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Compliance Review Services, Inc.Consulting and Training Services for Home Health and Long-Term Care AgenciesJuly 2012www.compliancereviewservices.com 11www.compliancereviewservices.comCompany BackgroundKimberley Kelly, RN, BSN, LNCFounder, CEO, and Senior ConsultantEstablished January 1997Incorporated February 1998September 2011 www.compliancereviewservices.com 22www.compliancereviewservices.com11201 Steeple Park Drive September 2011 www.compliancereviewservices.com 3

Mission StatementThe mission of Compliance Review Services, Inc. is to provide quality consulting services at an affordable rate and help home health agencies help themselves to stay in compliance with State, Federal, and all other regulatory agencies.September 2011 www.compliancereviewservices.com 44www.compliancereviewservices.comCEO CredentialsKimberley Kelly, RN, BSN, LNC Bachelor of Science Degree in Nursing from Ohio State UniversityLicensed in Ohio, Texas, and Florida and multi-state impact licensureCertified Legal Nurse Consultant 1999-2005Legal Nurse Consultant 2005-presentAdvisor to and expert witness for law firms on nursing home abuse and neglect lawsuitsAdministrator in home health and Supervising NurseDirector of Nurses in long-term careLiver transplant and GI/GU medical floor nurse and per diem visit nurse for home health for Cleveland Clinic FoundationLicensed vocational instructor for CNA/HCA course, both clinical and classroomSeptember 2011 www.compliancereviewservices.com 55www.compliancereviewservices.comCEO Credentials continuedKimberley Kelly, RN, BSN, LNCEnforcement monitor for Department of Aging and Disability Services 1999-current for Home Health, Hospice, PAS, ICF/ MR. External Rule Review Committee via DADS for Home Health and Hospice Former TAHC Committee member Clinical Practice Committee Nurse Quality Reviewer for NACES/DADS for long-term care facilities in Texas since 2006.Nurse Delegate Ambassador for Nursing Programs for U.S. Regional Faculty for American Heart AssociationCPR InstructorLead Nurse Planner for Educational Unit of companyDirector of Vocational Nursing school and Educational Unit

September 2011 www.compliancereviewservices.com 6Services OfferedWe offer a wide range of products and services, and were constantly expanding our list. If you dont see the service you need, please let us knowwe may be able to help. Our services are categorized as follows:Training Center Hepa fit testing, Live Classes, Competencies for nursesNurse Consulting (Home Health, Hospice, ICF/MR, ALF, and DME) Legal Nurse ConsultingHIPAA ComplianceAgency StartupsOn Line classes for Home Health, Hospice, LNC, ALF, and DMESeptember 2011 www.compliancereviewservices.com 77www.compliancereviewservices.comServices Offered (contd)Conferencing Center at the main office or local venues used:Continuing education training coursesCompetency evaluations for venipuncture and intravenous therapyIn-service education for clock and contact hours (our schedule of events is posted on our website)September 2011 www.compliancereviewservices.com 88www.compliancereviewservices.comServices Offered (contd)Nurse ConsultingPolicy and procedure development Mock state surveys Chart reviews Quality assurance programs Staff competency evaluations TJC/CHAP/ACHC & HQAA preparation for DME Note: (State of Texas only accepts TJC or CHAP for Home Health & HospicePlans of correction Staff in-services Problem resolution Business planning /Marketing plansCPR classes on line and in personSeptember 2011 www.compliancereviewservices.com 99www.compliancereviewservices.comServices Offered (contd)Legal Nurse ConsultingMedical reviewMediation/deposition preparationTrial preparationExpert testimonyExpertise of consulting firmNursing home Hospital ALF Hospice Home healthSeptember 2011 www.compliancereviewservices.com 1010www.compliancereviewservices.comServices Offered (contd)HIPAA ComplianceCustomized HIPAA policies and procedures Organization chart review and revision General and administrative policy review for HIPAA compliance Gap analysis to gauge overall HIPAA readiness HIPAA in-service Physical environment survey Required notices and forms September 2011 www.compliancereviewservices.com 1111www.compliancereviewservices.comServices Offered (contd)Agency StartupsState and federally mandated policies and proceduresAll required forms.Admit packetHuman resources packetIn-service educationPACGoverning bodyAnnual evaluationContinuing educationComplaint/incident/accident bindersAccreditation specific policies, procedures, forms and bindersSeptember 2011 www.compliancereviewservices.com 1212www.compliancereviewservices.comServices Offered (contd)ALF Consulting ServicesPolicies and ProceduresMonthly RN visits on-site for medication compliance On line classes for ALF Managers including: * Part I 8 hour class *Part II 16 hour class * Part III 12 hour class

September 2011 www.compliancereviewservices.com 1313www.compliancereviewservices.comServices Offered (continued)DME Consulting ServicesOn site accreditation preparationState, CMS, NPI, Accreditation applicationsOn line classes inclusive of all areas pertinent to DME companies from the ground upSeptember 2011 www.compliancereviewservices.com 14Consultant CredentialsRegistered Nurses or Licensed Vocational NursesExperience as Administrators, Director of Nurses, or Quality Assurance NursesMinimum of four years in home health care fieldDemonstrated proficiency with Home Health and Hospice State surveys with TJC and CHAP. Demonstrated proficiency with DME surveys with TJC/CHAP/ACHC/ and HQAA accreditation processSeptember 2011 www.compliancereviewservices.com 1515www.compliancereviewservices.comHow Do We Stay Current?The Home Health, Hospice, ALF, and DME fields are constantly changing: new regulations, updates to the regulations, updates to the updates its never ending. We understand the demands of the industry, and were committed to being your up-to-date resource.September 2011 www.compliancereviewservices.com 1616www.compliancereviewservices.comHow Do We Stay Current? (contd)Memberships and PositionsMember of TAHC since 1998CEO is an invited member of the Rule Review Committee for the 2005-2007 regulationsCEO is a State of Texas Consultant Enforcement Monitor and BNE Monitor since 1999 CEO was a member of the State OBQI Committee for over one yearCEO is a member of the Rule Review Stakeholder Committee 2005-2007CEO is independent contractor for DADS LTC Quality Review Project 2007Membership with HARCH (Houston Area Residential Care Homes Association) Compliance Review Services, Inc. is a Member of the following Chambers of Commerce:Cy-Fair HoustonHouston North WestGreater Tomball AreaTomball September 2011 www.compliancereviewservices.com 1717www.compliancereviewservices.comHow Do We Stay Current? (contd)Resources and NetworkingOn multiple regulatory mailing lists (both State, Medicare, and Accrediting bodies) for regulation and policy updatesCurrent in-house resources, such as coding books, nurse practice acts, and clinical skills manualsWe have a good rapport with the State and accrediting bodies and can call anytime to ask questions or get clarification on issues.We work closely with attorneys and CPAs who have expertise in home health and related health fieldsSeptember 2011 www.compliancereviewservices.com 1818www.compliancereviewservices.comHow Do We Stay Current? (contd)Ongoing EducationWe hold regular staff training events to ensure consistency and share informational updatesWe attend seminars sponsored by TAHC, DADS, and other authoritative sponsorsSeptember 2011 www.compliancereviewservices.com 1919www.compliancereviewservices.comAssociationsCompliance Review Services, Inc

TEXAS TEAM(Supports Nursing Shortage efforts)NATIONAL ASSOCIATION FOR PRACTICAL NURSE EDUCATION AND SERVICE, INC. (VNI)NATIONAL FEDERATION OF LICENSED PRACTICAL NURSING, INC. (VNI)TEXAS ASSOCIATION FOR HOME CARE VIA COMPLIANCE REVIEW SERVICES, INC.TEXAS NURSES ASSOCIATION (TNA)Kimberley Kelly RNCY-FAIR CHAMBER OF COMMERCE (CRS and VNI)TOMBALL CHAMBER OF COMMERCENORTHWEST HOUSTON CHAMBER OF COMMERCEHOUSTON ASSOCIATION OF RESIDENTIAL CARE HOMES (H.A.R.C.H)

September 2011 www.compliancereviewservices.com 20Can You Afford a Consultant?Can you afford not to have a nurse consultant?The cost of the consultant may be less than possible fines owed for noncompliance

September 2011 www.compliancereviewservices.com 2121www.compliancereviewservices.comConsultant vs. EmployeeNo payroll taxes (savings of 16% to your agency)No workers compensation costsNo unemployment taxesNo employee benefitsShort-term investment for a big returnCOMPLIANCE!Avoidance of State and Federal regulatory finesAgency can put consultative education on its cost reportSeptember 2011 www.compliancereviewservices.com 2222www.compliancereviewservices.comFinancial ConsiderationsOur goal is to try and work with our clients; however, like you, we are running a business, and we need to make sure that our financial side fulfills our CEO expectations.September 2011 www.compliancereviewservices.com 2323www.compliancereviewservices.comCost of ConsultantThe cost of the nurse consultant visits are $100.00-$120.00 per hour. It may be adjusted based on the following criteria:Size of the agencyServices to be providedDistance traveled and mileage considerationsHow many years the agency has been in businessFor out-of-town consulting or distances greater than 50 miles from the consulting firms office; the client is responsible for additional expenses (e.g., hotel accommodations and mileage). This is negotiated during contract signing. Our pricing is posted for the general public to see on our website under the pricing button. September 2011 www.compliancereviewservices.com 2424www.compliancereviewservices.comBilling ProceduresInvoicing schedule we produce weekly invoices to go out to our clientsWe receive payments the day of service for on-site consulting; our consultants will collect the payment We receive payments for plans of correction upon pick up from our office or via USPS, UPS, FedexWe will work with large corporations on receiving payments issued by a corporate entity. September 2011 www.compliancereviewservices.com 2525www.compliancereviewservices.comSchedulingWe offer scheduling on line at www.compliancereviewservices.com or You can call the office to schedule a consultant to visit with your company. September 2011 www.compliancereviewservices.com 26

September 2011 www.compliancereviewservices.com 2727www.compliancereviewservices.comMedicare Initial Survey ProcessRequest

Request initial application packet from State officeRequest CMS 855A to PalmettoRequest CLIA applicationComplete pre-survey on-line through DADSSubmit applicationsObtain NPI #Prepare

Finalize policies and proceduresConduct PAC and Governing Body meetings to approve p/p and appoint Administrator, Alternate and Supervising Nurse and Alternate

Receive

Receive initial license from StateContinued September 2011 www.compliancereviewservices.com 2828www.compliancereviewservices.comMedicare Initial Survey Process, contdPatient CareAdmit and provide skilled services to 10 clients (7 active for survey)RequestRequest in writing temporary OASIS user ID and passwordConduct OASIS test submissionRequest initial survey in writing to TJC using their form when readySurvey Apply for TJC/CHAP password and complete application for TJC/CHAP to conduct initial survey once State license is received from DADSContinued September 2011 www.compliancereviewservices.com 2929www.compliancereviewservices.comMedicare Initial Survey Process, contdPatient CareDo a new SOC assessment on all patients at next visit once you have passed the surveyCollect OASIS at all time pointsReceiveHHA and State Agency receive Medicare provider number from CMSPermanent OASIS user ID issued by State agencyRequestRequest MDCN accountBegin monthly submissions to the StateComplete!September 2011 www.compliancereviewservices.com 3030www.compliancereviewservices.comOur StaffKimberley Kelly, RN, BSN, LNC CEO & Senior ConsultantJanice M. Johnson-Umezulike, RN, BSN, MN, CNS, DNS Education CoordinatorJayne Jessop - Referral CoordinatorLeigh Duong- Administrative Assistant, Start Up ProductionsNurse ConsultantsKimberley Kelly, CEO and Senior ConsultantPaula Frate RN-Nurse ConsultantDenise Garcia RN-Nurse ConsultantConnie Almendarez RN- Nurse Consultant

September 2011 www.compliancereviewservices.com 3131www.compliancereviewservices.comWhy Choose Our Consulting Firm over Our Competitors?Our Top Ten List10.Customer service is our primary focus.9.We offer free phone and e-mail consultative support.8.We have over 10+ years of proven success with our clients.7.We have over 150 years of nursing experience within our staff.6.We have several former state surveyors and a DADS enforcement monitor on our staff.We .Care .CampaignSeptember 2011 www.compliancereviewservices.com 3232www.compliancereviewservices.comWhy Choose Our Consulting Firm over Our Competitors? contd5.We stay current with regulations and alert our clients to any changes. We are active with TAHC and BNE, are involved with DADS workgroups, and network with state regulators.4.We offer comprehensive start-up packages, manuals, forms, and other printed materials that are done professionally, accurately, and completed timely. We have done TJC successfully for years.3.We offer educational and training sessions with contact hours and are a TNA-approved educational provider unit.2.We provide a free newsletter to our clients several times a year.We .Care .CampaignSeptember 2011 www.compliancereviewservices.com 3333www.compliancereviewservices.comWhy Choose Our Consulting Firm over Our Competitors? contdAnd the number one reason isWe Care about Our Clients and Are Dedicated to Their Success. Your Success Is Our Success!We .Care .CampaignSeptember 2011 www.compliancereviewservices.com 3434www.compliancereviewservices.com

Take a Step in the Right DirectionWeve been helping home health and long-term care agencies help themselves to stay in compliance since 1997. Were looking forward to working with you.Kimberley Kelly, RN, BSN, LNC, and staffCompliance Review Services, Inc.September 2011 www.compliancereviewservices.com 3535www.compliancereviewservices.comNameTitle

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Company NameCompany NameDepartment NameDepartment of Aging and Disability Services Licensing Agency

Hospice

Federal regulationsState regulationsMedicaid rulesPrivate insurance guidelines

MedicareMedicaidPrivate payPrivate insurance

Skilled and nonskilled services provided: SN, volunteer, MSW, CNA, pastor, bereavement, equipment, meds

Supervision of staff per policiesPlans of care done q 2 weeksMedicare eligible 90-90-60-60-60

Licensed and Certified Home Health (LCHH)

Federal regulationsState regulationsMedicaid rulesPrivate insurance guidelines

LCHH can do PHC

MedicareMedicaidPrivate payPrivate insurance

Palmetto states supervision of aides q 2weeks by RNSupervision of RN, LVN per policiesPlans of care done q 60 days

Skilled and nonskilled services provided: SN, PT, OT, SLP, MSW, CNA, psych, pediatric, private

Licensed Home Health (LHH)

LHH can do PHC

No Medicare involvementNo Medicaid involvementPrivate payPrivate insurance

Skilled and nonskilled services provided: SN, PT, OT, SLP, MSW, CNA, psych, pediatric

State regulationsPrivate insurance guidelines

Supervision of staff per policiesPlans of care done q 6 months

Personal Assistance Services (PAS) License

Federal regulationsState regulationsMedicaid rules if PHCPrivate insurance guidelines

No Medicare involvementMedicaidPrivate payPrivate insurance

Only nonskilled services provided: providers, companions, sitters, attendants

PAS license (no other license required) can do PHC

Supervision per policies (not required by RN) usually q 60 daysIf patient on respite, q 14 days