Start with a Free Quality Assurance Audit for Critical Access Hospitals

AI-Driven Quality Assurance for CAHs that Medicare Pays For To Close Care Gaps

Most hospitals run Quality Improvement projects. Very few run continuous, reimbursable Quality Assurance. CARE-AI helps CAHs move from episodic QI to ongoing, Medicare-paid QA using AI-driven care reviews and experienced quality and project management experts, so you close care gaps, reduce HACs, HAIs, PSIs, LOS, readmissions, compliance exposure, and capture reimbursable revenue, resulting in $1-2.5M in annual benefits.

What You Get From Day One:

  • Cost Allocation

    Clarity for Medicare alignment

  • Reimbursable Expense

    Structured for CAH reimbursement

  • Low-Risk

    Start small and scale with proof

  • Cancel Anytime

    No long-term lock-in

  • No/Low Investment

    Minimal upfront cost

  • Free Audit

    Discover program gaps, compliance exposure, and missed reimbursement

  • QAPI Templates

    Ready-to-use policies, dashboards, and measures

  • Care Management

    Proactive gap recognition

  • Care Coordination:

    Escalation pathways

  • Orientation

    Fast onboarding for leaders and staff

  • Program Champions

    Dedicated QI support to sustain momentum

  • Accessible Experts

    On-demand quality and project management guidance

  • Flexible Integration

    Works as a standalone

  • Rapid Launch

    Go live in days, not months

  • ROI Calculator

    Quantify financial impact before you commit

  • QI Playbooks

    Step-by-step fixes for high-value gaps

  • Care Transitions:

    Optimize transfers & discharges

  • Cross Continuum:

    Closes post acute needs gaps

The Problem

Quality Improvement Alone Is Not Enough

Quality Improvement projects end.

Variation persists.

Risk quietly returns.

Critical Access Hospitals face increasing pressure from:

  • Conditions of Participation compliance requirements

  • MBQIP and CMS Stars performance expectations

  • Staffing shortages and burnout

  • Documentation gaps that reduce reimbursement

  • Rising adverse events, readmissions, and survey risk

Most hospitals know where issues exist. The challenge is closing care gaps reliably and sustainably. Quality Assurance is what makes performance repeatable. CARE-AI is built to do exactly that.

The Solution

A Full-Spectrum Quality Assurance Program, Enabled by AI

CARE-AI is "Clinical Assurance for Rural Excellence Artificial Intelligence" a full spectrum quality assurance program designed for hospitals.

CARE-AI combines:

Shorten Improvement Cycles with Performance Scorecards & Dashboards

Transition data monitoring to near real time performance, away from months old quality outcome data.

Near real-time gap detection and clinician guidance

Identify care gaps for clinicians to close near real time at the bedside to decrease HACs, HAIs, PSI, LOS, readmissions.

Experience quality & project management professionals

Get expert performance improvement project management professions to close complex care gaps.

Reimbursable AI, QA & PI. model aligned to CAH funding rules

AI-enabled quality assurance and performance improvement mapped to Medicare funding rules to maximize allowable reimbursement.

AI identifies the gaps.

Experts ensure they are actually closed.

How CARE-AI Works

Full spectrum AI-enabled quality assurance for CAHs designed to simplify quality management.

Detect

AI Clinical Care Reviews continuously analyze clinical and operational data to surface care gaps, risk patterns, and compliance issues.

Direct

Clinicians receive clear, actionable insights showing exactly where care needs to be adjusted, documented, or escalated.

Deliver

Experienced quality and project management experts guide complex change to closure, not just recommendations.

Measure

Transparent reporting aligns outcomes directly to Conditions of Participation, MBQIP, CMS Stars, and core measures.

Outcomes That Matter

Safer care, stronger compliance, and seven-figure savings, measured and repeatable.

Quality and Compliance

  • Stronger Conditions of Participation compliance

  • Improved MBQIP performance

  • Higher CMS Stars ratings

  • Better core-measure adherence

Financial Performance

  • Improved documentation and reimbursement accuracy

  • Average financial savings of $1,500 per patient

  • Average annual impact of $1.2M to $2.5M per hospital

Risk Reduction

  • Fewer HAIs, HACs, and PSIs

  • Shorter length of stay

  • Fewer readmissions and reencounters

  • Reduced legal and survey risk

Minimal Downside Risk

How CARE-AI

Is Paid For

CARE-AI is structured to align with

Critical Access Hospital reimbursement rules.

Hospitals receive:

  • A full QA operational playbook

  • Documentation templates

  • Policy Documents, including QAPI Guide

  • Coaching on internal record-keeping and cost allocation

Most hospitals can recover 55% to 75 % of CARE-AI costs through allowable reimbursement, often leaving little to no downside risk.

The AI, quality expertise, and project management support as needed.

AI Enables the Transition to True QA

More Than AI

AI alone does not fix quality problems.

CARE-AI uses AI to make Quality Assurance scalable, timely, and actionable, while experienced professionals ensure real-world execution. CARE-AI can integrate directly with your EHR or operate as a standalone SaaS platform.

Built for Critical

Access Hospitals

CARE-AI is designed around CAH realities:

Limited staff bandwidth

High regulatory pressure

Tight operating margins

Need for immediate, measurable results

Our quality team brings over 350 years of combined quality and project management

experience and can act on clinical, operational, or financial initiatives as needed.

Start With a Free Quality Assurance Audit

Before you invest in new technology or programs, understand where you actually stand.

Our free QA audit will:

  • Assess current hospital quality program

  • Identify opportunities to leverage AI

  • Identify opportunities to cover existing quality program costs

  • Calculate your hospitals ROI based operational numbers

  • Complete a readiness assessment

No obligation. No disruption to operations.

Frequently Asked Questions

What is the difference between QI and QA?

QI focuses on projects. QA ensures reliable, ongoing performance and compliance.

How quickly will we see results?

Many basic care gaps are identified and addressed near real time. Complex gaps are managed to closure with expert support.

What data is required?

CARE-AI integrates with EHR data or can operate as a standalone review platform.

How do clinicians interact with CARE-AI?

Clinicians receive targeted, actionable insights rather than alerts or dashboards.

Is this compliant and secure?

Yes. CARE-AI is designed for HIPAA compliance and healthcare data protection standards.

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