American Innovative American Innovative Healthcare Solutions Healthcare Solutions

ADVATAGES TO NURSING ADVATAGES TO NURSING HOMES AND PROVIDERSHOMES AND PROVIDERS

Psychiatric Care & Fall Psychiatric Care & Fall PreventionPreventionValue DrivenValue Driven

Regulatory Compliant Regulatory Compliant

Presentation OverviewPresentation Overview Who is American Who is American

Innovative Solutions? Innovative Solutions? 3-53-5

Targeted Targeted Populations. 6Populations. 6

Continuum of Care. 7Continuum of Care. 7 Advantages to Advantages to

Nursing Homes. 8Nursing Homes. 8 Advantages for Advantages for

Psychiatrists. 9Psychiatrists. 9

Professional Professional Disciplines. 10Disciplines. 10

Physician Functions. Physician Functions. 1111

Casework Functions. Casework Functions. 1212

Admission/Discharge Admission/Discharge Planning Functions. Planning Functions. 1313

Next Steps. 14Next Steps. 14 Contact Information. Contact Information.

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ValuesValues

CompassionCompassion ExcellenceExcellence PartnershipPartnership InnovationInnovation

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Principles of our Principles of our PhilosophyPhilosophy

Respect and dignity.Respect and dignity. Collaboration.Collaboration. Concern for the whole person.Concern for the whole person. Address clinical, business, corporate Address clinical, business, corporate

and social-ethical issues.and social-ethical issues. Social responsibility to help Social responsibility to help

underserved.underserved.

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Cost Effectiveness comes Cost Effectiveness comes from:from:

Innovative integration of billing and clinical Innovative integration of billing and clinical services. services.

Uses Medicare fee for service and Part B billing.Uses Medicare fee for service and Part B billing. Optimizing full time equivalent staff.Optimizing full time equivalent staff. Using Contractors to expand services minimize Using Contractors to expand services minimize

over head.over head. Removing obstacles to help patients.Removing obstacles to help patients. Matching skill levels of staff to case mix.Matching skill levels of staff to case mix. Rapid Innovation/anticipation of regulatory Rapid Innovation/anticipation of regulatory

changes.changes. Continuous Quality Improvement.Continuous Quality Improvement. Using Using ““ExpertsExperts”” for training. for training. Optimizes resources of talent Optimizes resources of talent

and time toward measurable training goals.and time toward measurable training goals.5

Targeted PopulationsTargeted PopulationsAdultsAdults

Inpatient Inpatient Readmissions Readmissions <30 days<30 days

Medicare FundedMedicare Funded Dual EligibleDual Eligible Behaviors beyond Behaviors beyond

Subpart SSubpart S Moderate-High Moderate-High

Fall RiskFall Risk

Severely Mentally Ill.Severely Mentally Ill. We serve Mentally ill We serve Mentally ill

patients living in patients living in extended care facilities.extended care facilities.

Mentally ill living in group Mentally ill living in group homes, shared homes, shared apartments.apartments.

Newly diagnosed.Newly diagnosed. Newly Diagnosed Newly Diagnosed

conditionsconditions Mental status changes.Mental status changes. General functioning General functioning

between 35-70 on the between 35-70 on the Global Assessment of Global Assessment of Functioning scale.Functioning scale.

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Developing a Continuum of Care

Advantages to Nursing Advantages to Nursing HomesHomes

Easily integrates with standard admission orders sets.Easily integrates with standard admission orders sets. We provide required patient treatment documentation.We provide required patient treatment documentation. We assess and/or treat qualifying psychiatric behaviors.We assess and/or treat qualifying psychiatric behaviors. We treat patients on site.We treat patients on site. Balance Testing provides data, MD interpretation & Balance Testing provides data, MD interpretation &

Recommendations.Recommendations. We provide assessments and treatment under Medicare We provide assessments and treatment under Medicare

standards.standards. Patient documentation may qualify patients for additional Patient documentation may qualify patients for additional

reimbursement under the Medicaid Minimum Data Set.reimbursement under the Medicaid Minimum Data Set. We use Illinois Clinically Licensed professionals.We use Illinois Clinically Licensed professionals.

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Advantages to Advantages to PsychiatristsPsychiatrists

Doctors focus on Doctors focus on excellent patient care.excellent patient care.

We monitor and manage We monitor and manage regulatory compliance regulatory compliance issues.issues.

We process and store We process and store patient charts.patient charts.

Assist in Audit Assist in Audit preparation.preparation.

We provide support from We provide support from Licensed Clinicians.Licensed Clinicians.

Able to incorporate some Able to incorporate some existing assistants.existing assistants.

Professional management of: Professional management of: Billing and revenue Billing and revenue

collection.collection. Provider registration with Provider registration with

Medicare and MedicaidMedicare and Medicaid Doctors receive income Doctors receive income

beforebefore providers pay claims. providers pay claims. Growing patient base of Growing patient base of

1000+1000+ Rapidly increasing Market Rapidly increasing Market

Share.Share. Monitor Anticipate Monitor Anticipate

Regulatory change.Regulatory change.

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LCPC

LCSW

Behavioral Health

Assistants

M.D.

Senior Leadership

Professional Disciplines

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Psychiatrists

AIHS Physician FunctionsAIHS Physician Functions

Complete Assessments Complete Assessments (Differential Diagnosis)(Differential Diagnosis)

Appropriate level of care Appropriate level of care determination with determination with medical necessity.medical necessity.

Authorize Treatment Authorize Treatment Plans.Plans.

Collaborate with primary Collaborate with primary care physicians.care physicians.

Interpret Balance Testing Interpret Balance Testing Data.Data.

Provide Incident to Provide Incident to supervision.supervision.

Provide individual therapy.Provide individual therapy.

Use critical thinking to:Use critical thinking to:

Compare treatment plan to Compare treatment plan to efficacy based practices.efficacy based practices.

Function in a collaborative Function in a collaborative and supportive role with:and supportive role with: Facility social service Facility social service

directors.directors. Clinically Licensed staff.Clinically Licensed staff. Behavioral Health Behavioral Health

Assistants.Assistants.

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Case Work - Five Basic Case Work - Five Basic FunctionsFunctions

1.1. Utilization managementUtilization managementa)a) Level of careLevel of careb)b) Clinical resource usageClinical resource usagec)c) External payer certificationsExternal payer certifications

2.2. Care CoordinationCare Coordination3.3. Admission/Discharge planningAdmission/Discharge planning4.4. Identification/management of other patient needsIdentification/management of other patient needs

a)a) EducationEducationb)b) PsychosocialPsychosocialc)c) SpiritualSpirituald)d) Medical, Infection, risk management, quality of care issuesMedical, Infection, risk management, quality of care issues

5.5. Outcomes measurementOutcomes measurementa)a) ClinicalClinicalb)b) SatisfactionSatisfactionc)c) FinancialFinancial

6.6. Communication!Communication!

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Admission/Discharge Planning Admission/Discharge Planning FunctionsFunctions

1.1. Ensure assessment Ensure assessment processprocess

High-level screen High-level screen and referrals, orand referrals, or

In-depth In-depth assessment for all assessment for all patients.patients.

2.2. Offer informed Offer informed choice/respect choice/respect patient rights.patient rights.

3. Communicate with 3. Communicate with facility nursing, social facility nursing, social service staff, family service staff, family members, power of members, power of attorney or guardian.attorney or guardian.

4. Coordinate with the 4. Coordinate with the facility to coordinate facility to coordinate relevant data to next relevant data to next level of care.level of care.

5. Close the circle 5. Close the circle between nursing home between nursing home and hospital.and hospital.

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Next StepsNext Steps

Completion of AIHS Management Completion of AIHS Management Services Agreement.Services Agreement.

Begin referring residents/patients.Begin referring residents/patients. Collaborate on timing for start up.Collaborate on timing for start up.

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Contact InformationContact Information

Robert J. SommerfeldRobert J. Sommerfeld, Business Development, Business DevelopmentCell Phone: 262-203-3480Cell Phone: 262-203-3480

sommerfed@aol.comsommerfed@aol.com

American Innovative Healthcare SolutionsAmerican Innovative Healthcare Solutions10 W. 35th Street, 11th Floor10 W. 35th Street, 11th Floor

Chicago, IL 60616Chicago, IL 60616

Main Number: 312-224-8075Main Number: 312-224-8075

Fax: 312-238-9782Fax: 312-238-9782

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