The regulatory landscape for post-acute care has shifted—and the impact on QA and compliance teams is immediate. With HOPE assessment requirements now live and the OASIS-E expansion in effect as of July 1, teams must move quickly to adapt.
Documentation accuracy, audit defensibility, and operational alignment are no longer just goals—they're must-haves in 2026.
In a recent industry webinar, Paul McMullen, COO of Choice Health at Home, offered an inside look at how his agency is navigating the regulatory landscape—from modifying QA workflows to investing in tools that support scalable documentation.
This guide summarizes his advice into practical steps your team can take immediately to strengthen audit readiness, improve documentation defensibility, and protect revenue performance.
Audits are More Frequent and More Focused on Documentation Quality
Audit scrutiny is not just about clinical gaps anymore.
Payers and surveyors are drilling into visit-level documentation, timelines, and whether the full clinical story supports coverage, conditions of participation, and claim validation.
Going into 2026, organizations should expect:
- More audits tied to HOPE and OASIS-E data integrity
- Denials based on vague or conflicting documentation
- Revenue hold-ups linked to late or mismatched notes
“Audit risk is what got me going in earnest around all things HOPE.”Paul McMullen, Choice Health at Home
For the most current HOPE guidance and submission resources from Medicare, visit the CMS HOPE page.
Whether your team is responding to post-HOPE survey feedback or working to stabilize OASIS-E compliance, now is the time to tighten up documentation accuracy, consistency, and defensibility.
Adjust Workflows to Protect Revenue—Not Just Stay Compliant
Meeting regulatory requirements isn’t just about avoiding survey citations, it’s about protecting your revenue cycle. In today’s environment, incomplete, delayed, or inconsistent documentation can directly interfere with claims processing, slow down reimbursement, or trigger recoupments.
Agencies are responding by redesigning workflows to help QA teams catch issues earlier, before they escalate into denials or payment delays.
At Choice Health at Home, that meant rethinking how supervision and documentation support were deployed to safeguard both compliance and revenue integrity:
“We leaned into staffing changes to keep case managing disciplines available, especially for assessments and death visits. We didn’t scale back; we grew. And we had to think differently about how we supervise, audit, and maintain compliance without just adding help.”Paul McMullen, Choice Health at Home
Suggested workflow changes:
- Build QA checkpoints into visit workflows instead of relying on end-of-cycle reviews.
- Align your QA and compliance teams – make sure both are trained on HOPE and OASIS-E fields that impact audit defensibility and revenue timing.
- Document visit completion promptly and accurately, especially for complex disciplines and transitional care, which often drive revenue recognition triggers.
Scale Smart—Not Just Bigger
It’s tempting to solve compliance issues by throwing more people at the problem. But in today’s environment, the smarter move is to scale systems, not just headcount.
That starts with examining whether your current documentation practices are sustainable as audit demands grow.
“If documentation isn’t scalable, it becomes a bottleneck. We’re investing in strategies that help everyone work smarter—not harder.”Paul McMullen, Choice Health at Home
Tips for scalable QA:
- Use templates and standardized documentation wherever possible.
- Apply AI tools to help surface gaps early (but avoid tools that require excessive cleanup).
- Focus training on the most frequent denial or citation issues – don't boil the ocean.
Prepare Your Audit Playbook
When an audit hits, the speed and clarity of your response can make all the difference. Agencies should be creating internal playbooks to prepare for the most common audit types.
Your playbook should include:
- Documentation checklists per discipline and visit type
- Pre-assembled documentation packets for HOPE or OASIS-E cases
- Escalation pathways and audit response templates
- Roles and responsibilities across compliance, clinical, and QA teams
Proactive prep builds team confidence and reduces last-minute panic.
Use Technology That Supports Compliance—Not Fights It
Documentation tools should support your compliance goals, not slow them down. If your systems aren’t integrated, intuitive, or scalable across service lines, they’ll hold you back.
“The key is usability. If AI adds steps or creates more cleanup, it doesn’t work. We need tools that integrate cleanly and support adoption.”Paul McMullen, Choice Health at Home
Look for tools that:
- Work across hospice and home health
- Support real-time or near-time documentation
- Integrate directly with your EHR and QA workflows
- Provide insight into visit quality, completion, and note accuracy
Documentation is no longer just a clinical task, it’s a strategic risk management lever. QA and compliance teams must be empowered to guide the organization’s preparedness with tools and workflows that scale.
If you're navigating HOPE, OASIS-E, or growing audit volume, now’s the time to stress-test your documentation systems. Talk to your team to explore voice and AI-powered solutions that support defensible, scalable, and audit-ready documentation.
If you’re interested in learning more about how nVoq’s innovative AI-powered solutions can lighten the documentation load for your clinicians, our experts are ready to help.
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