What must be reviewed if the error rate from a Discovery Sample exceeds 5%?

When the error rate from a Discovery Sample exceeds 5%, it is essential to conduct a Full Sample and a Systems Review. A Full Sample involves a comprehensive review of all relevant records to understand the scope of the error and to ensure that the issues identified in the Discovery Sample are not isolated incidents but are reflective of a broader problem. This extensive analysis is crucial for identifying patterns and determining root causes of errors.

Additionally, the Systems Review evaluates the processes and systems in place that may contribute to the errors. This step helps to assess if there are systemic issues or weaknesses that need to be addressed to improve compliance and accuracy moving forward. By reviewing both the Full Sample and the Systems, healthcare organizations can implement targeted corrective actions to enhance overall performance and reduce error rates in the future.

Other options, while they may involve relevant actions, do not directly address the procedural steps required to respond to an identified high error rate following a Discovery Sample. Conducting a report to the OIG, an internal audit, or a patient care quality review may be parts of a broader compliance strategy but are not specific, immediate steps taken when the error rate exceeds the determined threshold.