Blog | Engage Consulting

TPE Audits and Denials: Why Getting It Right the First Time Matters

Targeted Probe and Educate (TPE) audits are designed to identify billing and documentation vulnerabilities, but for providers, they often feel overwhelming. Tight timelines, complex documentation requirements, and the financial risk tied to unfavorable determinations make TPE audits one of the most high-stakes reviews organizations face. What many providers underestimate is what happens after a failed TPE review. An unfavorable outcome does not just result in denials. It in

Feb 113 min read

January 2026 Five-Star Report Update: What Changed and Why It Matters

CMS updated Care Compare on February 5, 2026, to reflect values for the new hybrid antipsychotic quality measure. However, when reviewing the January 2026 Five-Star Preview Reports today compared to when they were first released, the data presentation and scoring methodology appear to have changed. What the Five-Star Report Initially Showed When CMS first released the Five-Star Preview Reports on January 21, 2026, the new hybrid antipsychotic quality measure displayed “N/A” v

Feb 62 min read

Best Practices for Preparing for Medicare TPE Audits with Confidence

Targeted Probe and Educate (TPE) audits can be one of the most stressful experiences for post-acute providers. Tight timelines, extensive documentation requests, and the risk of payment denial place significant pressure on clinical, MDS, and billing teams. The good news is that TPE audits are highly manageable when organizations take a proactive, organized approach to information gathering and submission. Below are some best practices for preparing documentation, avoiding co

Feb 23 min read

CMS Updates Facility and Resident Level Quality Measure Reports with New “MDS Hybrid Measure”

Starting January 2026, CMS updates the long-stay antipsychotic QM with a new MDS Hybrid Measure. Understand the changes, triggers, exclusions, and reporting impact.

Jan 22 min read

Strengthening Medication Compliance in Assisted Living

Medication compliance in assisted living impacts safety, quality, and survey outcomes. Discover Ohio regulations, compliance risks, and proven strategies for safer medication management.

Dec 15, 20252 min read

Building a Stronger QAPI Culture Across Your Community

A Practical Look at Quality Assurance and Performance Improvement for Today’s Leaders Quality improvement is not a project. It is a habit that shapes the daily experience of residents and the teams who care for them. Although QAPI has been a regulatory focus for years, the conversation has shifted. Surveyors are looking more closely at how communities use data, identify root causes, and sustain meaningful change. Leaders are expected to show not only that a problem was correc

Dec 3, 20253 min read

State Case-Mix Audits Are Intensifying

Stay ahead of changing requirements with defensible, compliant documentation.

Nov 21, 20251 min read

Zero Tolerance: Building a Culture That Prevents Resident Abuse and Neglect in Assisted Living

Resident Abuse Prevention Protecting residents from abuse and neglect isn’t just a compliance issue, it’s a moral imperative. Every assisted living community must foster a culture where safety, dignity, and accountability are non-negotiable. Unfortunately, recent investigations in Ohio have revealed troubling lapses in how some facilities respond to abuse allegations, manage staff conduct, and protect vulnerable residents. In one case, a cognitively impaired resident was se

Nov 5, 20252 min read

Elopement in Assisted Living: Lessons from Real Incidents and How to Prevent Them

Elopement prevention is not just about locking doors, it’s about creating a culture of vigilance, accountability, and individualized care.

Oct 30, 20252 min read

New MDS 3.0 RAI Manual 2025 (v1.20.1) Released - What SNFs Need to Know

The Centers for Medicare & Medicaid Services (CMS) has posted on Friday August 29, 2025, the Final MDS 3.0 Resident Assessment Instrument (RAI) User’s Manual version 1.20.1 , which will take effect on October 1, 2025. This update marks a significant shift in assessment items, Quality Measures, and overall coding requirements for Skilled Nursing Facilities. CMS has also published the final MDS 3.0 Item Sets v1.20.1v3 and their corresponding Item Matrix, also scheduled to go l

Sep 3, 20253 min read