Facility Site Review Guidelines
CenCal Health conducts facility site reviews for new primary care providers as a requirement for participation in all CenCal Health programs. Corrective Action Plans are required for those providers who do not meet the minimum required score. Read below for details.
- California Department of Health Services Medi-Cal Managed Care Full Scope Site Review Survey.
- Medical Record Survey Tool.
- Physical Accessibility Review Survey.
- To assess whether a provider has Basic Access, Limited Access or Medical Equipment Access for persons with special needs. This information will be used in CenCal Health’s provider directory to indicate areas of accessibility at a provider office/site. There is no Corrective Action Plan required for this survey.
- A pre-contractual provider must score above 80% on the site review survey to be counted as a network provider.
- Providers who score below 80% will be re-surveyed and must pass the site review survey at 80% or higher.
- Providers that score 80—89% will be required to complete a Corrective Action Plan within specified timelines.
After the initial site review, the maximum time period before the next required site review is three years. Interim monitoring will occur within this time period to assess compliance to the critical elements of the site review or to follow up with findings from previous reviews. CenCal Health may review sites more frequently, or when determined necessary based on prior findings.
Please refer to the Facility Site Review Binder for forms to assist your office in preparing for site visits.