Team Up for Patient Safety: Why Program Integrity is the Ultimate Safety Net

By: Rolanda “Landi” Anderson, RN, CMRS – March 2026

At a Glance: In honor of Patient Safety Awareness Month, we explore how rigorous clinical reviews and 99% accuracy in program integrity protect more than just the bottom line—they protect our patients.

Patient safety is the core focus of our work at Constellation Quality Health (CQH). While many associate “safety” only with bedside care, our Program Integrity and Quality Monitoring teams provide a systematic oversight that ensures care is actually delivered correctly AND safely based on the needs of the person.

Identifying the “Invisible” Risks

Through our structured, comprehensive pre-payment reviews including but not limited to, Behavioral Health, PCS/IHC, CAP, DME, Ambulance, OPST, Physician Services, and Dental—we identify safety risks that are often invisible on the surface. Our analyses frequently reveal critical process vulnerabilities, such as:

• Overlapping Documentation: Aides documented in multiple locations simultaneously indicating billing for services not rendered.
• Missed Care Tasks: Essential services like transfers or medication assistance skipped or incorrectly logged, indicating billing for services not rendered.
• Compliance Gaps: Hiring of staff who do not meet state pre-employment criteria, which may put patients at risk of having these staff alone with them in their homes.

The Constellation Difference: 99% Accuracy

Identifying these gaps requires a seasoned clinical eye. By conducting rigorous pre-payment reviews, our team detects errors and safety issues in more real time than a post payment review conducted 3-4 years after the service has been billed and before they impact the patient. Our veteran reviewers, maintaining an industry-leading 99% accuracy rate on reviews, frequently uncover discrepancies—such as conflicting visits or failure to supervise paraprofessional staff—that detect unsafe or inconsistent care. Without this expert oversight, there is no reliable way to confirm that the person is receiving the right care from the right person at the right time.

Strengthening the Care Team

Our work aligns with the 2026 Patient Safety Awareness Month theme, “Team Up for Patient Safety.” By focusing on Fraud, Waste, and Abuse (FWA) and comprehensive pre-payment reviews, we foster the team-based collaboration essential to Quality Assurance and Performance Improvement (QAPI).

A Moment for Reflection

Patient Safety Awareness Month provides an opportunity for all care team members to reflect on their role in the safety chain:

• How has my work reviews helped improve patient safety today?
• Can I identify ways providers, patients, and families can be active members of the care team?
• What steps can I take to improve collaboration in care delivery?

These questions reinforce our shared responsibility. At Constellation Quality Health, our Program Integrity team contributes to this effort every day by identifying risks, supporting compliance, and educating providers.

Connect With Us

To learn more about our work and mission, we invite you to explore the Constellation Quality Health YouTube Channel. We are building out our video library with valuable insights, and we encourage you to check out our content as we continue to share resources on quality care.

References & Resources:

• Institute for Healthcare Improvement (IHI). Patient Safety Awareness Week 2026: Team Up for Patient Safety. Available at: ihi.org
• Center for Patient Safety (CPS). 2026 Patient Safety Awareness Week Toolkit and National Observance. Available at: centerforpatientsafety.org
• Centers for Medicare & Medicaid Services (CMS). Program Integrity and Compliance Guidelines for Home Health Services.
• American Hospital Association (AHA). Fostering a Culture of Safety and Quality.