Incomplete Records Exercises by hwh67049

VIEWS: 0 PAGES: 41

More Info
									          THE STATE OF TENNESSEE

DEPARTMENT OF FINANCE AND ADMINISTRATION

            BUREAU OF TENNCARE

                    AND

DIVISION OF INTELLECTUAL DISABLITIES SERVICES




   DATA MANAGEMENT REPORT

              October 22, 2010
                               TABLE OF CONTENTS

                   QUALITY MANAGEMENT DATA REPORT

                                   October 22, 2010


                                                      Page

A. Demographics for HCBS Waiver Recipients               1
B. Transitions, Enrollment and Conversions               3
C. Waiting List Demographics                             6
D. Protection From Harm                                  9
     Complaints                                          9
     Incidents                                          13
     Investigations                                     15
E. Provider Qualifications/Monitoring                   17
     Day-Residential Providers                           1
     Personal Assistance                                22
     ISC Providers                                      24
     Behavioral Providers                               26
     Nursing Providers                                  28
     Therapy Providers                                  30
     Personal Funds                                     33
F. Due Process/Freedom Of Choice                        35
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




A    Demographics for HCBS Waiver Recipients

Data Source:
The census represents the number of waiver participants throughout the reporting month. The number of remaining slots for the Statewide HCBS, ADC, and SD Waivers is based on the unduplicated slots used this
waiver year. The number of waiver slots are determined by calendar year. The census data is not related to number of slots left in the waiver calendar year. The source of this data is CS Tracking.


DIDS Demographics Main Waiver (CS Tracking)                    Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
   5 East                                                       2344         2349          2353           0           0             0            0           0            0            0          0          0
   6 Middle                                                     2350         2358          2366           0           0             0            0           0            0            0          0          0
   7 West                                                       1398         1410          1413           0           0             0            0           0            0            0          0          0
   8 Statewide                                                  6092         6117          6132           0           0             0            0           0            0            0          0          0
                      CALENDAR YEAR FORMULAS                   Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
   9                 Approved Slots per calendar year           6300         6300          6300       6300         6300          6300         6390        6390        6390         6390        6390       6390
  10         Used unduplicated slots (Jan-current mo.)          6196         6232          6256           0           0             0            0           0            0            0          0          0
  11             # of slots remaining for calendar year          104           68            44       6300         6300          6300         6390        6390        6390         6390        6390       6390


DIDS Demographics Arlington Waiver (CS Tracking)               Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
  12 East                                                           4           4             4           0           0             0            0           0            0            0          0          0
  13 Middle                                                         1           1             1           0           0             0            0           0            0            0          0          0
  14 West                                                        319          318           319           0           0             0            0           0            0            0          0          0
  15 Statewide                                                   324          323           324           0           0             0            0           0            0            0          0          0
                      CALENDAR YEAR FORMULAS                   Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
  16                 Approved Slots per calendar year            344          344           344        344          344           344          344         344         344          344         344        344
  17         Used unduplicated slots (Jan-current mo.)           327          327           327           0           0             0            0           0            0            0          0          0
  18             # of slots remaining for calendar year            17          17            17        344          344           344          344         344         344          344         344        344


DIDS Demographics SD Waiver (CS Tracking)                      Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
  19 East                                                        410          410           414           0           0             0            0           0            0            0          0          0
  20 Middle                                                      440          439           441           0           0             0            0           0            0            0          0          0
  21 West                                                        328          329           328           0           0             0            0           0            0            0          0          0
  22 Statewide                                                  1178         1178          1183           0           0             0            0           0            0            0          0          0
                      CALENDAR YEAR FORMULAS                   Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
  23                 Approved Slots per calendar year           2250         2250          2250       2250         2250          2250         2600        2600        2600         2600        2600       2600
  24         Used unduplicated slots (Jan-current mo.)          1218         1222          1229           0           0             0            0           0            0            0          0          0
  25             # of slots remaining for calendar year         1032         1028          1021       2250         2250          2250         2600        2600        2600         2600        2600       2600


DIDS Demographics State Funded (CS Tracking)                   Jul-10      Aug-10        Sep-10      Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11
  26 East                                                          52          49            51           0           0             0            0           0            0            0          0          0
  27 Middle                                                        22          22            25           0           0             0            0           0            0            0          0          0
  28 West                                                          37          36            37           0           0             0            0           0            0            0          0          0
  29 Statewide                                                   111          107           113           0           0             0            0           0            0            0          0          0




                                                                                                                 3
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




Developmental Center Census                                    Jul-10     Aug-10        Sep-10       Oct-10     Nov-10         Dec-10      Jan-11     Feb-11       Mar-11       Apr-11     May-11     Jun-11
 30 GVDC                                                         243         243           243            0          0              0           0          0            0            0          0          0
 31 CBDC                                                           88         78            76            0          0              0           0          0            0            0          0          0
 32 HJC                                                             9          8             8            0          0              0           0          0            0            0          0          0
 33 ADC                                                            30         26            14            0          0              0           0          0            0            0          0          0
 34 Total                                                        370         355           341            0          0              0           0          0            0            0          0          0

DIDS ICFMR Community Homes Census                              Jul-10     Aug-10        Sep-10       Oct-10     Nov-10         Dec-10      Jan-11     Feb-11       Mar-11       Apr-11     May-11     Jun-11
  35                                             East
  36                                           Middle
  37                                            West              23           24           33           0            0             0           0           0            0           0           0            0
  38                                           TOTAL              23           24           33           0            0             0           0           0            0           0           0            0



                                                          DIDS Census September 2010 Total Served: 8126
                                                                                                    State
                                                                  Statewide Arlington               Funded     Development DID ICF
                                                                  Waiver
                                                        Developmental Centers,Waiver
                                                                              341         SD Waiver Srvs       al Centers   Homes
                                                                         6132         324      1183        113          341        33                   8126
                                                                                                 DID ICF Homes, 33
                                                         State Funded Srvs, 113



                                                  SD Waiver, 1183




                                     Arlington Waiver, 324
                                                                                                                               Statewide Waiver, 6132




Analysis:
The Division supports 8126 people: 33 reside in the West Community Homes, 341 in Developmental Centers, with 243 at GVDC, 76 at CBDC, 8 at HJC and 14 at ADC, 113 are in state funded services, 1183 are in
the SD Waiver, 324 are in the Arlington Waiver and 6132 are in the Statewide Waiver.




                                                                                                                4
                                                                                                         Data Management Report
                                                                                                             October 22, 2010




B.       Waiver Enrollments

Data Source:
The figures represented in this section are pulled directly from the Community Services Tracking system and the Internal Wait List data report. Enrollment figures may be updated monthly as there is a 2 month
window of time in which enrollments are entered into the CST system. Disenrollment data is also based on queries pulled from CST and may also have a window of adjustment for data entry.


         Total Waiver Enrollments
                                                                 Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11 FYTD
     1                                    Arlington Waiver            0           0             1            0            0             0            0           0             0            0          0           0        1
     2                                          SD Waiver            12           3             7            1            0             0            0           0             0            0          0           0       23
     3                                  HCBS Main Waiver             30          32            30            7            0             0            0           0             0            0          0           0       99
     4                                               Total           42          35            38            8            0             0            0           0             0            0          0           0      123

         Arlington Waiver Enrollments                            Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11   FYTD
     5                                    Arlington At Risk           0           0             0                                                                                                                             0
     6                                 Arlington Transition           0           0             1                                                                                                                             1
     7                              Arlington Waiver Total            0           0             1             0            0             0            0           0             0            0           0        0           1

         SD Waiver Enrollments
         WL- Intake Commitee                                     Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
   8                                                  East            0           2             3                                                                                                                          5
   9                                                Middle            0           0             3            1                                                                                                             4
  10                                                West              0           0             1                                                                                                                          1
  11                                                 Total            0           2             7            1             0             0            0           0             0            0          0         0       10

         Conversions                                             Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  12                                                  East            0           0             0                                                                                                                          0
  13                                                Middle           12           0             0                                                                                                                         12
  14                                                West              0           0             0                                                                                                                          0
  15                                                 Total           12           0             0            0             0             0            0           0             0            0          0         0       12

     At Risk                                                     Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  16 At Risk Group Enrollments into SD                                0           1             0                                                                                                                          1

  17                                   Total by Region           Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  18                                               East               0           2             3            0            0             0            0           0             0            0          0           0       5
  19                                             Middle              12           0             3            1            0             0            0           0             0            0          0           0      16
  20                                              West                0           1             1            0            0             0            0           0             0            0          0           0       2
  21                             Grand Total SD Waiver               12           3             7            1            0             0            0           0             0            0          0           0      23

         HCBS Statewide Waiver Enrollments
         WL- Intake Commitee                                     Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  22                                                  East            6           3             6            1                                                                                                            16
  23                                                Middle            1           8             7            1                                                                                                            17
  24                                                West              2           1             2            1                                                                                                             6
  25                                                 Total            9          12            15            3             0             0            0           0             0            0          0         0       39

         Conversions                                             Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  26                                                  East            1           0             0                                                                                                                          1
  27                                                Middle            0           0             0                                                                                                                          0
  28                                                West              2           2             0                                                                                                                          4
  29                                                 Total            3           2             0            0             0             0            0           0             0            0          0         0        5

         Transfers from SD to HCBS                               Jul-10      Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11    FYTD
  30                                                  East            0           0             0                                                                                                                          0
  31                                                Middle            1           1             2                                                                                                                          4
  32                                                West              0           1             2                                                                                                                          3
  33                                                 Total            1           2             4            0             0             0            0           0             0            0          0         0        7




                                                                                                                    5
                                                                                          Data Management Report
                                                                                              October 22, 2010




         DCS Placements                                       Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11    FYTD
 34                                                   East         1        0        1                                                                                                2
 35                                                 Middle         3        1        1                                                                                                5
 36                                                 West           0        1        0        1                                                                                       2
 37                                                  Total         4        2        2        1           0             0       0        0        0        0         0       0        9

         PASSR/ Nursing Homes                                 Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11   FYTD
 38                                                   East         1        1        0                                                                                                   2
 39                                                 Middle         0        2        2                                                                                                   4
 40                                                 West           0        0        0                                                                                                   0
 41                                                  Total         1        3        2        0           0             0       0        0        0        0         0       0           6

         DC Completed Transitions into the Waiver             Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11    FYTD
 42                                              GVDC              1        0        0                                                                                                1
 43                                              CBDC              6        3        3                                                                                               12
 44                                                HJC             2        0        0                                                                                                2
 45                                               Total            9        3        3        0           0             0       0        0        0        0         0       0       15

         At Risk Class Enrollments                            Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11    FYTD
 46                                                   East         0        0        0                                                                                                0
 47                                                 Middle         0        0        0                                                                                                0
 48                                                  West          3        8        4        3                                                                                      18
 49                                                  Total         3        8        4        3           0             0       0        0        0        0         0       0       18


                                       Total by Region        Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11    FYTD
 50                                                East           10        4        7        1                                                                                      22
 51                                              Middle           13       15       15        1                                                                                      44
 52                                               West             7       13        8        5                                                                                      33
 53                       Grand Total Statewide Waiver            30       32       30        7           0            0        0        0        0        0        0        0       99

C.       Disenrollments and Transitions
         Arlington Waiver                                     Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11 FYTD
     1                                               Death         0        0        0        0          0              0        0        0        0        0        0        0          0
     2                Voluntary Request by person/family           0        0        0        0          0              0        0        0        0        0        0        0          0
     3                     Services no longer appropriate          0        0        0        0          0              0        0        0        0        0        0        0          0
     4                                               Moved         0        0        0        0          0              0        0        0        0        0        0        0          0
     5                                          Involuntary        0        0        0        0          0              0        0        0        0        0        0        0          0
     6               Transition to another waiver program          0        0        0        0          0              0        0        0        0        0        0        0          0
     7                           Transitioned to an ICFMR          0        0        0        0          0              0        0        0        0        0        0        0          0
     8                                    Total Disenrolled        0        0        0        0          0              0        0        0        0        0        0        0          0

         SD Waiver                                            Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11 FYTD
  9                                                  Death         0        1        0        0          0              0        0        0        0        0        0        0          1
 10                   Voluntary Request by person/family           1        0        0        0          0              0        0        0        0        0        0        0          1
 11                        Services no longer appropriate          1        0        0        0          0              0        0        0        0        0        0        0          1
 12                                                  Moved         0        0        0        0          0              0        0        0        0        0        0        0          0
 13                                             Involuntary        0        0        0        0          0              0        0        0        0        0        0        0          0
 14                  Transition to another waiver program          1        2        2        0          0              0        0        0        0        0        0        0          5
 15                              Transitioned to an ICFMR          0        0        0        0          0              0        0        0        0        0        0        0          0
 16                                       Total Disenrolled        3        3        2        0          0              0        0        0        0        0        0        0          8

         HCBS Main Waiver                                     Jul-10   Aug-10   Sep-10   Oct-10     Nov-10         Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11 FYTD
 17                                                  Death         9        5        6        0          0              0        0        0        0        0        0        0      20
 18                   Voluntary Request by person/family           2        3        1        0          0              0        0        0        0        0        0        0       6
 19                        Services no longer appropriate          1        0        1        0          0              0        0        0        0        0        0        0       2
 20                                                  Moved         0        0        0        0          0              0        0        0        0        0        0        0       0
 21                                             Involuntary        0        0        0        0          0              0        0        0        0        0        0        0       0
 22                  Transition to another waiver program          0        0        0        0          0              0        0        0        0        0        0        0       0
 23                              Transitioned to an ICFMR          0        0        1        0          0              0        0        0        0        0        0        0       1
 24                                       Total Disenrolled       12        8        9        0          0              0        0        0        0        0        0        0      29

 25                        Total Waiver Disenrollments:          15       11       11        0            0            0        0        0        0        0        0        0         37




                                                                                                    6
                                                                                                       Data Management Report
                                                                                                           October 22, 2010




       Developmental Center Transitions
       Greene Valley                                            Jul-10     Aug-10        Sep-10       Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11 FYTD
  26                                             Census           243         243           243
  27                                          Admissions                                      0                                                                                                                         0
                         Discharges
  28                                                Death                                      0                                                                                                                        0
  29                    Transition to another dev center                                       0                                                                                                                        0
  30                   Transition to community state ICF                                       0                                                                                                                        0
  31                             Transition to private ICF                                     0                                                                                                                        0
  32                       Transition to waiver program                                        0                                                                                                                        0
  33                       Transition to non DIDS srvs*                                        0                                                                                                                        0
  34                                   Total Discharges                                        0           0            0             0           0           0             0           0           0             0     0

       Clover Bottom                                            Jul-10     Aug-10        Sep-10       Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11 FYTD
  35                                             Census             88         78            76
  36                                          Admissions                                      0                                                                                                                         0
  37                     Discharges
  38                                                Death                                      0                                                                                                                        0
  39                    Transition to another dev center                                       0                                                                                                                        0
  40                   Transition to community state ICF                                       0                                                                                                                        0
  41                             Transition to private ICF                                     2                                                                                                                        2
  42                       Transition to waiver program                                        3                                                                                                                        3
  43                       Transition to non DIDS srvs*                                        0                                                                                                                        0
  44                                   Total Discharges                                        5           0            0             0           0           0             0           0           0             0     5

       Harold Jordan Center                                     Jul-10     Aug-10        Sep-10       Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11 FYTD
  45                                             Census              9          8             8
  46                                          Admissions                                      0                                                                                                                         0
                         Discharges
  47                                                Death                                      0                                                                                                                        0
  48                    Transition to another dev center                                       0                                                                                                                        0
  49                   Transition to community state ICF                                       0                                                                                                                        0
  50                             Transition to private ICF                                     0                                                                                                                        0
  51                       Transition to waiver program                                        0                                                                                                                        0
  52                       Transition to non DIDS srvs*                                        0                                                                                                                        0
  53                                   Total Discharges                                        0                                                                                                                        0

       Arlington Dev Center                                     Jul-10     Aug-10        Sep-10       Oct-10      Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11 FYTD
  54                                             Census             30         26            14
  55                                          Admissions                                      0                                                                                                                         0
  56                     Discharges
  57                                                Death                                      0                                                                                                                        0
  58                    Transition to another dev center                                       0                                                                                                                        0
  59                   Transition to community state ICF                                       7                                                                                                                        7
  60                             Transition to private ICF                                     3                                                                                                                        3
  61                    Transition to Arl waiver program                                       1                                                                                                                        1
  62                       Transition to non DIDS srvs*                                        0                                                                                                                        0
  63                                   Total Discharges                                       11                                                                                                                       11

Analysis:
In September 2010 there were 38 waiver enrollments. 1 person enrolled into the Arlington waiver from ADC, 7 people enrolled into the SD Waiver and 30 people enrolled into the Statewide Waiver. There were 11
disenrollments from the waiver programs- 2 people transferred out of the SD waiver and into the Statewide Waiver, and 9 people disenrolled from the Statewide Waiver. Clover Bottom had 5 discharges, 3 people
went into the Statewide Waiver and 2 people went into a private ICFMR facility. Arlington had 11 discharges: 7 people went into a state run community ICFMR home, 3 people went into a private ICFMR home and 1
person enrolled into the Arlingon Waiver. HJC awnd GVDC did not have any discharges.




                                                                                                                 7
                                                                                                         Data Management Report
                                                                                                             October 22, 2010




D.       Waiting List Demographics

Data Source:
The Central Office Compliance Unit maintains the wait list data below. The wait list is a web based data system in which Regional Intake Units update as needed. The reported data is compiled on a monthly basis.


         East                                                    Jul-10      Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11
     1   # of Crisis cases                                           34          33            25            0           0              0            0           0             0            0          0           0
     2   # of Urgent cases                                          366         367           367            0           0              0            0           0             0            0          0           0
     3   # of Active cases                                        1,422       1,421         1,425            0           0              0            0           0             0            0          0           0
     4   # of Deferred cases                                        502         513           517            0           0              0            0           0             0            0          0           0
     5                                    Wait List Total         2,324       2,334         2,334            0           0              0            0           0             0            0          0           0

         Middle                                                  Jul-10      Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11
   6     # of Crisis cases                                           28          30            33            0           0              0            0           0             0            0          0           0
   7     # of Urgent cases                                          297         298           297            0           0              0            0           0             0            0          0           0
   8     # of Active cases                                        1,352       1,356         1,357            0           0              0            0           0             0            0          0           0
   9     # of Deferred cases                                        332         332           334            0           0              0            0           0             0            0          0           0
  10                                      Wait List Total         2,009       2,016         2,021            0           0              0            0           0             0            0          0           0

         West                                                    Jul-10      Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11
  11     # of Crisis cases                                           31          36            35            0           0              0            0           0             0            0          0           0
  12     # of Urgent cases                                           86          90            91            0           0              0            0           0             0            0          0           0
  13     # of Active cases                                        1,695       1,679         1,684            0           0              0            0           0             0            0          0           0
  14     # of Deferred cases                                        294         318           335            0           0              0            0           0             0            0          0           0
  15                                      Wait List Total         2,106       2,123         2,145            0           0              0            0           0             0            0          0           0

         Statewide                                               Jul-10      Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11
  16     # of Crisis cases                                           93          99            93            0           0              0            0           0             0            0          0           0
  17     # of Urgent cases                                          749         755           755            0           0              0            0           0             0            0          0           0
  18     # of Active cases                                        4,469       4,456         4,466            0           0              0            0           0             0            0          0           0
  19     # of Deferred cases                                      1,128       1,163         1,186            0           0              0            0           0             0            0          0           0
  20                                      Wait List Total         6,439       6,473         6,500            0           0              0            0           0             0            0          0           0

  21                           Net Effect from Last Month            23           34            27      #REF!           #REF!       #REF!       #REF!        #REF!        #REF!        #REF!       #REF!      #REF!
                                                                                                                                                                                                                     Fiscal
         Additions                                               Jul-10      Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11      Feb-11        Mar-11       Apr-11     May-11      Jun-11 YTD
  22                              # of Crisis cases added            10          12             7            0           0              0            0           0             0            0          0           0         22
  23                             # of Urgent cases added              8          15             9            0           0              0            0           0             0            0          0           0         23
  24                              # of Active cases added            23          24            20            0           0              0            0           0             0            0          0           0         47
  25                          # of Deferred cases added              22          24            27            0           0              0            0           0             0            0          0           0         46
  26                      Total # Added to the Wait List             63          75            63            0           0              0            0           0             0            0          0           0        138




                                                                                                                    8
                                                                                         Data Management Report
                                                                                             October 22, 2010




                                                                                                                                                                                        Fiscal
     Removals                                           Jul-10   Aug-10     Sep-10      Oct-10     Nov-10         Dec-10   Jan-11   Feb-11        Mar-11      Apr-11   May-11    Jun-11 YTD
27                  For enrollment into SD Waiver            1        4          4           0          0              0        0        0             0           0        0         0          5
28               For enrollment into HCBS Waiver            19       12         19           0          0              0        0        0             0           0        0         0         31
29            For enrollment into Arlington Waiver           0        1          0           0          0              0        0        0             0           0        0         0          1
30               Receiving Other Funded Services             0        3          1           0          0              0        0        0             0           0        0         0          3
31                                        Voluntarily        1        5          3           0          0              0        0        0             0           0        0         0          6
32                                     Due to Death          2        0          3           0          0              0        0        0             0           0        0         0          2
33                         Not Eligible for Services         2        2          0           0          0              0        0        0             0           0        0         0          4
34                            Moved Out of Region            5        9          4           0          0              0        0        0             0           0        0         0         14
35                              Moved Out of State           8        2          2           0          0              0        0        0             0           0        0         0         10
36                                 Duplicate Name            0        1          0           0          0              0        0        0             0           0        0         0          1
37                                  Other Reasons           13       19         13           0          0              0        0        0             0           0        0         0         32
38 Total Number Removed this Month                          51       58         49           0          0              0        0        0             0           0        0         0        109

     Wait List by Region                                Jul-10   Aug-10     Sep-10      Oct-10     Nov-10         Dec-10   Jan-11   Feb-11        Mar-11      Apr-11   May-11    Jun-11
39                                              East    2,324     2,334      2,334
40                                            Middle    2,009     2,016      2,021
41                                              West    2,106     2,123      2,145
42                                         Statewide    6,439     6,473      6,500


                                         Wait List by Region                                                                  Wait List by Category of Need
                                                                                                                                             # of Crisis cases ,
              West, 2,145, 33%                                                                                                                     93, 1%
                                                                                                                                                                       # of Urgent cases
                                                                                                          # of Deferred                                                    , 755, 12%
                                                                                                          cases , 1,186,
                                                                          East, 2,334, 36%                     18%




                                                                                                                                                                                 # of Active cases ,
                                                                                                                                                                                    4,466, 69%



         Middle, 2,021,
             31%




                                                                                                   9
                                                                                                          Data Management Report
                                                                                                              October 22, 2010




E.        Waiting List Populations

                                                                     Jul-10   Aug-10        Sep-10       Oct-10      Nov-10         Dec-10       Jan-11         Feb-11        Mar-11       Apr-11      May-11   Jun-11
     43   School aged children (0-21, excluding DCS)                  2719      2718          2713
     44   DCS children (0-21)                                            92       92            88
     45   Nursing Home Residents                                         35       35            34
     46   Regional Mental Health Centers                                 22       22            22
     47   DIDS State Funded Services                                     23        0             0
     48   Adults with no Service                                      3548      3606          3643
     49                                                               6439      6473          6500            0            0              0            0              0             0            0          0        0


           Wait List Demographic Groups

                                                                                                                                                School aged children (0-21, excluding
                                      Adults with no Service, 3643, 56%                                                                                   DCS), 2713, 42%




                                                                                                                                                     Nursing Home Residents, 34, 1%

                                                                                                                                                  DIDS State Funded Services, 0, 0%


                                                                                                                                                              Regional Mental Health Centers, 22, 0%


                                                                                                                                                           DCS children (0-21), 88, 1%




Analysis:
In September 2010, the Wait List had a net increase of 27 people bringing the new total to 6500. East had a total of 2334, Middle had 2021 and West had 2145. 49 people were removed: 19 of those to be enrolled in the
Statewide Waiver and 4 people to be enrolled into the SD Waiver. 63 people were added statewide. 69% of the wait list is in the Active category, 18% is in Deferred, 12 % is in the Urgent category and 1% is in the Crisis
category. 56% of the list was comprised of adults with no services, 42% was of school aged children, DCS children and Nursing Home residents made up 1% each, and there were less than 1% in Regional Mental Health
Centers.




                                                                                                                    10
                                                                                                       Data Management Report
                                                                                                           October 22, 2010




G    Protection From Harm/ Complaint Resolution

Data Source:
Each Regional Office inputs all complaints information into COSMOS as each complaint is received. Every month a data report is generated which includes Complaint Information captured by each complaint type,
the source of each complaint and the number of complaints that are resolved within 30 days. The benchmark for resolution is 90% of all complaints resolved within 30 days. The data will be presented by waiver
instead of by region.

Complaints by Source- Self Determination Waiver                 Jul-10      Aug-10       Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11     YTD
  1 Total # of Complaints                                            0           0            4                                                                                                                        4
  2 # from TennCare                                                  0           0            0                                                                                                                        0
  3 % from TennCare                                              0.0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
  4 # from a Concerned Citizen                                       0           0            2                                                                                                                        2
  5 % from a Concerned Citizen                                   0.0%        0.0%         50.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   50.0%
  6 # from the Waiver Participant                                    0           0            0                                                                                                                        0
  7 % from the Waiver Participant                                0.0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
  8 # from a Family Member                                           0           0            1                                                                                                                        1
  9 % from a Family Member                                       0.0%        0.0%         25.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   25.0%
 10 # from Conservator                                               0           0            1                                                                                                                        1
 11 % from Conservator                                           0.0%        0.0%         25.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   25.0%
 13 # Advocate (Paid)                                                0           0            0                                                                                                                        0
 14 % from Advocate (Paid)                                       0.0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 15 # from PTP Interview                                             0           0            0                                                                                                                        0
 16 % from PTP Interview                                         0.0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%


Complaints by Source - Statewide Waiver                         Jul-10      Aug-10       Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11     YTD
 20 Total # of Complaints                                           15           14           22                                                                                                                       51
 21 # from TennCare                                                  0            0            0                                                                                                                        0
 21 % from TennCare                                                0%         0.0%         0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 22 # from a Concerned Citizen                                       1            0            0                                                                                                                        1
 23 % from a Concerned Citizen                                     7%         0.0%         0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    2.0%
 24 # from the Waiver Participant                                    0            0            2                                                                                                                        2
 25 % from the Waiver Participant                                  0%         0.0%         9.1%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    3.9%
 26 # from a Family Member                                           3            8           11                                                                                                                       22
 27 % from a Family Member                                      20.0%        57.1%        50.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   43.1%
 28 # from Conservator                                               8            6            8                                                                                                                       22
 29 % from Conservator                                            53%        42.9%        36.4%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   43.1%
 31 # Advocate (Paid)                                                0            0            0                                                                                                                        0
 32 % from Advocate (Paid)                                         0%         0.0%           0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 33 # from PTP Interview                                             3            0            1                                                                                                                        4
 34 % from PTP Interview                                          20%         0.0%         4.5%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    7.8%


Complaints by Source - Arlington Waiver                         Jul-10     Aug-10        Sep-10       Oct-10       Nov-10        Dec-10       Jan-11      Feb-11       Mar-11       Apr-11     May-11     Jun-11     YTD
 38 Total # of Complaints                                            6          2             6                                                                                                                        14
 39 # from TennCare                                                  0          0             0                                                                                                                         0
 40 % from TennCare                                                0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 41 # from a Concerned Citizen                                       0          0             2                                                                                                                         2
 42 % from a Concerned Citizen                                     0%        0.0%         33.3%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   14.3%
 43 # from the Waiver Participant                                    1          0             4                                                                                                                         5
 44 % from the Waiver Participant                                 17%        0.0%         66.7%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   35.7%
 45 # from a Family Member                                           0          0             0                                                                                                                         0
 46 % from a Family Member                                       0.0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 47 # from Conservator                                               4          2             0                                                                                                                         6
 48 % from Conservator                                            67%      100.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!   42.9%
 50 # Advocate (Paid)                                                0          0             0                                                                                                                         0
 51 % from Advocate (Paid)                                         0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%
 52 # from PTP Interview                                             0          0             0                                                                                                                         0
 53 % from PTP Interview                                           0%        0.0%          0.0%     #DIV/0!     #DIV/0!       #DIV/0!      #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!    0.0%




                                                                                                                 11
                                                                                 Data Management Report
                                                                                     October 22, 2010




Complaints by Issue- Self Determination Waiver   Jul-10   Aug-10    Sep-10      Oct-10     Nov-10         Dec-10     Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11     YTD
   Total Number of Complaints                         0        0         4                                                                                                             4
   # Behavior Issues                                  0        0         0                                                                                                             0
   % Behavior Issues                                0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
    # Day Service Issues                              0        0         0                                                                                                             0
   % Day Service Issues                             0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Environmental Issues                             0        0         0                                                                                                             0
   % Environmental Issues                           0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Financial Issues                                 0        0         0                                                                                                             0
   % Financial Issues                               0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Health Issues                                    0        0         0                                                                                                             0
   % Health Issues                                  0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Human Rights Issues                              0        0         1                                                                                                             1
   % Human Rights Issues                            0%       0%      25.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   25.0%
   # ISC Issues                                       0        0         0                                                                                                             0
   % ISC Issues                                     0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # ISP Issues                                       0        0         0                                                                                                             0
   % ISP Issues                                     0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Staffing Issues                                  0        0         2                                                                                                             2
   % Staffing Issues                                0%       0%      50.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   50.0%
   # Therapy Issues                                   0        0         0                                                                                                             0
   % Therapy Issues                                 0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Transportation Issues                            0        0         0                                                                                                             0
   % Transportation Issues                          0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Case Management Issues                           0        0         1                                                                                                             1
   % Case Management Issues                         0%       0%      25.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   25.0%
   # Other Issues                                     0        0         0                                                                                                             0
   % Other Issues                                   0%       0%       0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%


Complaints by Issue - Statewide Waiver           Jul-10   Aug-10    Sep-10      Oct-10     Nov-10         Dec-10     Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11     YTD
   Total Number of Complaints                        15        14        22                                                                                                            51
   # Behavior Issues                                  0         0         0                                                                                                             0
   % Behavior Issues                              0.0%      0.0%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
    # Day Service Issues                              1         1         0                                                                                                             2
   % Day Service Issues                             7%      7.1%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    3.9%
   # Environmental Issues                             2         0         3                                                                                                             5
   % Environmental Issues                          13%      0.0%     13.6%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    9.8%
   # Financial Issues                                 0         0         3                                                                                                             3
   % Financial Issues                               0%      0.0%     13.6%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    5.9%
   # Health Issues                                    1         2         1                                                                                                             4
   % Health Issues                                  7%     14.3%      4.5%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.8%
   # Human Rights Issues                              3         2         3                                                                                                             8
   % Human Rights Issues                           20%     14.3%     13.6%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   15.7%
   # ISC Issues                                       1         2         3                                                                                                             6
   % ISC Issues                                     7%     14.3%     13.6%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   11.8%
   # ISP Issues                                       0         0         0                                                                                                             0
   % ISP Issues                                     0%      0.0%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Staffing Issues                                  6         7         8                                                                                                            21
   % Staffing Issues                               40%     50.0%     36.4%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   41.2%
   # Therapy Issues                                   0         0         0                                                                                                             0
   % Therapy Issues                                 0%      0.0%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Transportation Issues                            0         0         1                                                                                                             1
   % Transportation Issues                          0%      0.0%      4.5%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    2.0%
   # Case Management Issues                           0         0         0                                                                                                             0
   % Case Management Issues                         0%      0.0%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Other Issues                                     0         0         0                                                                                                             0
   % Other Issues                                 0.0%      0.0%      0.0%    #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%




                                                                                          12
                                                                       Data Management Report
                                                                           October 22, 2010




Complaints by Issue - Arlington Waiver   Jul-10   Aug-10   Sep-10     Oct-10     Nov-10         Dec-10     Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11     YTD
   Total Number of Complaints                 6        2        6                                                                                                            14
   # Behavior Issues                          0        0        0                                                                                                             0
   % Behavior Issues                        0%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
    # Day Service Issues                      0        0        1                                                                                                             1
   % Day Service Issues                     0%      0.0%    16.7%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.1%
   # Environmental Issues                     1        0        0                                                                                                             1
   % Environmental Issues                  17%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.1%
   # Financial Issues                         0        0        0                                                                                                             0
   % Financial Issues                       0%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Health Issues                            0        1        0                                                                                                             1
   % Health Issues                          0%     50.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.1%
   # Human Rights Issues                      0        0        1                                                                                                             1
   % Human Rights Issues                    0%      0.0%    16.7%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.1%
   # ISC Issues                               1        0        0                                                                                                             1
   % ISC Issues                            17%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    7.1%
   # ISP Issues                               0        0        0                                                                                                             0
   % ISP Issues                             0%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Staffing Issues                          4        1        1                                                                                                             6
   % Staffing Issues                       67%     50.0%    16.7%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   42.9%
   # Therapy Issues                           0        0        0                                                                                                             0
   % Therapy Issues                         0%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Transportation Issues                    0        0        3                                                                                                             3
   % Transportation Issues                  0%      0.0%    50.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   21.4%
   # Case Management Issues                   0        0        0                                                                                                             0
   % Case Management Issues               0.0%      0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%
   # Other Issues                                      0        0                                                                                                             0
   % Other Issues                        0.0%       0.0%     0.0%   #DIV/0!    #DIV/0!      #DIV/0!      #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!    0.0%




                                                                                13
                                                                                                                          Data Management Report
                                                                                                                              October 22, 2010




Complaint Resolution-Self Determination Waiver                             Jul-10        Aug-10          Sep-10         Oct-10         Nov-10           Dec-10         Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11 YTD
   Total # of Complaints                                                        0             0               4                                                                                                                         4
   Resolved Within 30 Days                                                      0             0               4                                                                                                                         4
   # Pending                                                                    0             0               0                                                                                                                         0
   # Pending > than 31 to 60 days                                               0             0               0                                                                                                                         0
   # Resolved > than 31 to 60 days                                              0             0               0                                                                                                                         0
   # Pending > than 61 days                                                     0             0               0                                                                                                                         0
   # Resolved > than 61 days                                                    0             0               0                                                                                                                         0
   % Resolved within 30 Days                                                 N/A            N/A           100%              N/A     #DIV/0!                 N/A     #DIV/0!          N/A   #DIV/0!    #DIV/0!        N/A       N/A   100%

Complaint Resolution-Statewide Waiver                                      Jul-10        Aug-10          Sep-10         Oct-10         Nov-10           Dec-10         Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11 YTD
   Total # of Complaints                                                       15            14              22                                                                                                                            51
   Resolved Within 30 Days                                                     15            14              14                                                                                                                            43
   # Pending                                                                    0             0               7                                                                                                                             0
   # Pending > than 31 to 60 days                                               0             0               0                                                                                                                             0
   # Resolved > than 31 to 60 days                                              0             0               0                                                                                                                             0
   # Pending > than 61 days                                                     0             0               0                                                                                                                             0
   # Resolved > than 61 days                                                    0             0               0                                                                                                                             0
   % Resolved within 30 Days                                               100%           100%             64%       #DIV/0!        #DIV/0!         #DIV/0!         #DIV/0!     #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!       84%


Complaint Resolution-Arlington Waiver                                      Jul-10        Aug-10          Sep-10         Oct-10         Nov-10           Dec-10         Jan-11     Feb-11     Mar-11     Apr-11    May-11    Jun-11 YTD
   Total # of Complaints                                                        6             2               6                                                                                                                         14
   Resolved Within 30 Days                                                      6             2               6                                                                                                                         14
   # Pending                                                                    0             0               0                                                                                                                          0
   # Pending > than 31 to 60 days                                               0             0               0                                                                                                                          0
   # Resolved > than 31 to 60 days                                              0             0               0                                                                                                                          0
   # Pending > than 61 days                                                     0             0               0                                                                                                                          0
   # Resolved > than 61 days                                                    0             0               0                                                                                                                          0
   % Resolved within 30 Days                                               100%           100%            100%       #DIV/0!        #DIV/0!         #DIV/0!         #DIV/0!     #DIV/0!    #DIV/0!    #DIV/0!    #DIV/0!   #DIV/0!   100%

    Analysis:
    CRS Analysis Report for September 2010

    1. There were 32 statewide complaints: AW 6, SW 22, SDW 4.

    2. Source:
    Conservator: 9
    Family: 12
    Concerned Citizen: 4
    PTP: 1
    Recipient: 6

    3. Types of Complaints:

    Environmental: 3
    Day service: 1
    Financial: 3
    Human Rights: 5
    Staffing: 11
    Transportation: 4
    Case Management(SD) 1
    ISC: 3
    Most frequent complaint was staffing communication\supervision.

    4. There were 24 complaints resolved satisfactorily in 30 days and
    There are 8 pending to be resolved which are not due yet……….
    SDW: 4\4
    AW: 6\6
    SW: 14\14
    5. There were 26 interventions statewide.

    6. Plans are being finalized to hold the annual CRS meetings in conjunction with the Regional Provider forums and have been sc heduled between now and January 2011.




                                                                                                                                     14
                                                                                                         Data Management Report
                                                                                                             October 22, 2010




D    Protection From Harm/Incident Management

Data Source:
The Incident Management information in this report is now based on the total D.I.D.S. Community Protection From Harm census, which is all D.I.D.S. service recipients in the community and all private ICF/MR
service recipients who are currently required to report incidents to D.I.D.S.

Through August 2009, only the West Region private ICF/MR providers were required to report. As of September 2009, the East Region ICF/MR providers were also required to report incidents to D.I.D.S., and the
Middle Region ICF/MR providers started reporting to D.I.D.S. in February 2010.
Incidents / East                                                  Jul-10     Aug-10     Sep-10       Oct-10     Nov-10        Dec-10      Jan-11      Feb-11        Mar-11         Apr-11     May-11      Jun-11 YTD
   1 # of Reportable Incidents                                       363         404                                                                                                                                  767
   2 Rate of Reportable Incidents per 100 people                    11.9        13.2                                                                                                                                12.55
   3 # of Serious Injuries                                            26          22                                                                                                                                   48
     Rate of Incidents that were Serious Injuries per
   4 100 people                                                     0.85        0.72                                                                                                                                 0.79
   5 # of Incidents that were Falls                                   32          31                                                                                                                                   63
   6 Rate of Falls per 100 people                                   1.05        1.01                                                                                                                                 1.03
   7 # of Falls resulting in serious injury                           13          13                                                                                                                                   26
   8 % of serious injuries due to falls                           50.0%       59.1%                                                                                                                                54.6%
Incidents / Middle                                                Jul-10     Aug-10     Sep-10       Oct-10     Nov-10        Dec-10      Jan-11      Feb-11        Mar-11         Apr-11     May-11      Jun-11 YTD
  15 # of Reportable Incidents                                       412         423                                                                                                                                  835
  16 Rate of Reportable Incidents per 100 people                    13.5        13.9                                                                                                                                 13.7
  17 # of Serious Injuries                                            26          29                                                                                                                                   55
     Rate of Incidents that were Serious Injuries per
  18 100 people                                                     0.85        0.95                                                                                                                                 0.90
  19 # of Incidents that were Falls                                   23          32                                                                                                                                   55
  20 Rate of Falls per 100 people                                   0.76        1.05                                                                                                                                 0.91
  21 # of Falls resulting in serious injury                            8          15                                                                                                                                   23
  22 % of serious injuries due to falls                           30.8%       51.7%                                                                                                                                41.3%
Incidents / West                                                  Jul-10     Aug-10     Sep-10       Oct-10     Nov-10        Dec-10      Jan-11      Feb-11        Mar-11         Apr-11     May-11      Jun-11 YTD
  29 # of Reportable Incidents                                       291         313                                                                                                                                  604
  30 Rate of Reportable Incidents per 100 people                    12.8        13.7                                                                                                                                13.25
  31 # of Serious Injuries                                            18          19                                                                                                                                   37
     Rate of Incidents that were Serious Injuries per
  33 100 people                                                     0.79        0.83                                                                                                                                 0.81
  37 # of Incidents that were Falls                                   19          17                                                                                                                                   36
  39 Rate of Falls per 100 people                                   0.83        0.74                                                                                                                                 0.79
  40 # of Falls resulting in serious injury                            6           5                                                                                                                                   11
  41 % of serious injuries due to falls                           33.3%       26.3%                                                                                                                                29.8%

D    Protection From Harm/Incident Management

Incidents / Statewide                                            Jul-10      Aug-10        Sep-10       Oct-10      Nov-10        Dec-10        Jan-11      Feb-11       Mar-11        Apr-11    May-11         Jun-11 YTD
  44 # of Reportable Incidents                                    1066         1140                                                                                                                                       2206
  45 Rate of Reportable Incidents per 100 people                   12.7         13.6                                                                                                                                     13.15
  46 # of Serious Injuries                                           70           70                                                                                                                                       140
     Rate of Incidents that were Serious Injuries per
  47 100 people                                                    0.84         0.83                                                                                                                                       0.84
  48 # of Incidents that were Falls                                  74           80                                                                                                                                        154
  49 Rate of Falls per 100 people                                  0.88         0.95                                                                                                                                       0.92
  50 # of Falls resulting in serious injury                          27           33                                                                                                                                         60
  51 % of serious injuries due to falls                          38.6%        47.1%                                                                                                                                      42.9%




                                                                                                                   15
                                                                                                                                          Data Management Report
                                                                                                                                              October 22, 2010




                                                                                                                    Monthly DIDS Reportable Incident and Serious Injury Rates
                                                                                                                 All DIDS Community and eligible Private ICF/MR Service Recipients

                                    16.0


                                    14.0
  Rate per 100 Service Recipients




                                    12.0


                                    10.0


                                     8.0
                                                                                                                                                                                                                Reportable Incident Rate
                                                                                                                                                                                                                Serious Injury Rate
                                     6.0
                                                                                                                                                                                                                Linear (Reportable Incident Rate)
                                     4.0                                                                                                                                                                        Linear (Serious Injury Rate)

                                     2.0


                                     0.0
                                           August 2009   September 2009   October 2009   November 2009   December 2009     January 2010      February 2010       March 2010          April 2010   May 2010   June 2010          July 2010           August 2010
                                                                                                                                                 Month




PFH Analysis: Incident Management

Chart: Monthly Rate: Reportable Incidents and Serious Injuries.


The monthly statewide rate of Reportable Incidents per 100 service recipients for August 2010 (the last point on the line graph at the top of the chart) shows a slight increase (7%) from the previous month.

August has historically been the month with the highest incident rate, and this year follows that pattern. The rate for this August is slightly lower than the rate for August 2009. The monthly rate of Reportable
Incidents per 100 service recipients has shown slight variation from month to month. This rate has ranged from the high of 13.6 incidents per 100 services recipients per month for August 2010 to a low of 10.7 for
February 2010.

The August 2010 statewide rate of Serious Injuries per 100 service recipients shows a comparable slight increase (1%) from the previous month.

The monthly rate of Serious Injuries per 100 service recipients, at the bottom of the chart, has shown relatively greater monthly variation than the incident rate, at least partly due to the relatively lower rate of serious
injuries. (Approximately 6% of Reportable Incidents are associated with a Serious Injury.) The Serious Injury rate ranged from a high of 0.88 Serious Injuries per 100 services recipients per month (April 2010) to a
low of 0.62 (February 2010).


Conclusions and actions taken for the reporting period:

D.I.D.S. Protection From Harm has continued to conduct quarterly training and discussion meetings in each of the three Regions with service provider Incident Management Coordinators. The most recent round of
sessions, conducted in July 2010, included two presentations on home safety. The first one, developed by the Centers for Disease Control (CDC) and the National Fire Prevention Association (NFPA),
demonstrates the relationship between fire prevention and fall prevention, and was presented by Randy Fox, Columbia Fire Department. The second presentation, by Sandra Clamp, discussed the D.I.D.S.
Supported Living Home Inspection process. A third presentation, by Eleanor Brantley, RN, D.I.D.S. Clinical Investigator, covered four years of information (2006-2009) about abuse and neglect investigations of
deaths.
D.I.D.S. Protection From Harm also continues to coordinate with other D.I.D.S. sections to develop interventions aimed at reducing abuse and neglect, injuries, and incidents such as choking. To help reduce
choking, training in awareness of swallowing difficulties is being expanded so that it will be available to family members, and training on swallowing issues is to be set up on the College of Direct Support system.
The overall Protection From Harm training curriculum will be revised in coordination with the pending policy revision and will also incorporate elements from the pre-CDS “What Is Abuse? How Do We Prevent It?”
curriculum.

DIDS Protection From Harm is also in the process of revising the policy that covers incident management and abuse investigations. Several focus group meetings were conducted with provider Incident
Management Coordinators in August.




                                                                                                                                                      16
                                                                                      Data Management Report
                                                                                          October 22, 2010




D        Protection From Harm/Investigations
         East Region                                    Jul-10   Aug-10   Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
     1   Census                                          3054     3052
     2   # of Investigations                              58       59
     3   Rate of Investigations per 100 people           1.90     1.93
     4   # of Substantiated Investigations                12       23
     5   Rate of Substantiated Investigations per 100
         people                                         0.39      0.75
     6   Percentage of Investigations Substantiated     21%       39%

     7 Middle Region                                    Jul-10   Aug-10   Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
     8 Census                                            3046     3052
     9 # of Investigations                                87       79
    10 Rate of Investigations per 100 people             2.86     2.59
    11 # of Substantiated Investigations                  26       17
    12 Rate of Substantiated Investigations per 100
       people                                           0.85      0.56
    13 Percentage of Investigations Substantiated       30%       22%

       West Region                                      Jul-10   Aug-10   Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
    14 Census                                            2299     1993
    15 # of Investigations                                65       71
    16 Rate of Investigations per 100 people             2.83     3.56
    17 # of Substantiated Investigations                  18       22
    18 Rate of Substantiated Investigations per 100
       people                                           0.78      1.10
    19 Percentage of Investigations Substantiated       28%       31%

       Statewide                                        Jul-10   Aug-10   Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
    20 Census                                            8399     8097
    21 # of Investigations                                210      209
    22 Rate of Investigations per 100 people             2.50     2.58
    23 # of Substantiated Investigations                   56      62
    24 Rate of Substantiated Investigations per 100
       people                                           0.67      0.77
    25 Percentage of Investigations Substantiated       27%       30%




                                                                                               17
                                                                                                                                                                  Data Management Report
                                                                                                                                                                      October 22, 2010




                                                                                                            Monthly DIDS Abuse, Neglect, & Exploitation Investigation and Substantiation Rates
                                                                                                                                 All DIDS Community and eligible Private ICF/MR Service Recipients
                                              3




                                             2.5
 Rate per 100 Service Recipients per Month




                                              2




                                             1.5



                                                                                                                                                                                                                    Investigation Rate
                                              1                                                                                                                                                                     Substantiated Investigation Rate




                                             0.5




                                              0
                                                   August 2009   September 2009   October 2009   November 2009   December 2009      January 2010     February 2010       March 2010         April 2010   May 2010    June 2010       July 2010         August 2010
                                                                                                                                                          Month



D    Protection From Harm/Investigations
Analysis:
SQMC Investigation Data – August 2010

In August, 2010, the Middle Region led the other regions in the number of investigations conducted, opening a total of 79 investigations for a rate of 2.59 investigations opened per 100 people served in their region.
Only 17 (22%) of these were substantiated for abuse, neglect, or exploitation for a rate of .56 substantiated investigations per 100 people served.
The West Region conducted 71 investigations during August 2010 for a rate of 3.56 investigations conducted per 100 people served. Only 22 (31%) of these investigations were substantiated for abuse, neglect, or
exploitation for a rate of 1.10 investigations substantiated per 100 people served.

The East Region conducted the fewest number of investigations during August 2010, conducting 59 investigations for a rate of 1.93 investigations per 100 people served. 23 (39%) of these were substantiated for
abuse, neglect, or exploitation for a rate of .75 substantiated investigations per 100 people served in this region.
Statewide, there were 209 investigations conducted during the month of August 2010. 2.58 investigations were conducted per 100 people served during this reporting period. 62 (30%) of the investigations were
substantiated for abuse, neglect, or exploitation for a statewide rate of .77 substantiated investigations per 100 people served.
Conclusions and actions taken for the reporting period:
The DIDS Protection From Harm unit was very glad to be able to offer Mortality Review & Death Investigations training, conducted by Labor Relations Alternatives, to the Investigations Staff and several Regional
Office staff. Approximately 75 Regional and Central Office staff received this very valuable training. Equally beneficial was the CAARE (Committee Against Abuse in Residential Environments) meeting that was
attended by PFH staff. Present during this meeting were TBI Medicaid Fraud Agents, DOH, Licensure, and APS personnel. Discussions related to inter-agency referral processes, Service Recipients who are
familiar to each entity, and on-going investigations being conducted amongst various represented entities.




                                                                                                                                                                              18
                                                                                                       Data Management Report
                                                                                                           October 22, 2010




E      Provider Qualifications / Monitoring (II.H., II.K.)
Data Source:
The information contained in this section comes from the Quality Assurance Teams. The numbers in each column represents the percentage of provider agencies that scored either substantial compliance, partial
compliance, minimal compliance or non-compliance.

       Day and Residential Provider                                          Statewide 9/10                              Cumulative / Statewide 9/10
     1 # of Day and Residential Providers Monitored this                          15                                                  87
       Month
     2 Total Census of Providers Surveyed                                         694                                          5286
     3 # of Sample Size                                                           114                                          874
     4 % of Individuals Surveyed                                                  16%                                          17%
       # of additional Focused Files Reviewed                                      0                                            0
                                                             Substantial  Partial    Minimal    Non-       Substantial Partial    Minimal   Non-
                                                             Compliance % Compliance Compliance compliance Compliance Compliance Compliance compliance
     5 Domain 2. Individual Planning and
       Implementation
     6 Outcome A. The person’s plan reflects his or her             100%         0%           0%          0%          89%            9%          1%          0%
       unique needs, expressed preferences and
       decisions.
     7 Outcome B. Services and supports are provided                 66%        33%           0%          0%          71%          24%           4%          0%
       according to the person’s plan.
     8 Outcome C. Individual risk is assessed and                   100%         0%           0%          0%          87%            8%          1%          3%
       adequate, timely intervention is provided.
     9 Outcome D. The person’s plan and services are                 80%        20%           0%          0%          55%          29%           9%          5%
       monitored for continued appropriateness and
       revised as needed.
    10 Domain 3: Safety and Security
    11 Outcome A. Where the person lives and works is                86%        13%           0%          0%          75%          22%           1%          0%
       safe.
    12 Outcome B. The person has a sanitary and                      86%        13%           0%          0%          89%          10%           0%          0%
       comfortable living arrangement.
    13 Outcome C. Safeguards are in place to protect                 20%        80%           0%          0%          31%          62%           5%          1%
       the person from harm.
    14 Domain 4: Rights, Respect and Dignity
    15 Outcome A. The person is valued, respected and               100%         0%           0%          0%          96%            2%          1%          0%
       treated with dignity.
    16 Outcome B. The person has a positive image in                100%         0%           0%          0%          100%           0%          0%          0%
       the community.
    17 Outcome C. The person exercises his or her                    93%         6%           0%          0%          95%            4%          0%          0%
       rights.
    18 Outcome D. Restricted interventions are imposed               64%        35%           0%          0%          68%          20%           4%          6%
       only with due process.
    19 Domain 5: Health
    20 Outcome A. The person has the best possible                   86%        13%           0%          0%          70%          20%           1%          8%
       health.
    21 Outcome B. The person takes medications as                    60%        40%           0%          0%          44%          38%           8%          9%
       prescribed.
    22 Outcome C. The person's dietary and nutritional               86%        13%           0%          0%          89%            6%          2%          1%
       needs are adequately met.




                                                                                                                 19
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




E      Provider Qualifications / Monitoring (II.H., II.K.)
                                                              Substantial  Partial    Minimal    Non-       Substantial Partial      Minimal    Non-
                                                              Compliance % Compliance Compliance compliance Compliance Compliance    Compliance compliance
    23 Domain 6: Choice and Decision-Making
    24 Outcome A. The person and family members are                   86%        13%          0%        0%          95%        4%           0%         0%
       involved in decision-making at all levels of the
       system.
    25 Outcome B. The person and family members have                 100%         0%          0%        0%          100%       0%           0%         0%
       information and support to make choices about
       their lives.
    26 Domain 7: Relationships and Community
       Membership
    27 Outcome A. The person has relationships with                  100%         0%          0%        0%          100%       0%           0%         0%
       individuals who are not paid to provide support.
    28 Outcome B. The person is an active participant in             100%         0%          0%        0%          98%        1%           0%         0%
       community life rather than just being present.
    29 Outcome C. The person has a valued role in the                100%         0%          0%        0%          98%        1%           0%         0%
       community.
    30 Domain 8: Opportunities for Work
    31 Outcome A. The person has a meaningful job in                  92%         0%          7%        0%          90%        6%           3%         0%
       the community.
    32 Outcome B. The person's day service leads to                  100%         0%          0%        0%          95%        4%           0%         0%
       community employment or meets his or her
       unique needs.
    33 Domain 9: Provider Capabilities and
       Qualifications
    34 Outcome A. The provider meets and maintains                    66%        13%         20%        0%          66%        21%          8%         3%
       compliance with applicable licensure and provider
       agreement requirements.
    35 Indicator 9.A.1.: The provider meets and                      100%                               0%          97%                                2%
       maintains compliance with applicable licensure,
       certification and contract requirements.
    36 Indicator 9.A.2.: The provider complies with                  100%                               0%          97%                                2%
       requirements in the provider agreement.
    37 Indicator 9.A.4.: The provider develops and                    93%                               6%          97%                                2%
       implements a written management plan describing
       how the agency conducts its business and
       specifying the provider's processes for protecting
       the health, safety and welfare of the persons
       whom it supports.
    38 Outcome B. Provider staff are trained and meet                 60%        40%          0%        0%          67%        25%          4%         2%
       job specific qualifications.
    39 Indicator 9.B.2.: Provider staff have received                 53%                              46%          66%                               33%
       appropriate training and, as needed, focused or
       additional training to meet the needs of the person.

    40 Outcome C. Provider staff are adequately                       60%        40%          0%        0%          63%        25%          6%         4%
       supported.
    41 Outcome D. Organizations receive guidance from                 93%         6%          0%        0%          89%        6%           2%         1%
       a representative board of directors or a
       community advisory board.
    42 Domain 10: Administrative Authority and
       Financial Accountability
    43 Outcome A. Providers are accountable for DIDS                  73%        13%          6%        6%          87%        9%           2%         1%
       requirements related to the services and supports
       that they provide.
    44 Outcome B. People’s personal funds are                         38%        46%         15%        0%          53%        38%          5%         2%
       managed appropriately.




                                                                                                               20
                                                                                                           Data Management Report
                                                                                                               October 22, 2010




                                                                        Cumulative Performance Ratings Across All Regions- Day/Residential
                                    30

                                    25


               Number of Agencies
                                    20
                                                                                                                                                                                              Exceptional Performance
                                    15
                                                                                                                                                                                              Proficient

                                    10                                                                                                                                                        Fair

                                                                                                                                                                                              Significant Concerns
                                    5
                                                                                                                                                                                              Serious Deficiencies
                                    0
                                                       East                                                Middle                                                  West
                                                                                                     Performance Ratings


Analysis: Note- Statewide and Cumulative / Statewide data in the table above may sometimes exceed or be just below 100% due to the numerical rounding functions during calculations.
Providers reviewed: East: East: Adult Community Training, Lakeway Achievement Center, Rhea of Sunshine; Middle- Care for Meg, Homeplace, Omni Visions, Restoration Residential Services, RHA Health
Services, Rutherford County Adult Activity Center, Starcare of Tennessee, Tennessee Family Solutions, Volunteers of America; West- Brenda Richardson Memorial Care Homes, C. S. Patterson Training and
Habilitation Center, Mosaic.
In the East Region:
Adult Community Training, Inc. - The survey resulted in an overall performance rating of Exceptional, score of 52, reflecting a slight increase from the previous 2008 survey which resulted in an overall performance
rating of Proficient, score of 50. The agency was exempt from a survey in 2009 due to achievement of Star status. Some issues pertaining medication histories, parameters for PRN medications and a need for
clarification of doctor-ordered diets were noted which resulted in PC for Domain 5, a decrease from SC on the previous survey. Improvements in the areas of service delivery covered by Domains 4 and 10 resulted
in SC, an increase from PC on the previous survey. All other applicable Domains resulted in SC.
Lakeway Achievement Center - The survey resulted in an overall performance rating of Fair, score of 42, reflecting a decrease from the previous survey which resulted in an overall performance rating of Proficient,
score of 48. For Domain 2, issues pertaining to service documentation and monthly review processes contributed to a result of PC, a decrease from SC in the previous survey. In Domain 8, individual issues
pertaining to choice and organizational issues re; oversight and processes to promote the development of supports contributed to a result of PC, a decrease from SC. Due to a few billing issues and repeat issues
regarding the management of personal funds, Domain 10 resulted in MC, a decrease from PC. Otherwise, Domains 5 and 9 were maintained at PC and Domains 3, 4, 6 and 7 were maintained at SC.

Rhea of Sunshine, Inc. - The survey resulted in an overall performance rating of Proficient, score of 50, which reflects a slight increase in score from the previous survey which also resulted in Proficient, however
the score was 48. Repeat issues pertaining to the timely completion of registry checks and medication variances resulted in a decrease in the results for Domain 3 from SC to PC. Improvements, however, were
noted in the results for Domain 5, Health, and Domain 9, Provider Capabilities and Qualifications, which improved from PC to SC. All other applicable Domains resulted in SC.timely completion of registry checks
and medication variances resulted in a decrease in the results for Domain 3 from SC to PC. Improvements, however, were noted in the results for Domain 5, Health, and Domain 9, Provider Capabilities and
Qualifications, which improved from PC to SC. All other applicable Domains resulted in SC.
In the Middle Region:
RHA- Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. Family Based services had several issues identified. One home did not have an ISP and a sanction occurred, there
were issues with the person's bedroom being on the 2nd floor and inaccessible and personal funds/financial issues noted and Internal Audit will review. Inadequate staff in the family-based home resulted in a rate
adjustment also. A complete review of Family-Based requirements was provided at the exit conference. New hires and tenured staff training had not occurred timely. Personal funds reimbursement was required of
4/4 individuals on the survey sample.

Tennessee Family Solutions- Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. A rate adjustment occurred for Family-Based 5 services for failure to provide adequate
staffing. Personal funds were reimbursement required for 2/4 persons
Starcare- Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. However, Outcome 9.A. scored Minimal Compliance due to the failure to analyze self-assessment data for
inclusion in a quality improvement process.

Omni-Visions- Scored Fair on the QA survey with no Domains scoring less than Partial Compliance. CPR was completed on-line for 3 tenured employees and First-Aid was completed on-line for 1 tenured
employee. Agency informed that these staff could not work alone with individuals until recertified correctly. Personal funds reimbursement required for 3/3 people reviewed on the sample.
Homeplace- Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. Personal funds reimbursement was required for 2/2 people on the sample. However much improvement noted
overall with the agency.

RCAAC- Scored Exceptional on the QA survey with no Domains scoring less than Partial Compliance. No concerns.

Restoration Residential-Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. Issues noted with timely personnel checks for new hires and rebilling occurred for lack of
documentation to support billing for one person.
VOA- Scored Proficient. No domains scored less than Partial Compliance. Background checks were completed early for 44/105 new staff for a compliance rating of 35.3%. Tenured staff training for CPR recerts
were late for 10/19 staff. Medication Administration issues were identified for individuals served through only the Hermitage office. No other concerns.

Care for Meg- Scored Exceptional on the QA survey with a perfect score. No concerns and the agency was closed as of October 1, 2010.

Other
BIOS-A Review of the QA survey findings was completed on 9/2/10. No changes were made to the survey report.


                                                                                                                     21
                                                                                                           Data Management Report
                                                                                                               October 22, 2010




In the West Region:
Mosaic – Day/Res provider scored 44 of 54/Fair; no Domains or Outcomes scored less than PC. Areas needing attention include 2 homes in need of cleaning/maintenance; background and registry checks present
with 1 exception but not timely; RIFs not fully or accurately completed; repeat finding re: not maintaining evidence of HRC review of psychotropic medications; one staff administered medications for two weeks with
lapsed medication administration certification; two people did not have appropriately maintained controlled medication counts; no evidence of mechanism to gather and use consumer/family satisfaction information;
self assessment activities were primarily focused on individuals rather than inclusive of systems/organizational processes and findings were presented nationwide but findings specific to the local organization were
not evident; quality improvement planning processes did reflect planning for correction/ change but data reflecting provider actions based on self assessment results was lacking; training competency and timeliness
issues for both new and tenured staff; no minutes presented for either national board or local advisory group so could not determine appropriate meeting frequency. Note personal funds was not reviewed this
survey due to concurrent full audit of personal funds by FAR.
Brenda Richardson Memorial Care Homes – Day/Res provider scored 50 of 54/ Proficient; no Domains scored less than PC; outcome 9A scored MC. Areas needing attention include 2B (2B5 – documentation of
outcomes/actions); 3C (3C6 – all background checks present with majority early [none late]; all registry checks present/timely except for 1 staff); 4D (4D3 – 1 of 2 people in sample taking psychotropic medications
did not have evidence of HRC review); 5B (5B3 – one staff with lapsed certification gave medications during the review period); 9A (9A5 & 6 – repeat issues re: weak self-assessment and quality improvement
planning processes); and 9C (9C2 – documentation does not reflect when the weekly supervisory visits to homes are completed unannounced)

C.S. Patterson Training & Habilitation Center – Day/Res provider scored 50 of 54/ Proficient; no Domain scored less than PC; outcome 9A scored MC. Areas needing attention include 3C (3C6 – early background
checks; 3C10 – some late reporting of incidents); 9A (9A3 & 9A4– incomplete records policy and management plan; 9A5 & 9A6 – no system-wide process for self-assessment and quality improvement planning; and
9C (9C2 – lack of documented supervisory visits to people receiving PA).
As represented in the graph, 21 (29%) Day-Residential providers have performed in the Exceptional Performance category, 32 (44%) have performed in the Proficient category, 14 (19%) are in the Fair category and
5 (7%) are in the category of Significant Concerns.
The following Outcomes are being studied by DIDS.
Domain 2, Outcome B (Services and Supports are provided according to the person’s plan.)
Of the providers surveyed in September 2010, 66% achieved Substantial Compliance with this Outcome. Cumulative performance is at 71% Substantial Compliance for the providers surveyed this year.
Domain 2, Outcome D (The person’s plan and services are monitored for continued appropriateness and revised as needed.)
Of the providers surveyed in September 2010, 80% achieved Substantial Compliance with this Outcome. Cumulative performance is at 55% Substantial Compliance for the providers surveyed this year.


The following QA Indicators are being tracked to meet requirements of CMS Special Terms and Conditions of Approval and / or TennCare.
9.A.1. (The provider meets and maintains compliance with applicable licensure, certification, and contract requirements.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 97% Substantial Compliance for the providers surveyed this year.
9.A.2. (The provider complies with requirements in the provider agreement.- relates to requirements regarding subcontracts.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 97% Substantial Compliance for the providers surveyed this year.
9.A.4. (The provider develops and implements a written management plan describing how the agency conducts its business and specifying the provider’s processes for protecting the health, safety and welfare of
persons whom it supports.) Of the providers surveyed in September 2010, 93% achieved Substantial Compliance with this Indicator. Cumulative performance is at 97% Substantial Compliance for the providers
surveyed this year.
9.B.2. (Provider staff have received appropriate training and, as needed, focused or additional training to meet the needs of the person.) Of the providers surveyed in September 2010, 53% achieved Substantial
Compliance with this Indicator. Cumulative performance is at 66% Substantial Compliance for the providers surveyed this year.

As represented in the graph, 24 (28%) Day-Residential providers have performed in the Exceptional Performance category, 41 (47%) have performed in the Proficient category, 17 (20%) are in the Fair category and
5 (6%) are in the category of Significant Concerns.
Conclusions:
DIDS is continuing close review of Domain 2, Outcomes B and D.
Follow-up on actions taken from the previous reporting periods:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                     22
                                                                                                     Data Management Report
                                                                                                         October 22, 2010




E      Provider Qualifications / Monitoring (II.H., II.K.)
       Personal Assistance                                                   Statewide 9/10                           Cumulative / Statewide 9/10
     1 # of Day and Residential Providers Monitored this                           3                                              13
       Month
     2 Total Census of Providers Surveyed                                         29                                             457
     3 # of Sample Size                                                            6                                              77
     4 % of Individuals Surveyed                                                 21%                                             17%
     5 # of Additional Focused Files Reviewed                                      0                                              0

                                                                          Partial    Minimal    Non-       Substantial Partial         Minimal    Non-
                                                             Substantial  Compliance Compliance compliance Compliance Compliance       Compliance compliance
                                                             Compliance % %          %           %         %           %               %           %
     7 Domain 2. Individual Planning and
       Implementation
     8 Outcome A. The person’s plan reflects his or her             100%         0%           0%       0%          92%          0%            7%         0%
       unique needs, expressed preferences and
       decisions.
     9 Outcome B. Services and supports are provided                 66%        33%           0%       0%          53%         38%            7%         0%
       according to the person’s plan.
    10 Outcome C. Individual risk is assessed and                    66%         0%           0%      33%          76%          7%            0%        15%
       adequate, timely intervention is provided.
    11 Outcome D. The person’s plan and services are                 33%        33%           33%      0%          46%         30%            7%        15%
       monitored for continued appropriateness and
       revised as needed.
    12 Domain 3: Safety and Security
    13 Outcome A. Where the person lives and works is               100%         0%           0%       0%          92%          7%            0%         0%
       safe.
    15 Outcome C. Safeguards are in place to protect                 33%        66%           0%       0%          15%         84%            0%         0%
       the person from harm.
    16 Domain 4: Rights, Respect and Dignity
    17 Outcome A. The person is valued, respected and               100%         0%           0%       0%          100%         0%            0%         0%
       treated with dignity.
    18 Outcome B. The person has a positive image in                100%         0%           0%       0%          100%         0%            0%         0%
       the community.
    19 Outcome C. The person exercises his or her                    66%        33%           0%       0%          92%          7%            0%         0%
       rights.
    20 Outcome D. Restricted interventions are imposed              100%         0%           0%       0%          100%         0%            0%         0%
       only with due process.
    21 Domain 5: Health
    22 Outcome A. The person has the best possible                  100%         0%           0%       0%          66%         25%            0%         8%
       health.
    23 Outcome B. The person takes medications as                                                                  66%         16%            0%        16%
       prescribed.
    24 Outcome C. The person's dietary and nutritional              100%         0%           0%       0%          84%          7%            7%         0%
       needs are adequately met.
    25 Domain 6: Choice and Decision-Making
    26 Outcome A. The person and family members are                 100%         0%           0%       0%          100%         0%            0%         0%
       involved in decision-making at all levels of the
       system.
    27 Outcome B. The person and family members have                100%         0%           0%       0%          100%         0%            0%         0%
       information and support to make choices about
       their lives.




                                                                                                              23
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




E      Provider Qualifications / Monitoring (II.H., II.K.)                 Partial    Minimal    Non-       Substantial Partial      Minimal    Non-
                                                              Substantial  Compliance Compliance compliance Compliance Compliance    Compliance compliance
                                                              Compliance % %          %           %         %           %            %           %
    35 Domain 9: Provider Capabilities and
       Qualifications
    36 Outcome A. The provider meets and maintains                    33%        33%         33%        0%          46%        30%         15%         7%
       compliance with applicable licensure and provider
       agreement requirements.
    37 Indicator 9.A.1.: The provider meets and                      100%                               0%          100%                               0%
       maintains compliance with applicable licensure,
       certification and contract requirements.
    38 Indicator 9.A.2.: The provider complies with                  100%                               0%          100%                               0%
       requirements in the provider agreement.
    39 Indicator 9.A.4.: The provider develops and                   100%                               0%          92%                                7%
       implements a written management plan describing
       how the agency conducts its business and
       specifying the provider's processes for protecting
       the health, safety and welfare of the persons
       whom it supports.
    40 Outcome B. Provider staff are trained and meet                 66%        33%          0%        0%          46%        46%          7%         0%
       job specific qualifications.
    41 Indicator 9.B.2.: Provider staff have received                 66%                              33%          46%                               53%
       appropriate training and, as needed, focused or
       additional training to meet the needs of the person.

    42 Outcome C. Provider staff are adequately                       33%        66%          0%        0%          46%        46%          7%         0%
       supported.
    43 Outcome D. Organizations receive guidance from                100%         0%          0%        0%          92%        7%           0%         0%
       a representative board of directors or a
       community advisory board.
    44 Domain 10: Administrative Authority and
       Financial Accountability
    45 Outcome A. Providers are accountable for DIDS                  66%        33%          0%        0%          84%        15%          0%         0%
       requirements related to the services and supports
       that they provide.




                                                                                                               24
                                                                                                              Data Management Report
                                                                                                                  October 22, 2010




                                                                       Cumulative Performance Ratings Across All Regions- Personal Assistance
                                    5


                                    4

               Number of Agencies
                                    3
                                                                                                                                                                                                  Exceptional Performance
                                                                                                                                                                                                  Proficient
                                    2                                                                                                                                                             Fair
                                                                                                                                                                                                  Significant Concerns
                                    1                                                                                                                                                             Serious Deficiencies


                                    0
                                                      East                                                 Middle                                                     West
                                                                                                     Performance Ratings


Analysis:
Note- Statewide and Cumulative / Statewide data in the table above may sometimes exceed or be just below 100% due to the numerical rounding functions during calculations
Providers reviewed: Middle: Sitters and More; West: CAK, Mic’s Place.

In the Middle Region:
Sitters and More- Scored Proficient on the QA survey with no Domains scoring less than Partial Compliance. No concerns.
In the West Region:
Mic’s Place – first full survey completed for this microboard; Domain 2 and Outcomes 2C, 2D and 9A scored MC or NC; all other Domains and Outcomes scored at least PC. Areas needing attention include daily
notes did not document implementation of several ISP outcomes/action steps and at the time of their initial review did not provide time in/out of the service; staff from each shift do not write notes with one staff only
writing all notes; no RIIT presented; no formal planning to address person’s behavioral issues that have resulted in use of manual restraint at times; no evidence of formal training for staff regarding appropriate
techniques for addressing the person’s behavioral issues.
Monthly reviews did not note lack of ISP outcome/action implementation; though provider did request change to draft ISP [current final ISP reportedly is not appropriate for the person in several places], additional
communication with the ISC to initiate ISP changes was not evident; agency IMC has not completed approved DIDS training; RIFs not completed/ submitted for use of emergency manual restraint; person is
manually restrained if, in the opinion of staff, behaviors warrant this; no current evidence of any self assessment or quality improvement planning activities; 2 of 2 staff did not have current CPR training and 1 of 2
did not have current First Aid training; and no documentation reflecting implementation of the supervision plan.
CAK – PA/Day microboard scored 50 of 54/Proficient; Outcome 10B is the only Outcome or Domain scoring less than PC. Areas of concern noted include late background & registry checks and incomplete self
assessment and absent quality improvement planning processes. Compliance with personal funds management requirements was not evident the majority of the review period; at the time of the survey, parents
were almost done transferring responsibility for being rep payee and personal funds management requirements should not apply from this point forward.
The following Outcomes are being studied by DIDS.
Domain 2, Outcome B (Services and Supports are provided according to the person’s plan.)
Of the providers surveyed in September 2010, 66% achieved Substantial Compliance with this Outcome. Cumulative performance is at 53% Substantial Compliance for the providers surveyed this year.

Domain 2, Outcome D (The person’s plan and services are monitored for continued appropriateness and revised as needed.)
Of the providers surveyed in September 2010, 33% achieved Substantial Compliance with this Outcome. Cumulative performance is at 46% Substantial Compliance for the providers surveyed this year.

The following QA Indicators are being tracked to meet requirements of CMS Special Terms and Conditions of Approval and / or TennCare.
9.A.1. (The provider meets and maintains compliance with applicable licensure, certification, and contract requirements.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.
9.A.2. (The provider complies with requirements in the provider agreement.- relates to requirements regarding subcontracts.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.
9.A.4. (The provider develops and implements a written management plan describing how the agency conducts its business and specifying the provider’s processes for protecting the health, safety and welfare of
persons whom it supports.) The providers surveyed in September 2010 achieved Substantial Compliance with this Indicator. Cumulative performance is at 92% Substantial Compliance for the providers surveyed
this year.
9.B.2. (Provider staff have received appropriate training and, as needed, focused or additional training to meet the needs of the person.) Of the providers surveyed in September 2010, 66% achieved Substantial
Compliance with this Indicator. Cumulative performance is at 46% Substantial Compliance for the providers surveyed this year.

As represented in the graph, 3 (23%) providers have performed in the Exceptional Performance category, 7 (54%) have performed in the Proficient category, and 3 (23%) are in the Fair category.
Conclusions and actions taken for the reporting period:
DIDS is continuing close review of Domain 2, Outcomes B and D.
Follow-up on actions taken from the previous reporting periods:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                        25
                                                                                                       Data Management Report
                                                                                                           October 22, 2010




E        Provider Qualifications / Monitoring (II.H., II.K.)

         ISC Providers                                                         Statewide 9/10                           Cumulative / Statewide 9/10
     1   # of ISC Providers Monitored this Month
     2   Total Census of Providers Surveyed
     3   # of Sample Size
     4   % of Individuals Surveyed                                                #DIV/0!                                        #DIV/0!
         # of Additional Focused Files Reviewed
                                                               Substantial  Partial    Minimal    Non-       Substantial Partial      Minimal    Non-
                                                               Compliance % Compliance Compliance compliance Compliance Compliance    Compliance compliance
     5 Domain 1: Access and Eligibility
     6 Outcome A. The person and family members are
       knowledgeable about the HCBS waiver and other
       services, and have access to services and choice
       of available qualified providers.
     7 Domain 2: Individual Planning and
       Implementation
     8 Outcome A. The person's plan reflects his or her
       unique needs, expressed preferences and
       decisions.
     9 Indicator 2.A.4.: Current and appropriate
       assessments of the person's abilities, needs and
       desires for the future are used in developing the
       plan.
    10 Outcome B. Services and supports are provided
       according to the person's plan.
    11 Outcome C. Individual risk is assessed and
       adequate timely intervention is provided.
    12 Outcome D. The person's plan and services are
       monitored for continued appropriateness and
       revised as needed.
    13 Domain 3: Safety and Security
    14 Outcome A. Where the person lives and works is
       safe.
    15 Outcome B. The person has a sanitary and
       comfortable living arrangement.
    16 Outcome C. Safeguards are in place are in place
       to protect the person from harm.
    17 Domain 9: Provider Capabilities and
       Qualifications
    18 Outcome A. The provider meets and maintains
       compliance with applicable licensure and provider
       agreement requirements.
    19 Indicator 9.A.2.: The provider complies with
       requirements in the provider agreement.
    20 Outcome B. Provider staff are trained and meet
       job specific qualifications.
    21 Indicator 9.B.2.: Provider staff have received
       appropriate training and, as needed, focused or
       additional training to meet the needs of the person.

    22 Outcome C. Provider Staff are adequately
       supported.
    23 Outcome D. Organizations receive guidance from
       a representative board of directors or a
       community advisory board.
    24 Domain 10: Administrative Authority and
       Financial Accountability
    25 Outcome A. Providers are accountable for DIDS
       requirements related to the services and supports
       that they provide.




                                                                                                                26
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




                                                                     Cumulative Performance Ratings Across All Regions- ISC
                      2
 Number of Agencies




                                                                                                                                                                           1 Exceptional Performance

                                                                                                                                                                           2 Proficient

                      1                                                                                                                                                    3 Fair

                                                                                                                                                                           4 Significant Concerns

                                                                                                                                                                           5 Serious Deficiencies




                      0
                                          East                                               Middle                                                 West
                                                                                       Performance Ratings



Analysis:
Providers reviewed: no reviews.

Conclusions and actions taken for the reporting period:
Close monitoring of the Outcomes will continue throughout the fiscal year.
Follow-up on actions taken from previous reporting periods:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                27
                                                                                                      Data Management Report
                                                                                                          October 22, 2010




E        Clinical Providers- Behavioral                                       Statewide 9/10                           Cumulative / Statewide 9/10
     1   # of Clinical Providers Monitored for the month                                                                            9
     2   Total Census of Providers Surveyed                                                                                       476
     3   # of Sample Size                                                                                                          42
     4   % of Individuals Surveyed                                               #DIV/0!                                           9%
         # of Additional Focused Files Reviewed                                    0                                                0

                                                                           Partial    Minimal    Non-       Substantial Partial       Minimal    Non-
                                                              Substantial  Compliance Compliance compliance Compliance Compliance     Compliance compliance
                                                              Compliance % %          %          %          %           %             %          %
     5 Domain 2: Individual Planning and
       Implementation
     6 Outcome A. The person's plan reflects his or her                                                             87%          0%          12%        0%
       unique needs, expressed preferences and
       decisions.
     7 Outcome B. Services and supports are provided                                                                77%         11%          11%        0%
       according to the person's plan.
     8 Outcome C. Individual risk is assessed and                                                                   77%         11%          11%        0%
       adequate, timely intervention is provided.
     9 Outcome D. The person's plan and services are                                                                100%         0%           0%        0%
       monitored for continued appropriateness and
       revised as needed.
    10 Domain 3: Safety and Security
    11 Outcome A. Where the person lives and works is                                                               100%         0%           0%        0%
       safe.
    12 Outcome C. Safeguards are in place to protect                                                                66%         22%          11%        0%
       the person from harm.
    13 Domain 4: Rights, Respect and Dignity
    14 Outcome A. The person is valued, respected, and                                                              100%         0%           0%        0%
       treated with dignity.
    15 Outcome D. Restricted interventions are imposed                                                              100%         0%           0%        0%
       only with due process.
    16 Domain 6: Choice and Decision-Making
    17 Outcome A. The person and family members are                                                                 88%          0%           0%       11%
       involved in decision-making at all levels of the
       system.
    18 Domain 9: Provider Capabilities and
       Qualifications
    19 Outcome A. The provider meets and maintains                                                                  33%         55%          11%        0%
       compliance with applicable licensure and provider
       agreement requirements.
    20 Indicator 9.A.1.: The provider meets and                                                                     100%                                0%
       maintains compliance with applicable licensure,
       certification and contract requirements.
    21 Indicator 9.A.2.: The provider complies with                                                                 88%                                11%
       requirements in the provider agreement.
    22 Outcome B. Provider staff are trained and meet                                                               100%         0%           0%        0%
       job specific qualifications.
    23 Indicator 9.B.2.: Provider staff have received                                                               100%                                0%
       appropriate training and, as needed, focused or
       additional training to meet the needs of the person.

    24 Outcome C. Provider staff are adequately                                                                     100%         0%           0%        0%
       supported.
    25 Domain 10: Administrative Authority and
       Financial Accountability
    26 Outcome A. Providers are accountable for DIDS                                                                88%          0%          11%        0%
       requirements related to the services and supports
       that they provide.




                                                                                                               28
                                                                                                           Data Management Report
                                                                                                               October 22, 2010




                                                                      Cumulative Performance Ratings Across All Regions- Clinical- Behavioral
                                     4



                                     3
                Number of Agencies




                                     2                                                                                                                                                   1 Exceptional Performance
                                                                                                                                                                                         2 Proficient
                                                                                                                                                                                         3 Fair

                                     1                                                                                                                                                   4 Significant Concerns
                                                                                                                                                                                         5 Serious Deficiencies



                                     0
                                                     East                                                Middle                                              West
                                                                                                  Performance Ratings



Analysis:
Note- Statewide and Cumulative / Statewide data in the tables above may sometimes exceed or be just below 100% due to the numerical rounding functions during Excel calculations.
Behavioral: no reviews
In the West Region:
Quality Care Behavior Services – consultation survey completed for this independent provider who began providing BA services 7/16/10 and was serving 11 people at the time of the consult. Surveyor comments
reflected the need to ensure the BSP sections were as per updated DIDS requirements, to include dates of service provision on all CSMRs, and to ensure evidence of participation in Regional Office New Behavior
Service Provider Orientation is maintained.
As shown in the graph, the 7 (78%) of the providers reviewed thus far this year are in the Exceptional Performance category, 1 (11%) is in the Proficient category, and 1 (11%) is in the Serious Deficiencies category.


Conclusions and actions taken for the reporting period:
Close monitoring of the Outcomes will continue throughout the fiscal year.


Follow-up on actions taken from previous reporting periods:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                        29
                                                                                                        Data Management Report
                                                                                                            October 22, 2010




E        Clinical Providers- Nursing                                            Statewide 9/10                           Cumulative / Statewide 9/10
     1   # of Clinical Providers Monitored for the month                                                                              5
     2   Total Census of Providers Surveyed                                                                                          66
     3   # of Sample Size                                                                                                            15
     4   % of Individuals Surveyed                                                   #DIV/0!                                        23%
         # of Additional Focused Files Reviewed                                                                                       0
                                                                Substantial  Partial      Minimal  Non-       Substantial Partial       Minimal      Non-
                                                                Compliance % Compliance Compliance compliance Compliance Compliance Compliance compliance
     5 Domain 2: Individual Planning and
       Implementation
     6 Outcome A. The person's plan reflects or her                                                                   80%        20%        0%        0%
       unique needs, expressed preferences and
       decisions.
     7 Outcome B. Services and supports are provided                                                                  60%        40%        0%        0%
         according to the person's plan.
     8   Outcome C. Individual risk is assessed and                                                                   100%        0%        0%        0%
         adequate, timely intervention is provided.
     9   Outcome D. The person's plan and services are                                                                40%        40%       20%        0%
         monitored for continued appropriateness and
         revised as needed.
    10   Domain 3: Safety and Security
    11   Outcome A. Where the person lives and works is                                                               100%        0%        0%        0%
    12   safe.
         Outcome C. Safeguards are in place to protect                                                                 0%        100%       0%        0%
         the person from harm.
    13   Domain 4: Rights, Respect and Dignity
    14   Outcome A. The person is valued, respected, and                                                              100%        0%        0%        0%
         treated with dignity.
    15   Outcome D. Restricted interventions are imposed                                                               0%        100%       0%        0%
         only with due process.
    16   Domain 5: Health
    17   Outcome A. The person has the best possible                                                                  80%        20%        0%        0%
    18   health. B. The person takes medications as
         Outcome                                                                                                      60%        20%       20%        0%
         prescribed.
    19   Outcome C. The person’s dietary and nutritional                                                              100%        0%        0%        0%
         needs are adequately met.
    20   Domain 6: Choice and Decision-Making
    21   Outcome A. The person and family members are                                                                 80%        20%        0%        0%
         involved in decision-making at all levels of the
    22   system. 9: Provider Capabilities and
         Domain
         Qualifications
    23   Outcome A. The provider meets and maintains                                                                  40%        60%        0%        0%
         compliance with applicable licensure and provider
         agreement requirements.
    24   Indicator 9.A.1.: The provider meets and                                                                     100%                            0%
         maintains compliance with applicable licensure,
         certification and contract requirements.
    25   Indicator 9.A.2.: The provider complies with                                                                 100%                            0%
         requirements in the provider agreement.
    26   Outcome B. Provider staff are trained and meet                                                               60%        40%        0%        0%
         job specific qualifications.
    27   Indicator 9.B.2.: Provider staff have received                                                               50%                            50%
         appropriate training and, as needed, focused or
         additional training to meet the needs of the person.

    28 Outcome C. Provider staff are adequately                                                                       80%        20%        0%        0%
    29 supported. Administrative Authority and
       Domain 10:
       Financial Accountability
    30 Outcome A. Providers are accountable for DIDS                                                                  80%        20%        0%        0%
       requirements related to the services and supports
       that they provide.




                                                                                                                 30
                                                                                                             Data Management Report
                                                                                                                 October 22, 2010




                                                                             Cumulative Performance Ratings Across All Regions- Clinical- Nursing
                                      2




                 Number of Agencies
                                      1


                                                                                                                                                                                             1 Exceptional Performance

                                                                                                                                                                                             2 Proficient

                                                                                                                                                                                             3 Fair

                                                                                                                                                                                             4 Significant Concerns
                                      0
                                                                                                                                                                                             5 Serious Deficiencies
                                                         East                                                      Middle                                                    West
                                                                                                             Performance Ratings


Analysis:
Nursing: No reviews
As shown in the graph, 1 (20%) of the providers reviewed thus far this year is in the Exceptional Performance category, 2 (40%) are in the Proficient category, and 2 (40%) is performing in the Fair category.

Conclusions and actions taken for the reporting period:
Close monitoring of the Outcomes will continue throughout the fiscal year.

Follow-up on actions taken from previous reporting period:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                        31
                                                                                                        Data Management Report
                                                                                                            October 22, 2010




E        Clinical Providers- Therapy                                            Statewide 9/10                           Cumulative / Statewide 9/10
     1   # of Clinical Providers Monitored for the month                               2                                             15
     2   Total Census of Providers Surveyed                                           86                                           1047
     3   # of Sample Size                                                             10                                            100
     4   % of Individuals Surveyed                                                   12%                                            10%
     5   # of Additional Focused Files Reviewed                                        0                                              0

                                                                             Partial    Minimal    Non-       Substantial Partial       Minimal    Non-
                                                                Substantial  Compliance Compliance compliance Compliance Compliance     Compliance compliance
                                                                Compliance % %          %          %          %           %             %          %
       Domain 2: Individual Planning and
     6 Implementation
       Outcome A. The person's plan reflects or her
       unique needs, expressed preferences and
     7 decisions.                                                      100%         0%           0%       0%          86%         13%           0%        0%
       Outcome B. Services and supports are provided
     8 according to the person's plan.                                  50%        50%           0%       0%          33%         33%          26%        6%
       Outcome C. Individual risk is assessed and
     9 adequate, timely intervention is provided.                       50%         0%           50%      0%          46%         40%          13%        0%
       Outcome D. The person's plan and services are
       monitored for continued appropriateness and
    10 revised as needed.                                               50%         0%           50%      0%          33%         26%          40%        0%
    11 Domain 3: Safety and Security
       Outcome A. Where the person lives and works is
    12 safe.                                                            50%        50%           0%       0%          93%          6%           0%        0%
       Outcome C. Safeguards are in place to protect
    13 the person from harm.                                           100%         0%           0%       0%          93%          6%           0%        0%
    14 Domain 4: Rights, Respect and Dignity
       Outcome A. The person is valued, respected, and
    15 treated with dignity.                                           100%         0%           0%       0%          100%         0%           0%        0%
       Outcome D. Restricted interventions are imposed                 100%         0%           0%       0%          100%         0%           0%        0%
    16 only with due process.
    17 Domain 6: Choice and Decision-Making
       Outcome A. The person and family members are
       involved in decision-making at all levels of the
    18 system.                                                         100%         0%           0%       0%          100%         0%           0%        0%
       Domain 9: Provider Capabilities and
    19 Qualifications
       Outcome A. The provider meets and maintains
       compliance with applicable licensure and provider
    20 agreement requirements.                                          50%        50%           0%       0%           53%        40%           6%        0%
       Indicator 9.A.1.: The provider meets and                        100%                               0%          100%                                0%
       maintains compliance with applicable licensure,
    21 certification and contract requirements.
       Indicator 9.A.2.: The provider complies with                    100%                               0%          100%                                0%
    22 requirements in the provider agreement.
       Outcome B. Provider staff are trained and meet
    23 job specific qualifications.                                    100%         0%           0%       0%          100%         0%           0%        0%
                                                                       100%                               0%          100%                                0%
         Indicator 9.B.2.: Provider staff have received
         appropriate training and, as needed, focused or
    24   additional training to meet the needs of the person.
         Outcome C. Provider staff are adequately                      100%         0%           0%       0%          90%          9%           0%        0%
    25   supported.
         Domain 10: Administrative Authority and
    26   Financial Accountability
         Outcome A. Providers are accountable for DIDS
         requirements related to the services and supports
    27   that they provide.                                            100%         0%           0%       0%          66%         26%           6%        0%




                                                                                                                 32
                                                                                                            Data Management Report
                                                                                                                October 22, 2010




                                                                        Cumulative Performance Ratings Across All Regions- Clinical- Therapy
                                    6

                                    5




               Number of Agencies
                                    4
                                                                                                                                                                                             1 Exceptional Performance

                                    3                                                                                                                                                        2 Proficient

                                                                                                                                                                                             3 Fair
                                    2
                                                                                                                                                                                             4 Significant Concerns
                                    1
                                                                                                                                                                                             5 Serious Deficiencies

                                    0
                                                    East                                                Middle                                                  West
                                                                                                  Performance Ratings


Analysis:
Reviews: East: Dynamic Dietetics, Focus on Function; Middle: no reviews; West: no reviews.
In the East Region:
Focus on Function, Inc. - This OT provider serves people residing in both the Middle and East Regions. As the office is maintained in the Chattanooga area, the survey was conducted by the East Region with
information provided by the Middle Region for some individuals included in the sample. The survey resulted in an overall performance rating of Fair, score of 30, which reflects a decrease from the previous survey
which resulted in an overall performance rating of Proficient, score of 32. Due to issues pertaining to the procurement of needed equipment, lapses in the identification of emerging risks/interventions to address risk
issues and a lack of follow-up to address/resolve identified issues resulted in a decrease in the results for Domain 2 from PC to MC. Domain 3 was maintained at PC as the provider's system for identifying
measures to be taken when safety issues are identified needs to be strengthened. All other applicable Domains resulted in SC; 4, 6, 9 and 10.
Dynamic Dietetics, Inc. - This Nutrition provider serves people residing in both the Middle and East Regions. As the office is maintained in the Chattanooga area, the survey was conducted by the East Region with
information provided by the Middle Region for some individuals included in the sample. The survey resulted in an overall performance rating of Exceptional, score of 36, the highest possible with all applicable
Domains resulting in SC. It is also significant to note that all applicable Indicators also resulted in Y.

Summit View Health Services - East - A consultative survey was conducted in order to focus specifically on the newly added Speech Language Therapy service; the agency's provision of Nutrition services has been
well established for quite some time and the agency was designated as a Four Star agency in 2010, hence, exempt from a regular, annual, survey. Some improvements were indicated in the areas of service
delivery covered by Domain 2 pertaining to the completion of assessments, documentation, processes to assure competence in risk management and information needing to be clearly identified in discharge
summaries. The agency is encouraged to strengthen processes to more clearly show how input from family members and individuals is utilized and to maintain complete records.
In the West Region:
Lifestyle Nutrition – consultation survey completed for this independent RD who began providing services in April 2010; at the time of the visit, she was supporting 55 people. Surveyor comments reflected a need to
regularly review and, as indicated, update agency policies to ensure they continually reflect current operation. No other issues were noted.

Kimberly Musicante, OT - consultation survey completed for this independent provider who began providing OT services in July 2010 and was serving 7 people at the time of the review. Surveyor comments
reflected no systemic or individual concerns.

The following QA Indicators are being tracked to meet requirements of CMS Special Terms and Conditions of Approval and / or TennCare.
9.A.1. (The provider meets and maintains compliance with applicable licensure, certification, and contract requirements.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.
9.A.2. (The provider complies with requirements in the provider agreement.- relates to requirements regarding subcontracts.) The providers surveyed in September 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.
9.B.2. (Provider staff have received appropriate training and, as needed, focused or additional training to meet the needs of the person.) The providers surveyed in September 2010 achieved Substantial
Compliance with this Indicator. Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.

As shown in the graph, the 6 (40%) of the providers reviewed thus far this year are in the Exceptional Performance category, 2 (13%) is in the Proficient category, and 7 (47%) are performing in the Fair category.


Conclusions and actions taken for the reporting period:
Close monitoring of the Outcomes will continue throughout the fiscal year.

Follow-up in actions taken from previous reporting period:
All survey findings are reported to the RQMC for review and determination of actions to be taken. RQMC recommendations are then reviewed by the SQMC for final approval.




                                                                                                                      33
                                                                                                         Data Management Report
                                                                                                             October 22, 2010




                                                       Cumulative Performance Ratings Across All Regions / All Types
                      30


                      25
 Number of Agencies




                      20

                                                                                                                                                                                          Exceptional Performance
                      15                                                                                                                                                                  Proficient
                                                                                                                                                                                          Fair
                                                                                                                                                                                          Significant Concerns
                      10
                                                                                                                                                                                          Serious Deficiencies

                       5


                       0
                                     East                                                     Middle                                                        West
                                                                                        Performance Ratings


Graph of all Providers:

Analysis:
As represented in the graph, 41 providers (32%) have performed at the level of Exceptional Performance, 53 providers (41%) have performed at the Proficient level, 29 providers (22%) have performed in the Fair
category, 5 (4%) are in the category of Significant Concerns and one provider (1%) is in the category of Serious Deficiencies.




                                                                                                                   34
                                                                                                       Data Management Report
                                                                                                           October 22, 2010




E    Provider Qualifications / Monitoring (II.H., II.K.) Personal Funds
Data Source:

Data collected for the personal funds information is garnered from the annual QA survey. The number of Individual Personal Funds reviewed is based on the sample size for each survey, approximately 10%. Also,
personal funds are reviewed only if the provider agency is the Representative Payee. DIDS does not have authority to review personal funds managed by other entities.

         Personal Funds - East                                                            Jul-10     Aug-10       Sep-10        Oct-10      Nov-10       Dec-10       Jan-11       Feb-11     Mar-11     Apr-11       May-11    Jun-11
         # of Individual Personal Funds Accounts
     1   Reviewed                                                                             26          15           15
         # of Individual Personal Funds Accounts Fully
     2   Accounted For                                                                       26           13            7
     3   # of Personal Funds Accounts Found Deficient                                         0            2            8
     4   % of Personal Funds Fully Accounted for                                          100%          87%           47%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!
     5   % of Personal Funds Found Deficient                                                0%          13%           53%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!

         Personal Funds - Middle                                                          Jul-10     Aug-10       Sep-10        Oct-10      Nov-10       Dec-10       Jan-11       Feb-11     Mar-11     Apr-11       May-11    Jun-11
         # of Individual Personal Funds Accounts
     6   Reviewed                                                                              9          12           19
         # of Individual Personal Funds Accounts Fully
     7   Accounted For                                                                       9            11             9
     8   # of Personal Funds Accounts Found Deficient                                        0             1            10
     9   % of Personal Funds Fully Accounted for                                          100%          92%           47%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!
    10   % of Personal Funds Found Deficient                                                0%           8%           53%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!

       Personal Funds - West                                                              Jul-10     Aug-10       Sep-10        Oct-10      Nov-10       Dec-10       Jan-11       Feb-11     Mar-11     Apr-11       May-11    Jun-11
       # of Individual Personal Funds Accounts
    11 Reviewed                                                                                8          16            9
       # of Individual Personal Funds Accounts Fully
    12 Accounted For                                                                          5           9             8
    13 # of Personal Funds Accounts Found Deficient                                           3           7             1
    14 % of Personal Funds Fully Accounted for                                              63%          NA           89%       #DIV/0!         NA      #DIV/0!           NA      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!
    15 % of Personal Funds Found Deficient                                                  38%          NA           11%       #DIV/0!         NA      #DIV/0!           NA      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!   #DIV/0!

       Personal Funds - Statewide                                                         Jul-10     Aug-10       Sep-10        Oct-10      Nov-10       Dec-10       Jan-11       Feb-11     Mar-11     Apr-11       May-11    Jun-11
       # of Individual Personal Funds Accounts
    16 Reviewed                                                                               43          43           43             0           0           0             0           0           0             0        0         0
       # of Individual Personal Funds Accounts Fully
    17 Accounted For                                                                          40          33            24            0           0           0            0            0           0         0             0       0
    18 # of Personal Funds Accounts Found Deficient                                            3          10            19            0           0           0            0            0           0         0             0       0
    19 % of Personal Funds Fully Accounted For                                              93%         77%           56%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0! #DIV/0!
    20 % of Personal Funds Found Deficient                                                   7%         23%           44%       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0! #DIV/0!


E        Provider Qualifications / Monitoring (II.H., II.K.) Personal Funds


    21 Cumulative Funds Data                                                  Jul-10     Aug-10      Sep-10       Oct-10        Nov-10      Dec-10       Jan-11       Feb-11       Mar-11     Apr-11     May-11       Jun-11
       # of Individual Personal Funds Accounts
    22 Reviewed                                                                 271         314         357
       # of Individual Personal Funds Accounts Fully
    23 Accounted For                                                            230         263          287
    24 # of Personal Funds Accounts Found Deficient                              41          51           70
    25 % Funds Accounted for, Cumulatively                                     85%          84%         80%       #DIV/0!       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!
    26 % Funds Deficient, Cumulatively                                         15%          16%         20%       #DIV/0!       #DIV/0!     #DIV/0!     #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!   #DIV/0!       #DIV/0!




                                                                                                                 35
                                                                                                            Data Management Report
                                                                                                                October 22, 2010




E     Provider Qualifications / Monitoring (II.H., II.K.) Personal Funds
Analysis:
The criteria used for determining if personal funds are fully accounted for is tied to compliance with all requirements in the Personal Funds Management Policy.
In the East Region, 47% of personal funds were fully accounted for.
In the Middle Region, 47% of personal funds were fully accounted for.
In the West Region, 89% of personal funds were fully accounted for.
Statewide, 56% of funds were fully accounted for in September 2010.
Among the issues identified with personal funds management included:

East Region:
Adult Community Training (ACT): Of the 7 accounts reviewed, 5 were considered to be fully accounted for. Issues pertaining to the 2 accounts found deficient were: payments and deposits not always identified
with a check number, personal allowance in the home goes over-limit, cash logs not accurate and ending balances do not match beginning balances, community money over-limit, missing lease, payroll stubs
missing, and missing receipts.

Lakeway Achievement Center: Of the 6 accounts reviewed, 2 were considered to be fully accounted for. Issues pertaining to the 4 accounts found deficient were: Documentation missing for bank deposits,
payments to the agency that were not owed, utility bills lacked details of the service, duplicate payment for Dollywood pass, change left from checks not redeposited, personal allowance logs not accurate and not
legible, inventory not updated timely, check written and not used or voided, unclear if all food receipts were used in splitting expense, late charges, utility payment not split between roommates, check numbers not
on payments or deposits leaving no audit trail, and food and supply expense not reconciled monthly.
Rhea of Sunshine: Of the 2 accounts reviewed, both accounts were found deficient. Issues with the 2 accounts were: Documents showing source and the amount of personal funds received were lacking, person
signed for her allowance money and receipts were not maintained even though the ISP does not indicate that she can make purchases without staff assistance, allowance logs were not accurate and ending
balances did not match the beginning balance on the next log, minimal spending activity, no ledger for cash given to the workshop and personal property inventories did not always include components needed to
protect the person's property.
Middle Region:
Homeplace- Two out of two files reviewed required minimal personal funds reimbursement and much improvement noted in the fiscal overview of personal funds.

Omni-Visions- Three out of three files reviewed required reimbursement of personal funds with lack of receipts or documentation kept of personal spending.

RHA- Three out of four files reviewed required reimbursement of personal funds for lack of receipts and one family-based provider had no records of the individuals monies. This issue was referred to internal audit
for review and disposition.

Starcare- Three individuals reviewed had adequate documentation to support personal funds management.

Restoration Residential- A new agency with 1 out of 2 individuals records reviewed requiring reimbursement of personal funds with lack of adequate documentation to reconcile spending.

RCAAC- Only one out of the 5 records reviewed required reimbursement of personal funds for failure to maintain receipts appropriately.
West Region:
Brenda Richardson Memorial Care Homes - The agency’s inventory did not include P-008 3.g.5. “Inventories of personal property shall be updated in a timely manner (i.e., on the day of the occurrence or the
following morning) to indicate personal property removed from or brought into the home, as described above, and must include dated signatures of the individuals who supplied or disposed of the personal property.”
 Two out of the four service recipients are due reimbursements for one missing receipt and a money order fee.

C.S. Patterson - Out of the four individuals surveyed only one and a missing receipt. One household did not have food stamps divided equally on several occasions. One lacked an adequate inventory list. One of
the personal funds log had several math errors. Three of four were receiving more personal funds cash than the ISP stated was adequate.
Mosaic - No personal funds review completed as 100% audit for entire review period being completed by FAR/IA.

Mic's Place - Personal funds requirements not applicable to this microboard

CAK - At last year's review of this microboard, the family stated their intention was that the parent who was not the Representative Payee would be the paid staff; however, this did not occur until July 5, 2010.
Conclusions and actions taken for the reporting period:
None

Follow-up action taken from previous reporting periods:
The Quality Management Committee will continue to analyze data from this area to identify other ways to address concerns.




                                                                                                                       36
                                                                                                         Data Management Report
                                                                                                             October 22, 2010




F    Due Process / Freedom of Choice
Data Source:
Each Regional Office Appeals Director collects data regarding Grier related appeals. The DIDS Central Office Grier Coordinator maintains the statewide database regarding the specifics of the Grier related

     East Region                                             Jul-10         Aug-10        Sep-10      Oct-10      Nov-10        Dec-10        Jan-11      Feb-11       Mar-11        Apr-11      May-11        Jun-11
     SERVICE REQUESTS
     Total Service Requests Received                              2585          2283
     Total Adverse Actions (Incl. Partial Approvals)               179           148
     % of Service Requests Resulting in Adverse
     Actions                                                          7%         6%
     Total Grier denial letters issued                                104         91
     APPEALS RECEIVED
     DELIVERY OF SERVICE
     Delay                                                             1              0
     Termination                                                       0              0
     Reduction                                                         0              0
     Suspension                                                        0              0
     Total Received                                                    1              0
     DENIAL OF SERVICE
     Total Received                                                   17             22
     Total Grier Appeals Received                                     18             22
     Total Non-Grier Appeals Received                                  0              0

     Total appeals overturned upon reconsideration                     1              4

     TOTAL HEARINGS                                                   41             29

     DIRECTIVES
     Directive Due to Notice Content Violation                       0             0
     Directive due to ALJ Ruling in Recipient's Favor                0             1
     Other                                                           5             6
     Total Directives Received                                       5             7
     Overturned Directives                                           0             0
     MCC Directives                                                  0             0
     Cost Avoidance (Estimated)                             $68,525.90       $21,138
     LATE RESPONSES
     Total Late Responses                                             0            0
     Total Days Late                                                  0            0
     Total Fines Accrued (Estimated)                              $0.00        $0.00
     DEFECTIVE NOTICES
     Total Defective Notices Received                                 0            0
     Total Fines Accrued (Estimated)                              $0.00        $0.00
     *fine amount is based on timely responses                        0            0
     PROVISION OF SERVICES
     Delay of Service Notifications Sent (New)                         1              0
     Continuing Delay Issues (Unresolved)                              0              1
     Total days service(s) not provided per
     TennCare ORR                                                     0            0
     Total Fines Accrued (Estimated)                              $0.00        $0.00




                                                                                                                   37
                                                                                           Data Management Report
                                                                                               October 22, 2010




Middle Region                                      Jul-10        Aug-10        Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
SERVICE REQUESTS
Total Service Requests Received                         2292        2747
Total Adverse Actions (Incl. Partial Approvals)          297         364
% of Service Requests Resulting in Adverse
Actions                                                 13%          13%
Total Grier denial letters issued                        194          224
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                        0             0
Termination                                                  0             0
Reduction                                                    0             0
Suspension                                                   0             0
Total Received                                               0             0
DENIAL OF SERVICE
Total Received                                              27            24
Total Grier Appeals Received                                27            24
Total Non-Grier Appeals Received                             0             0

Total appeals overturned upon reconsideration                5             9

TOTAL HEARINGS                                              12            21

DIRECTIVES
Directive Due to Notice Content Violation                    0          0
Directive due to ALJ Ruling in Recipient's Favor             0          1
Other                                                        1          1
Total Directives Received                                    1          2
Overturned Directives                                        0          0
MCC Directives                                               0          0
Cost Avoidance (Estimated)                                  $0    $16,592
LATE RESPONSES
Total Late Responses                                       1               0
Total Days Late                                            1               0
Total Fines Accrued (Estimated)                         $100              $0
DEFECTIVE NOTICES
Total Defective Notices Received                             0         1
Total Fines Accrued (Estimated)                             $0      $500
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                    0             0
Continuing Delay Issues (Unresolved)                         0             0
Total days service(s) not provided per
TennCare ORR                                                 0             0
Total Fines Accrued (Estimated)                              0             0




                                                                                                    38
                                                                                            Data Management Report
                                                                                                October 22, 2010




West Region                                        Jul-10         Aug-10        Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
SERVICE REQUESTS
Total Service Requests Received                         2201         2236
Total Adverse Actions (Incl. Partial Approvals)          168          181
% of Service Requests Resulting in Adverse
Actions                                                     8%         8%
Total Grier denial letters issued                            85         77
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                         0             0
Termination                                                   0             0
Reduction                                                     0             0
Suspension                                                    0             0
Total Received                                                0             0
DENIAL OF SERVICE
Total Received                                               12            10
Total Grier Appeals Received                                 12            10
Total Non-Grier Appeals Received                              0             0

Total appeals overturned upon reconsideration                 3             1

TOTAL HEARINGS                                               13            16

DIRECTIVES
Directive Due to Notice Content Violation                  0             0
Directive due to ALJ Ruling in Recipient's Favor           0             0
Other                                                      2             1
Total Directives Received                                  2             1
Overturned Directives                                      0             0
MCC Directives                                             0             0
Cost Avoidance (Estimated)                           $16,592       $12,384
LATE RESPONSES
Total Late Responses                                          1             0
Total Days Late                                               1             0
Total Fines Accrued (Estimated)                             100             0
DEFECTIVE NOTICES
Total Defective Notices Received                              0         1
Total Fines Accrued (Estimated)                              $0      $500
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                     3             0
Continuing Delay Issues (Unresolved)                          5             5
Total days service(s) not provided per
TennCare ORR                                                  0             0
Total Fines Accrued (Estimated)                               0             0




                                                                                                     39
                                                                                            Data Management Report
                                                                                                October 22, 2010




Statewide                                          Jul-10         Aug-10        Sep-10   Oct-10     Nov-10       Dec-10   Jan-11   Feb-11   Mar-11   Apr-11   May-11   Jun-11
SERVICE REQUESTS
Total Service Requests Received                         7078         7266
Total Adverse Actions (Incl. Partial Approvals)          644          693
% of Service Requests Resulting in Adverse
Actions                                                     9%        10%
Total Grier denial letters issued                           383        392
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                         1             0
Termination                                                   0             0
Reduction                                                     0             0
Suspension                                                    0             0
Total Received                                                1             0
DENIAL OF SERVICE
Total Received                                               56            56
Total Grier Appeals Received                                 57            56
Total Non-Grier Appeals Received                              0             0

Total appeals overturned upon reconsideration                 9            14

TOTAL HEARINGS                                               66            66

DIRECTIVES
Directive Due to Notice Content Violation                  0             0
Directive due to ALJ Ruling in Recipient's Favor           0             2
Other                                                      8             8
Total Directives Received                                  8            10
Overturned Directives                                      0             0
MCC Directives                                             0             0
Cost Avoidance (Estimated)                           $85,117       $50,113
LATE RESPONSES
Total Late Responses                                          2             0
Total Days Late                                               2             0
Total Fines Accrued (Estimated)                             200             0

Total Defective Notices Received                              0          2
Total Fines Accrued (Estimated)                              $0     $1,000
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                     4             0
Continuing Delay Issues (Unresolved)                          5             6
Total days service(s) not provided per
TennCare ORR                                                  0             0
Total Fines Accrued (Estimated)                               0             0




                                                                                                     40
                                                                                                                        Data Management Report
                                                                                                                            October 22, 2010




 Appeals:

DIDS received 56 appeals in August which is a 2% decrease in volume compared to the previous month. Statewide, 7266 service requests were submitted in August which is a 3% increase in volume compared
to the previous month. The percentage of service requests resulting in adverse actions increased 1% for August compared to th e previous month.


 Directives:

A total of 10 directives were received statewide in the month of August.

The East Region received 7 directives. 1 directive regarded a request for SL6-IND for the ISP year. The region had approved SL4-IND and a SLSNADJ for the ISP year. The ALJ ruled in favor of the recipient. 2
directives were the result of TennCare overturning the region’s denial upon medical necessity review. The appeals regarded 24 ,820 units of LPN for the ISP year and 64 units per day of LPN for the ISP year. 1
directive regarded a request for 24 hrs per day in PA services where the region agreed to provide the care as requested.

A total of 10 directives were received statewide in the month of August.

The East Region received 7 directives. 1 directive regarded a request for SL6-IND for the ISP year. The region had approved SL4-IND and a SLSNADJ for the ISP year. The ALJ ruled in favor of the recipient. 2
directives were the result of TennCare overturning the region’s denial upon medical necessity review. The appeals regarded 24 ,820 units of LPN for the ISP year and 64 units per day of LPN for the ISP year. 1
directive regarded a request for 24 hrs per day in PA services where the region agreed to provide the care as requested.

1 directive regarded a request for 16 hours a day in PA services where the region agreed to provide10 hrs per day during the week, 16 hrs per day on weekends and CBDay-4 for the ISP year. This decision
resulted in a cost avoidance (see below). The remaining 2 directives were the result of the ALJ ruling in favor of the region regarding requests for SL4-2 for the ISP year where the region had approved SL3-2 as the
medically necessary alternative. This resulted in a cost avoidance (see below)

The West Region received 1 directive regarding a request for 17,788 units of PA services for the ISP year. The region approve d 14,432 units for the ISP year as the medically necessary alternative. The ALJ upheld
the region’s denial which resulted in cost avoidance (see below).

The Middle Region received 2 directives. 1 directive regarded a request for SL3-IND for the ISP year. The region approved SL3-2 for the ISP year as the medically necessary alternative. The ALJ ruled in favor of
DIDS. This resulted in a cost avoidance (see below). The remaining directive regarded a request for SL4 -IND for the ISP year where the ALJ ruled in favor of the recipient.



Cost Avoidance:


 2 directives were received regarding East Region appeals where the ALJ ruled in favor of the region’s denials and another directive was received where the region partially approved the requested service.
 These directives resulted in a cost avoidance of $21,137.88.

 The ALJ ruled in favor of the West Region regarding an appeal which resulted in a cost avoidance of $12,383.64.

 The ALJ ruled in favor of the Middle Region regarding an appeal which resulted in a cost avoidance of $16,591.50.

 The Division’s estimated cost avoidance for the month of August 2010 is $167,999.06 and is $2,056,780.31 for the year.


 Sanctioning/Fining Issues:
  There was no delay of service issues received in this month. There are 9 ongoing delays which have carried over from the previous month.
 Late Responses

 Statewide, there were no late responses for this month.

 Defective Notices:

 Statewide, 2 defective notices were received this month. The Middle region received 1 due to listing the service amount incor rectly and the other was received by the West region due to citing incorrect legal basis
 for denial. This resulted in a total fine amount of $1,000.00.




                                                                                                                                    41

								
To top