Company 1 10

Compliance Review Services, Inc.Compliance Review Services, Inc.

Consulting and Training Services for Home Health and Long-Term Care Consulting and Training Services for Home Health and Long-Term Care AgenciesAgencies

www.compliancereviewservices.com 1

Company Background

Kimberley Kelly, RN, BSN, LNCFounder, CEO, and Senior Consultant

• Established January 1997• Incorporated February 1998


11201 Steeple Park Drive (September 2005 )


Mission Statement

• The 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.


CEO CredentialsKimberley Kelly, RN, BSN, LNC • Bachelor of Science Degree in Nursing from Ohio State University• Licensed in Ohio, Texas, and Florida and multi-state impact licensure• Certified Legal Nurse Consultant 1999-2005• Legal Nurse Consultant 2005-present

– Advisor to and expert witness for law firms on nursing home abuse and neglect lawsuits

• Administrator in home health and Supervising Nurse• Director of Nurses in long-term care• Liver transplant and GI/GU medical floor nurse and per diem visit nurse

for home health for Cleveland Clinic Foundation• Licensed vocational instructor for CNA/HCA course, both clinical and

classroomwww.compliancereviewservices.com 5

Services Offered• We offer a wide range of products and services, and we’re

constantly expanding our list. If you don’t see the service you need, please let us know—we may be able to help. Our services are categorized as follows:– Training Center– Nurse Consulting (Home Health, Hospice, ICF/MR, ALF, and DME)

– Legal Nurse Consulting– HIPAA Compliance– Agency Startups– On Line classes for Home Health, Hospice, LNC, ALF, and DME


Services Offered (cont’d)

• Conferencing Center at the main office:– Continuing education training courses– Competency evaluations for venipuncture

and intravenous therapy– In-service education for clock and contact

hours (our schedule of events is posted on our website)


Services Offered (cont’d)• Nurse Consulting

– Policy and procedure development – Mock state surveys – Chart reviews – Quality assurance programs – Staff competency evaluations – JCAHO/CHAP/ACHC & HQAA preparation for DME (State of

Texas only accepts JCAHO or CHAP for Home Health & Hospice– Plans of correction – Staff in-services – Problem resolution – Business planning – Marketing plans



• Legal Nurse Consulting– Medical review– Mediation/deposition preparation– Trial preparation– Expert testimony– Expertise of consulting firm

• Nursing home • Hospital • ALF • Hospice • Home health



• HIPAA Compliance– Customized 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


Services Offered (cont’d)• Agency Startups

– State and federally mandated policies and procedures– All required forms.– Admit packet– Human resources packet– In-service education– PAC– Governing body– Annual evaluation– Continuing education– Complaint/incident/accident binders– Accreditation specific policies, procedures, forms and binders



• ALF Consulting Services– Policies and Procedures– Monthly 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


Services Offered (continued)

• DME Consulting Services• On site accreditation preparation• State, CMS, NPI, Accreditation

applications• On line classes inclusive of all areas

pertinent to DME companies from the ground up


Consultant Credentials• Registered Nurses or Licensed Vocational Nurses• Experience as Administrators, Director of Nurses, or

Quality Assurance Nurses• Minimum of four years in home health care field• Demonstrated proficiency with Home Health and

Hospice State surveys with JCAHO and CHAP. • Demonstrated proficiency with DME surveys with

JCAHO/CHAP/ACHC/ and HQAA accreditation process


How 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… it’s never ending. We understand the demands of the industry, and we’re committed to being your up-to-date resource.


How Do We Stay Current? (cont’d)

• Memberships and Positions– Member of TAHC since 1998– CEO is an invited member of the Rule Review Committee for the

2005-2007 regulations– CEO 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 year– CEO is a member of the Rule Review Stakeholder Committee 2005-

2007– CEO is independent contractor for DADS LTC Quality Review Project

2007– Membership with HARCH (Houston Area Residential Care Homes

Association) pending 1/09. www.compliancereviewservices.com 16


• Resources and Networking

– On multiple regulatory mailing lists (both State, Medicare, and Accrediting bodies) for regulation and policy updates

– Current in-house resources, such as coding books, nurse practice acts, and clinical skills manuals

– We 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 fields



• Ongoing Education– We hold regular staff training events to

ensure consistency and share informational updates

– We attend seminars sponsored by TAHC, DADS, and other authoritative sponsors


Can 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


Consultant vs. Employee• No payroll taxes (savings of 16% to your agency)• No worker’s compensation costs• No unemployment taxes• No employee benefits• Short-term investment for a big return—

COMPLIANCE!• Avoidance of State and Federal regulatory fines• Agency can put consultative education on its cost

reportwww.compliancereviewservices.com 20

Financial Considerations

• Our 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.


Cost of Consultant• The cost of the nurse consultant visits are $80.00-$100.00 per hour. It may be

adjusted based on the following criteria:– Size of the agency– Services to be provided– Distance traveled and mileage considerations– How many years the agency has been in business

• For out-of-town consulting or distances greater than 50 miles from the consulting firm’s 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.


Billing Procedures• Invoicing schedule – we produce weekly invoices to

go out to our clients• We 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, Fedex• We will work with large corporations on receiving

payments issued by a corporate entity.


Scheduling

• We offer scheduling on line at www.compliancereviewservices.com or

• You can call the office to schedule a consultant to visit with your company.


http://www.compliancereviewservices.com/

Medicare Initial Survey ProcessRequest

• Request initial application packet from State office

• Request CMS 855A to Palmetto

• Request CLIA application

• Complete pre-survey on-line through DADS

• Submit applications

• Obtain NPI #

Prepare

• Finalize policies and procedures

• Conduct PAC and Governing Body meetings to approve p/p and appoint Administrator, Alternate and Supervising Nurse and Alternate

Receive

• Receive initial license from State

Continued


Medicare Initial Survey Process, cont’d

Patient Care

• Admit and provide skilled services to 10 clients (7 active for survey)

Request

• Request in writing temporary OASIS user ID and password

• Conduct OASIS test submission

• Request initial survey in writing to JCAHO using their form when ready

Survey

• Apply for JCAHO/CHAP password and complete application for JCAHO/CHAP to conduct initial survey once State license is received from DADS

Continued


Medicare Initial Survey Process, cont’d

Patient Care• Do a new SOC

assessment on all patients at next visit once you have passed the survey

• Collect OASIS at all time points

Receive• HHA and

State Agency receive Medicare provider number from CMS

• Permanent OASIS user ID issued by State agency

Request

• Request MDCN account

Begin monthly

submissions to the State

Complete!


Our Staff• Kimberley Kelly, RN, BSN, LNC – CEO & Senior Consultant• Michael Bradshaw, RN – Assistant Senior Consultant• Janice M. Johnson-Umezulike, RN, BSN, MN, CNS, DNS – Education Coordinator• Marie Luque – General/Office Manager• Jayne Jessop - Referral Coordinator• Barbara Rodriguez -- Assistant to Referral Coordinator/Administrative Assistant • Nurse Consultants

– Kimberley Kelly, CEO and Senior Consultant– Michael Bradshaw RN-former DADS Surveyor and Assistant Senior Consultant– Paula Frate RN-Nurse Consultant– Denise Garcia RN-Nurse Consultant– Linda Henslee LVN, Certified OASIS Specialist, Nurse Consultant– Bette Lou Hurford RN, RNC, CRRN, LNC– Joyce May RN-former DADS Surveyor and ESRD Surveyor, Nurse Consultant– Christy Slaughter RN, BSHA, MSHP, LNC– Doris McCain-Walker, RN


Kimberley Kelly, RN, BSN, LNC CEO & Senior Consultant

Kimberley graduated from Ohio State University with a Bachelor of Science in Nursing in 1986. She has 20+ years of experience in the healthcare field, ranging from Administrator, to Director of Nurses, to home health agency owner. She has worked in multiple medical environments, taught at a vocational college, and developed and taught numerous educational offerings. Kimberley is a member of the Home Health Alliance Team, Texas Association for Health Care, and Better Business Bureau. She is a Texas Department of Human Services Consultant-Monitor and currently sits on the Texas Outcome Based Quality Management coalition team. Since receiving her Certified Legal Nurse Consultant certification in 1999 and maintained it through 2005, she is a consulting nurse expert and testifying nurse expert witness in both plaintiff and defense cases. In addition, Kimberley was inducted into the Business Who’s Who in March of 2004 for her accomplishments as a small business owner.


Michael Bradshaw, RNAssistant Senior Consultant

•Michael earned an Associate degree in Nursing in 1977 from Angelina College in Lufkin, Texas.•His nursing career began in a hospital setting including: Medical/Surgical Staff Nurse, Shift Supervisor, Assistant Charge Nurse, Intensive Care Staff Nurse, Intensive Care Manager; Home Health and Nursing Home which included Administrator, Supervising Nurse, QA Nurse, Assistant Director of Clinical Services, Home Health Aide Supervisor, and Field Nurse.•Michael worked as a HCSSA Nurse Surveyor for the Department of Aging & Disability Services in Houston, Texas for 5 years before joining the Compliance Review Services, Inc. team in 2005.


Janice M. Johnson-Umezulike, RN, BSN, MN, CNS, DNS – Education Coordinator

Janice received her Bachelor of Science in Nursing from McNeese State University in Lake Charles, Louisiana, in 1984. She received both her Masters in Nursing and Doctor of Nursing Science from Louisiana State University Medical Center in New Orleans, Louisiana in 1989 and 1997, respectively. Since 1990, she has been a member of Sigma Theta Tau, International Honor Society of Nursing. Janice is currently a professor and continuing education instructor at Lee College in Baytown, Texas, as well as an educational consultant for a home health and medical staff employment agency.


Marie Luque, Office/General Manager • Marie worked for many years in human resources for

the State of New York before marrying into the oil business and traveling the globe. She lived overseas for 15 years in Asia and South America, with two daughters, Joline and Jessica, born in Bolivia and Chile, respectively. After she returned to the U.S., Marie worked in real estate marketing for several years from her home office. She joined the Compliance Review Services, Inc. team in April 2004.

• As a frustrated English major, Marie has been writing for some time and has had a short story published. Her goal is to have one of her two novels in shape to submit for publication within her lifetime. Marie is also devoted to soccer and plays in two competitive leagues. Her other hobbies include golf, squash, tennis, and volleyball.


Jayne Jessop Referral Coordinator

• Jayne Jessop joined the Compliance Review Services, Inc. Administrative Team in July 2006. Ms. Jessop has over 15 years of sales and diversified administrative experience, and has wasted no time becoming an integral part of the Compliance Review Services, Inc. family. Ms. Jessop comes to us via England, and has put her experience both here and abroad to work in helping Compliance Review Services, Inc. acquire new business as well as give our existing clients, managers, and consultants the highest level of service and support.


Barbara RodriguezAssistant to Referral Coordinator

• Barbara joined the Compliance Review Services team in October of 2006. She comes to us with an impressive customer service background which includes extensive experience with computers and account maintenance. Barbara is also a veteran who served our country in the military for 12 years. Barbara assists the Referral Coordinator with new business projects, maintains the company databases, and heads up production of marketing material.


Paula Frate, RN Consultant•Paula began her nursing career in 1978 with an Associate Degree of Applied Science in Nursing from a small college in northern Ohio. She relocated to Houston, Texas in 1981 and comes to Compliance Review Services with a broad background in both business and healthcare.Her clinical experience spans the continuum of healthcare including intensive care, emergency room, rehabilitation, home health and hospice. In 2000 she became certified as a holistic nurse to better address the needs of dying patients and their families. Paula’s business experience began in 1984 as a consultant to insurance companies and large corporations implementing case management and health promotion programs. Over the past ten years she has worked with a large county hospital system to improve charge capture and revenue management for medical research and as an Education and Performance Improvement Coordinator with a large home health and hospice agency. She is an experienced home health and hospice software trainer and is currently pursuing certification as a business coach. www.compliancereviewservices.com 36

Denise Garcia, RN Consultant• Denise Garcia, RN earned her BS in Nursing from

Mercy College of Detroit, in Michigan and continued with an MS in Health Services Administration from St. Joseph's College in Standish, Maine. Denise has 20 years of experience ranging from Director of Operations for a multimillion dollar non-profit home health agency, to Administrator of two home health care operations, and including positions as Patient Care Administrator, Director of Clinical Services and Director of Nursing in the area of Hospice. We are proud to have Denise bring her expertise to our nurse consultant staff as of August 1, 2007.


Linda Henslee, Educational Consultant/TrainerField Consultant, COS

• Linda Henslee comes to Compliance Review Services, Inc. with many years of Home Health experience, as an Administrator, Alternate Administrator, QA Coordinator, and as a Nurse Consultant. Ms. Henslee attended nursing school and received her degree in Arkansas. In addition to her years of experience as a staff nurse, Ms. Henslee joined our consultant team in July 2006, and has proven uniquely qualified to give our clients the best possible consulting services. Linda is also a Certified Oasis Specialist.


Christy Slaughter, RN, BSHA, LNC, MSHP, Nurse Consultant

Christy began her career at Midland Memorial Hospital in 1979. She graduated from Odessa College in Odessa, Texas, with an Associate of Nursing degree in 1980 and worked in staff and charge nurse roles at the hospital until 1990. After that, she worked for a series of home health care companies in positions ranging from staff nurse to Patient Care Coordinator to Assistant Director of Professional Services. In 1997 and 1999, Christy earned her Bachelor and Master of Science degrees from Southwest Texas State University in San Marcos, Texas. She became certified as a Legal Nurse Consultant in 2002. Christy has been working for Compliance Review Services since 2000.


Joyce May, RN, BSNNurse Consultant

•Joyce began her nursing career in 1972 at the first NICU in the Dallas area. After helping to open the unit and serving as Assistant Head Nurse, Joyce moved to Big Spring, Texas, in 1974 and was Charge Nurse PACU/Staff Nurse OR in a hospital. From 1976 to 1984, Joyce wore multiple hats at an Andrews, Texas, hospital, and served as Charge Nurse/Assistant Director OR/PACU, Staff Nurse OR/PACU, and Director of Material Management Department. She developed the procedure manual for the department, was the quality assurance representative for OR/PACU, and was active on the Safety and Infection Control committee. After two other hospital staff nurse positions, Joyce became a Nursing Specialist for the Texas Department of Health/Department of State Health Services. From 1990 to 2004, she conducted initial and recertification surveys, evaluated healthcare agencies for compliance with Medicare Conditions of Participation and State License Rules, and provided educational and consultative assistance to all provider types. In 2005, Joyce joined the Compliance Review Services, Inc., team. •Joyce obtained her Associate in Applied Science from El Central College in Dallas, Texas, in 1972 and her Bachelor of Science in Nursing from Texas Tech University in Lubbock, Texas, in 1989. She received nine months of training in the Texas Department of Health Continuous Quality Improvement process in 2001 and her CLEAR Certification for Complaint Investigation in 2003.


Doris McCain-Walker, RN Consultant

•Doris graduated with an Associates Degree in Nursing from Lawson State Community College of Birmingham, Alabama in 1967. She began her career as an RN in Home Health and Pediatric Hematology-Oncology. She relocated to Houston in 2000. Though most of her experience has been in home health, she also has diverse hospital experience including Medical-Surgical, Telemetry Units and ER. Doris brings to Compliance Review Services and its clients invaluable experience as a Home Health field nurse, Home Health Director/Supervising Nurse and Alternate Administrator.


Why 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 .Campaign


Why Choose Our Consulting Firm over Our Competitors? cont’d5. 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 JCAHO 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 .Campaign


Why Choose Our Consulting Firm over Our Competitors? cont’d

And the number one reason is…

We Care about Our Clients and Are Dedicated to Their Success. Your Success Is

Our Success!We .Care .Campaign


Take a Step in the Right Direction

We’ve been helping home health and long-term care

agencies help themselves to stay in compliance since

1997. We’re looking forward to working with you.

—Kimberley Kelly, RN, BSN, LNC, and staffCompliance Review Services, Inc.


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