual aligned
3
Compliance Risk Report
Within 5–7 days you receive a structured report: risk dashboard, specific findings tied to CFR citations, non-clinical action steps, and a monthly compliance score.
Timestamped audit trail included
4
Ongoing Monthly Monitoring
Monthly cycles build a continuous compliance record — demonstrating good-faith regulatory oversight presentable during surveys, audits, or attorney reviews.
Corporate Integrity readiness support
Sample Output

What You Receive Every Month

A clear, action-oriented compliance report — not a binder of jargon. Every issue is risk-coded, every finding cites a specific regulation, and every report is timestamped for your audit file.

  • Risk-coded scorecard — High / Medium / Low by category
  • Findings anchored to CFR citations & F-Tags — not generic checklists
  • Non-clinical action steps for your licensed facility team
  • Timestamped audit-ready documentation log for regulatory defense
Sunrise Care & Rehabilitation Center
April 2026 · Monthly Review
Moderate Risk4 findings · 1 high-priority
OIG / SAM Exclusions
Clear — 0 findings
Billing Documentation
4 of 22 claims lack medical necessity notes (42 CFR §411.15)
Documentation Records
Missing physician signatures on 3 records
Staffing Log Review
Schedule discrepancy — Apr 14 & 22
Incident Pattern Review
No escalating patterns
Monthly Compliance Score
76% — Moderate Risk
Advisory findings only.
Final decisions with facility staff.

Advisory Services Disclosure: NCRCC provides non-clinical compliance monitoring and advisory services based exclusively on documentation review and applicable federal and state regulatory standards. NCRCC does not perform clinical evaluations, medical determinations, or legal advice, and does not hold a clinical license. All findings are informational and risk-identification in nature only. QAPI-related services are limited to program structure, data tracking framework, and documentation setup — clinical interpretation of quality measures remains the sole responsibility of licensed clinical professionals. Services to specialty facilities (including behavioral health centers, group homes, and Medicaid waiver-funded programs) are limited to exclusion monitoring and general documentation review; NCRCC does not provide specialty regulatory compliance advice specific to those program types. Client records shared with NCRCC are handled confidentially and used solely for service delivery. Final clinical, operational, and legal decisions remain the sole responsibility of licensed professionals employed or contracted by the client facility. Services do not guarantee regulatory compliance or protection from citations, penalties, or audits.

Investment

Transparent, Value-Anchored Pricing

Unlike most compliance firms, we publish our pricing. You'll always know what you're investing — and the value far exceeds the cost when one CMP or denied claim is prevented.

Why our pricing is different: Most compliance consultancies charge $10,000–$70,000 for one-time engagements or don't publish pricing at all. NCRCC operates as a fractional monthly partner — giving you enterprise-level compliance oversight at a fraction of those costs. A single prevented CMP, audit finding, or billing denial can reimburse months of monitoring.

Month-to-month · No long-term contracts
Sentinel Entry
Starting at $750
per month · exclusion monitoring
  • Monthly OIG LEIE + SAM.gov screening
  • State Medicaid exclusion cross-check
  • Monthly Exclusion Verification Certificate
  • Timestamped audit trail (SSA §1128)
Get Started
Most Popular
Core Compliance
Starting at $2,500
per month · models 1, 2 & 3
  • Everything in Sentinel Entry
  • Billing integrity & claims documentation review
  • Operational documentation compliance audit
  • Monthly risk report with compliance score
  • Audit-ready timestamped documentation log
Get Started
Full Nexus Program
Custom Quote
all 4 models + Nexus Risk Modules
  • All four core compliance models
  • Nexus Risk Modules (staffing, incidents, admissions)
  • QAPI program structure & documentation setup
  • Quarterly executive compliance summary
  • Priority access & survey readiness support
Request a Quote

One-time services: Free initial Compliance Risk Check · QAPI Program Structure Setup (project-based, administrative & documentation framework only) · Mock Audit Preparation (non-clinical, project-based). All monthly plans are month-to-month with 30-day written cancellation. No penalties.

Why NCRCC

What No Other Firm in This Space Offers Together

Every competitor does one or two of these things. NCRCC does all of them — in a single monthly engagement, without clinical staff requirements.

01
Transparent, Published Pricing
Every major competitor — CMS Compliance Group, Proactive LTC, Polaris Group — hides their pricing behind a contact form. NCRCC publishes clear starting rates. Administrators know what they're investing before the first call.
Industry first
02
Monthly Monitoring — Not One-Time Audits
Most consultants show up once, deliver a report, and disappear. NCRCC monitors every month — building a continuous compliance record and catching risk as it develops, not after a surveyor has already found it.
Ongoing protection
03
Reports Delivered in 7 Days — Not Months
Large compliance firms take weeks or months to deliver findings. NCRCC delivers structured monthly reports within 5–7 business days of receiving documentation. Speed is a service.
Fast turnaround
04
Fractional Model — Enterprise Oversight at Small-Facility Cost
A full-time compliance officer costs $70,000–$120,000/year plus benefits. Large consulting engagements run $10,000–$70,000 per project. NCRCC delivers equivalent oversight from $750/month — no full-time hire, no long-term contracts.
Cost efficiency
05
Every Finding Cites the Actual Regulation
Solo consultants give opinions. Software gives checklists. NCRCC anchors every finding to a specific CFR citation, F-Tag, or OIG standard. Your reports hold up under regulatory scrutiny — not just internal review.
Defensible documentation
07
Serves the Market Enterprise Firms Ignore
CMS Compliance Group and Polaris Group focus on large hospital systems and multi-facility chains. NCRCC was built for the independent nursing home, the small home health agency, and the single-location assisted living community — facilities with real compliance risk but no enterprise budget.
Underserved market
2026 Enforcement Spotlight

CMS Is Actively Auditing Right Now — Not Next Year

Three enforcement actions are running simultaneously in 2026 that directly affect your facility's documentation, billing, and staffing records.

10%
Of all certified SNFs selected for CMS VBP & QRP audits in 2026
45 days
To submit medical records after CMS audit notification — with only 5 business days to identify a contact
13
Active OIG workplans targeting nursing homes in 2025–2026
PBJ
Payroll-Based Journal retrospective audits are ongoing — staffing log accuracy is under scrutiny
VBP & QRP Data Audits
CMS is reviewing MDS assessments for accuracy
Healthcare Management Solutions is auditing up to 1,500 randomly selected SNFs. Each facility must submit records for up to 10 MDS assessments within 45 days. Documentation gaps identified now could become violations.
PBJ Retrospective Audits
Staffing log accuracy is a live enforcement priority
Discrepancies between submitted Payroll-Based Journal data and actual staffing records can trigger citations. NCRCC's Staffing Compliance Module catches these discrepancies monthly before they appear in an audit.
14,742
Certified nursing facilities in the US
83.5%
Of home health agencies are for-profit
$11K
Max per-day CMP per violation (2026)
70%
OIG exclusions affect nurses & CNAs — not physicians
"We focus on what builds quietly between surveys — where most compliance risk actually originates."
About NCRCC

A Different Kind of Compliance Partner

Nexus Care Regulatory and Compliance Consulting (NCRCC) was built on a simple insight: most facilities prepare intensely for inspections but monitor compliance inconsistently between them. That gap is where citations, penalties, and revenue losses originate.

Fractional Model — Ongoing, Not One-Time
Enterprise-level compliance oversight at a fraction of the cost of a full-time hire or a single major consulting engagement.
Regulatory Language in Every Report
All findings are anchored to specific CFR citations and F-Tags — not generic checklists. Your reports hold up under actual regulatory scrutiny.
Documentation-Based, Non-Clinical
All services are advisory and based on documentation review. Clinical decisions remain with licensed facility staff — we protect the compliance documentation layer.
Registered U.S. Federal Contractor — Active in SAM.gov
NCRCC is an active registered federal contractor in the System for Award Management (SAM.gov) — eligible to serve federal agencies, VA facilities, and government-contracted healthcare programs across Virginia, Maryland, DC, and nationwide.
Request a Free Risk Check

Ready to Know Where Your Real Compliance Exposure Is?

We'll run a no-cost, no-obligation risk check on one area of your operation. If we find nothing — you're in excellent shape. If we do — you'll know exactly where to focus before it costs you.

Contact

Let's Start With One Conversation

Request your free compliance risk check or ask about any service model. We typically respond within one business day.

Email
info@ncrcconsulting.com
Service Area
Virginia · DC · Maryland · Nationwide
Hours
Monday – Friday, 9am – 6pm EST
Industry Classification
NAICS 541611 Administrative Management & General Management Consulting (Primary)
NAICS 541618 Other Management Consulting Services
NAICS 541990 All Other Professional & Technical Services
Federal Registered U.S. Federal Contractor — Active in System for Award Management (SAM.gov)
Request a Compliance Risk Check