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Tools and guidelines for FSR and MRR

The Department of Healthcare Services (DHCS) has made updates to the Facility Site Review (FSR) and Medical Record Review (MRR) standards and criteria effective July 1, 2022. The tools and guidelines are used to assess provider offices for how well they meet regulatory requirements. DHCS has updated the new standards and criteria to align with current guidelines and restructured criteria groups to better help identify deficiencies.

DHCS has released a new All Plan Letter (APL) 20-006 to identify these updates. All PCP sites participating in the Medi-Cal Managed Care Program and the Medicare-Medicaid Plans are required to complete an initial FSR and subsequent periodic full scope reviews. Based on the review findings, PCP sites must complete Corrective Action Plans (CAPS) within DHCS CAP timelines for cited deficiencies.

Here are the FSR tools and guidelines:

Here are the MRR tools and guidelines:

SCFHP keeps an eye on when providers are approaching their next FSR and connects with providers individually to schedule a walkthrough. The walkthrough covers details of the FSR and how it may have changed from its prior iteration.