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					          THE STATE OF TENNESSEE

DEPARTMENT OF FINANCE AND ADMINISTRATION

            BUREAU OF TENNCARE

                    AND

DIVISION OF INTELLECTUAL DISABLITIES SERVICES




   DATA MANAGEMENT REPORT

               June 28, 2010
                               TABLE OF CONTENTS

                   QUALITY MANAGEMENT DATA REPORT

                                        June 25, 2010


                                                        Page

A. Demographics for HCBS Waiver Recipients                 1
B. Transitions, Enrollment and Conversions                 3
C. Waiting List Demographics                               7
D. Protection From Harm                                   11
     Complaints                                           11
     Incidents                                            16
     Investigations                                       18
E. Provider Qualifications/Monitoring                     20
     Day-Residential Providers                            20
     Personal Assistance                                  24
     ISC Providers                                        27
     Behavioral Providers                                 29
     Nursing Providers                                    31
     Therapy Providers                                    33
     Personal Funds                                       36
F. Due Process/Freedom Of Choice                          38
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A   Demographics for HCBS Waiver Recipients

Data Source:
The census represents the number of waiver recipients as of the last day of 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. SD Waiver
Demographics are taken from Regional Office Intake Unit's databases.
DIDS Demographics HCBS and ADC Waiver Only (CS                        Jul-09       Aug-09        Sep-09      Oct-09      Nov-09           Dec-09        Jan-10      Feb-10        Mar-10        Apr-10 May-10       Jun-10
   1 East                                                              2354          2357          2357        2352         2350             2348         2341        2347          2346         2348      2351
   2 Middle                                                            2323          2327          2324        2327         2331             2332         2325        2333          2329         2332      2333
   3 West                                                              1707          1700          1700        1701         1701             1696         1686        1687          1695         1696      1700
   4 Statewide                                                         6384          6384          6381        6380         6382             6376         6352        6367          6370         6376      6384


DIDS Demographics Main Waiver (CS Tracking)                           Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
  5 East                                                               2351         2354          2354        2349          2347          2344         2337         2343        2342          2344      2347
  6 Middle                                                             2322         2326          2323        2326          2330          2331         2324         2332        2328          2331      2332
  7 West                                                               1394         1388          1385        1383          1381          1378         1370         1373        1380          1381      1383
  8 Statewide                                                          6067         6068          6062        6058          6058          6053         6031         6048        6050          6056      6062            0
                        CALENDAR YEAR FORMULAS                        Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
  9                    Approved Slots per calendar year                6723         6723          6723        6723          6723          6723         6723         6723        6723          6723      6723         6723
 10            Used unduplicated slots (Jan-current mo.)               6155         6173          6182        6195         6208          6228          6051         6079        6094          6107      6130
 11                # of slots remaining for calendar year               568          550           541         528           515           495          672          644         629           616        593

DIDS Demographics Arlington Waiver (CS Tracking)                      Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
 12 East                                                                   3           3             3            3            3             4            4            4            4             4         4
 13 Middle                                                                 1           1             1            1            1             1            1            1            1             1         1
 14 West                                                                313          312           315         318           320           318          316          314         315           315        317
 15 Statewide                                                           317          316           319         322           324           323          321          319         320           320        322           0
                        CALENDAR YEAR FORMULAS                        Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
 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.)                319          318           322         325           328           329          322          322         323           323        325
 18                # of slots remaining for calendar year                 25          26            22           19           16            15           22           22           21            21        19

DIDS Demographics SD Waiver (CS Tracking)                             Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
 19 East                                                                427          426           420         420           419           418          419          419         413           414        407
 20 Middle                                                              438          435           430         430           428           426          425          423         422           428        430
 21 West                                                                334          337           337         340           335           333          333          335         333           332        333
 22 Statewide                                                          1199         1198          1187        1190          1182          1177         1177         1177        1168          1174      1170            0
                        CALENDAR YEAR FORMULAS                        Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
 23                    Approved Slots per calendar year                1900         1900          1900        1900          1900          1900         2250         2250        2250          2250      2250         2250
 24            Used unduplicated slots (Jan-current mo.)               1259         1263          1266        1268         1270          1272          1176         1183        1183          1192      1196
 25                # of slots remaining for calendar year               641          637           634         632           630           628         1074         1067        1067          1058      1054

DIDS Demographics State Funded (CS Tracking)                          Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10      Jun-10
 26 East                                                                174          171           171         177           175           175          175          175         175           172        172
 27 Middle                                                              130          129           130         133           125           129          130          132         134           129        122
 28 West                                                                  70          72            75           75           77            80           80           75           68            70        64
 29 Statewide                                                           374          372           376         385           377           384          385          382         377           371        358           0




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Developmental Center Census                                        Jul-09        Aug-09          Sep-09        Oct-09         Nov-09       Dec-09       Jan-10    Feb-10   Mar-10   Apr-10   May-10      Jun-10
 30 GVDC                                                             254            252             252          250             250          248          248       248     247      247       244
 31 CBDC                                                             111            111             111          110             110          110          109       109     108      108       105
 32 HJC                                                                15            15              18            17             16           14           14        13       13       12       12
 33 ADC                                                                64            64              60            55             50           50           50        47       47       46       38
 34 Total                                                            444            442             441          432             426          422          421       417     415      413       399           0

DIDS ICFMR Homes Census                                            Jul-09        Aug-09          Sep-09        Oct-09         Nov-09       Dec-09       Jan-10    Feb-10   Mar-10   Apr-10   May-10      Jun-10
                                                                       12            12              12            12             12           12           12        12       12       12       16



                                                                               2010
                                                             DIDS Census May ArlingtonTotal Served: 8327
                                                                     Statewide                      State Funded                     Developmental DID ICF
                                                                            Waiver          Waiver         SD Waiver   Srvs          Centers       Homes
                                                                                     6062              322        1170           358           399           16     8327
                                                                              Developmental Centers, 399
                                                           State Funded Srvs, 358              DID ICF Homes, 16




                                                                               SD Waiver,
                                                                                 1170
                                                      Arlington Waiver, 322
                                                                                                      Statewide
                                                                                                     Waiver, 6062




Analysis:
The census for the statewide waiver for Mayl 2010 was 6062. The Arlington waiver had 322, and the SD waiver was at 1170. The state funded census was at 358. Total Developmental Census was 399, with 244 being
at GVDC, 105 at CBDC, 12 at HJC, and 38 at ADC. There was a total census of 16 people in the DIDS ICF/MR homes in the West Region. All combined including the West Tn DIDS ICF MR homes, the total population
served is 8327.




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B.       Transitions, Enrollments, Disenrollments

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.

         Arlington Waiver Enrollments                            The Arlington Waiver data includes enrollments from ADC into the community as well as individuals from the At Risk portion of the class and have enrolled into the
                                                                 FY 0809              Jul-09       Aug-09      Sep-09       Oct-09      Nov-09         Dec-09        Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10      FYTD
     1                                         Arlington At Risk             23            0              0          1            0            0             1            0             0             0         0           0                  2
     2                                      Arlington Transition             19            1              0          3            1            0             0            0             0             0         0           1                  6
     3                                   Arlington Waiver Total              42            1              0          4            1            0             1            0             0             0         0           1       0          8

         SD Waiver Enrollments
         WL- Intake Commitee                                     FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
     4                                                   East               74             0           0            0             0            1            0            1            1             3          1         0                 7
     5                                                  Middle              44             1           0            1             0            0            1            3            0             0          1         1                 8
     6                                                  West                45             1           1            2             1            1            1            1            1             0          1         0                10
     7                                                   Total             163             2           1            3             1            2            2            5            2             3          3         1      0         25

         Conversions                                             FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
  8                                                      East                1             0           0            0             0            0            0            0            0             0          0         1                 1
  9                                                     Middle               0             0           0            0             0            0            0            0            0             0          4         1                 5
 10                                                     West                 0             2           0            0             1            0            0            0            0             0          0         0                 3
 11                                                      Total               1             2           0            0             1            0            0            0            0             0          4         2      0          9

                                                                 FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
         At Risk Group Enrollments into SD                                   6             0           1            0             0            0            0            0            0             0          1         1                 3

 12                                                   SD Total             170            4             2            3            2             2            2            5            2            3          8          4        0       37

         HCBS Statewide Waiver Enrollments
         WL- Intake Commitee                                     FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
 13                                                      East               15             2           3            1             4            1            2            1            1             2          2         3                22
 14                                                     Middle              19             0           1            0             4            3            3            6            2             2          2         0                23
 15                                                     West                21             3           0            0             0            0            0            1            1             2          0         0                 7
 16                                                      Total              55             5           4            1             8            4            5            8            4             6          4         3      0         52

         Conversions                                             FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
 17                                                      East                1             0           0            0             0            0            0            0            1             0          1         0                 2
 18                                                     Middle               3             0           0            0             0            0            0            0            1             0          2         0                 3
 19                                                     West                 0             0           0            0             0            0            0            0            0             0          1         0                 1
 20                                                      Total               4             0           0            0             0            0            0            0            2             0          4         0      0          6

         Transfers from SD to HCBS                               FY 0809              Jul-09      Aug-09       Sep-09        Oct-09       Nov-09       Dec-09       Jan-10       Feb-10        Mar-10     Apr-10    May-10 Jun-10       FYTD
 21                                                      East               13             0           4            0             1            0            2            1            4             0          3         3                18
 22                                                     Middle               9             1           1            0             1            1            3            1            1             0          1         0                10
 23                                                     West                 7             1           1            0             0            0            0            0            1             0          1         0                 4
 24                                                      Total              29             2           6            0             2            1            5            2            6             0          5         3      0         32




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      DCS Placements                                  FY 0809            Jul-09      Aug-09      Sep-09           Oct-09      Nov-09       Dec-09        Jan-10    Feb-10   Mar-10   Apr-10   May-10 Jun-10   FYTD
 25                                           East               8            0           2           0                0           0            1             0         1        0        0        0             4
 26                                          Middle             10            2           1           1                0           1            1             0         2        1        2        2            13
 27                                          West                6            0           0           0                0           0            1             0         0        0        0        0             1
 28                                           Total             24            2           3           1                0           1            3             0         3        1        2        2      0     18

      PASSR/ Nursing Homes                            FY 0809            Jul-09      Aug-09      Sep-09           Oct-09      Nov-09       Dec-09        Jan-10    Feb-10   Mar-10   Apr-10   May-10 Jun-10   FYTD
 29                                           East              17            1           0           1                2           0            0             1         1        0        0        1              7
 30                                          Middle              1            0           1           0                1           0            1             0         3        1        0        0              7
 31                                          West                0            0           0           0                0           0            0             0         1        0        0        0              1
 32                                           Total             18            1           1           1                3           0            1             1         5        1        0        1      0      15

      DC Completed Transitions                        FY 0809            Jul-09      Aug-09      Sep-09           Oct-09      Nov-09       Dec-09        Jan-10    Feb-10   Mar-10   Apr-10   May-10 Jun-10   FYTD
 33                                          GVDC                7            1           0           0                0           0            1             0         0        0        0        1             3
 34                                          CBDC                8            2           0           0                0           0            0             0         0        0        0        2             4
 35                                           HJC                3            0           0           0                1           1            1             1         1        0        0        0             5
 36                                           Total             18            3           0           0                1           1            2             1         1        0        0        3      0     12

      At Risk Class Enrollments                       FY 0809            Jul-09      Aug-09      Sep-09           Oct-09      Nov-09       Dec-09        Jan-10    Feb-10   Mar-10   Apr-10   May-10 Jun-10   FYTD
                                              West              13            2           3           2                3           5            4             2         1        8        4        5            39
                                             Middle                                                                                                                     1        0        0        0             1
                                               East                                                                                                                     0        0        0        0             0
                                              Total             13            2            3           2               3            5            4            2         2        8        4        5      0     40

 37                                      HCBS Total             161          15           17           5              17           12           20           14       23       15       19       17       0     156

YTD Consumer Directed Supports Program                                 FY 2007 FY 2008
Expenditures                                          FY 2006 Total       Total Total            Aug-09          Sep-09        Oct-09      Nov-09       Dec-09
 38 YTD CDS Funds Spent                                  $3,899,727   $4,676,041   $4,991,455                  $1,741,284   $2,227,902   $2,298,045   $2,497,758




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B.    Transitions, Enrollments, Disenrollments and Conversions

Disenrollments                                               Disenrollments are reported monthly by each Regional Office administrative departments. Data is separated by waiver and by reason for discharge.
Arlington Waiver
                                                                     Jul-09      Aug-09        Sep-09      Oct-09       Nov-09        Dec-09       Jan-10      Feb-10       Mar-10        Apr-10   May-10       Jun-10 FYTD
 39                                                 Death                 0           0             1           0            0             1            1           1            1             0        0                  5
 40                     Voluntary Request by person/family                0           0             0           0            0             0            0           0            0             0        0                  0
 41                                      Moved to ICFMR                   0           0             0           0            0             0            0           0            0             0        0                  0
 42                                Moved to Nursing Home                  0           0             0           0            0             0            0           0            0             0        0                  0
 43                             Moved to home with family                 0           0             0           0            0             0            0           0            0             0        0                  0
 44                                    Moved out of state                 0           0             0           0            0             0            0           0            0             0        0                  0
 45                                          Incarceration                0           0             0           0            0             0            0           0            0             0        0                  0
 46                                    Not Waiver Eligible                0           0             0           0            0             0            0           0            0             0        0                  0
 47                                                 Other                 0           0             0           0            0             0            0           0            0             0        0                  0
 48                                            Involuntary                0           0             0           0            0             0            0           0            0             0        0                  0
 49                                      Total Disenrolled                0           0             1           0            0             1            1           1            1             0        0                  5

SD Waiver
                                                                     Jul-09      Aug-09        Sep-09      Oct-09       Nov-09        Dec-09       Jan-10      Feb-10       Mar-10        Apr-10   May-10       Jun-10 FYTD
 50                                                 Death                 1           0             0           0            0             2            1           0            0             1        0                  5
 51                     Voluntary Request by person/family                4           3             1           5            2             0            2           3            0             0        2                 22
 52                                      Moved to ICFMR                   0           0             0           0            0             0            0           0            0             0        0                  0
 53                                Moved to Nursing Home                  0           0             0           0            0             0            0           0            0             0        0                  0
 54                             Moved to home with family                 0           0             0           0            0             0            0           0            0             0        0                  0
 55                                    Moved out of state                 1           2             0           0            2             0            0           1            0             0        0                  6
 56                                          Incarceration                0           0             0           0            0             0            0           0            0             0        0                  0
 57                                    Not Waiver Eligible                0           0             0           0            0             0            0           0            0             0        0                  0
 58                                                 Other                 0           0             0           0            0             0            0           1            0             0        0                  1
 59                                            Involuntary                1           0             0           0            0             0            0           0            0             0        0                  1
 60                                      Total Disenrolled                7           5             1           5            4             2            3           5            0             1        2            0    35

Statewide Waiver
                                                                     Jul-09      Aug-09        Sep-09      Oct-09       Nov-09        Dec-09       Jan-10      Feb-10       Mar-10        Apr-10   May-10       Jun-10 FYTD
 61                                                 Death                 8          13             7          13            8            15           15           8           10             8        7                112
 62                     Voluntary Request by person/family                5           6             2           2            4             2            2           2            0             1        0                 26
 63                                      Moved to ICFMR                   0           0             0           1            0             0            0           0            0             0        0                  1
 64                                Moved to Nursing Home                  0           0             0           0            0             0            0           0            0             0        0                  0
 65                             Moved to home with family                 0           0             0           0            0             0            0           0            0             0        0                  0
 66                                    Moved out of state                 2           1             0           0            2             0            0           0            0             2        0                  7
 67                                          Incarceration                0           0             0           0            0             0            0           0            0             0        0                  0
 68                                    Not Waiver Eligible                1           0             1           0            0             0            0           0            0             0        0                  2
 69                                                 Other                 0           0             0           0            0             0            0           0            0             0        0                  0
 70                                            Involuntary                0           0             1           0            2             2            0           0            0             0        0                  5
 71                                      Total Disenrolled               16          20            11          16           16            19           17          10           10            11        7            0   153




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State Funds
                                                                      Jul-09      Aug-09        Sep-09       Oct-09        Nov-09        Dec-09       Jan-10      Feb-10        Mar-10        Apr-10    May-10     Jun-10 FYTD
 72                                                  Death                 1           1             0            0             0             1            1           0             0             0         0                4
 73                      Voluntary Request by person/family                0           0             1            1             0             2            0           0             1             0         0                5
 74                                       Moved to ICFMR                   0           0             0            0             0             0            0           0             0             0         0                0
 75                                 Moved to Nursing Home                  0           0             0            0             0             0            0           0             0             0         0                0
 76                              Moved to home with family                 0           0             0            0             0             0            0           0             0             0         0                0
 77                                     Moved out of state                 1           0             0            0             0             0            0           0             0             0         0                1
 78                                           Incarceration                0           0             0            0             0             0            0           0             0             0         0                0
 79                                     Not Waiver Eligible                0           0             0            0             0             0            0           0             0             0         0                0
 80                                                  Other                 0           0             0            0             0             0            0           0             0             0         0                0
 81                                             Involuntary                0           0             0            0             0             0            0           0             0             0         0                0
 82                                       Total Disenrolled                2           1             1            1             0             3            1           0             1             0         0          0    10

 83                                  Total Disenrollments:                25           26            14           22           20            25           22           16            12           12          9          0   203


Analysis:
In May 2010, there were a total of 22 waiver enrollments. 4 enrolled into the SD Waiver, 1 enrolled into the Arlington waiver and 17 people enrolled into the Statewide waiver. There were 9 disenrollments: 2 from the SD
Waiver and 9 from the Statewide Waiver.




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C   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 Tennessee Waiting List Demographics                              Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10         Jun-10
  1 # of Individuals Classified as Crisis                                 22          23            25           20           25            24           23          22            26           34        33
  2 # of Individuals Classified as Urgent                               333          333           344          340          348           352          347         350           354          356       362
  3 # of Individuals Classified as Active                              1311         1326         1,340        1,356        1,373         1,374        1,391       1,409         1,424        1,427      1423
  4 # of Individuals Classified as Deferred                             490          492           491          492          498           499          492         493           499          502       502
  6                 # of Individuals Added to the Waiting List            26          30            31           22           36            18           12          38            39           27        12
  7 # of Individuals Removed to SD Waiver                                  0           0             0            0            1             0            1           1             1            1         0
  8 # of Individuals Removed - to HCBS Waiver                              3           5             2            7            1             3            2           4             4            3         4
  9 # of Individuals Removed - Other Reasons                              11           7             3            7            1            10            5          12             5            7         7             0
 10                                   Total Number Removed                14          12             5           14            3            13            8          17            10           11        11
 11 Total Number on ETRO Waiting List                                  2156         2174          2200         2208         2244          2249         2253        2274          2303         2319      2320              0
Middle Tennessee Waiting List Demographics                            Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10         Jun-10
 12 # of Individuals Classified as Crisis                                  9          17            17           19           23            23           23          24            17           23        27
 13 # of Individuals Classified as Urgent                               286          281           291          300          300           301          299         307           313          310       304
 14 # of Individuals Classified as Active                              1298         1294         1,300        1,312        1,318         1,321        1,325       1,328         1,334        1,342      1352
 15 # of Individuals Classified as Deferred                             286          295           297          300          301           305          305         307           314          322       326
 16                 # of Individuals Added to the Waiting List            26          25            28           29           17            16           13          16            27           32        15
 17 # of Individuals Removed to SD Waiver                                  1           1             0            0            0             1            3           0             0            2         1
 18 # of Individuals Removed - to HCBS Waiver                              1           2             1            1            5             3            3           0             9            3         0
 19 # of Individuals Removed - Other Reasons                              22          14             9            2            1             4            5           2             6            8         2             0
 20                                   Total Number Removed                24          17            10            3            6             8           11           2            15           13         3
 21 Total Number on MTRO Waiting List                                  1879         1887          1905         1931         1942          1950         1952        1966          1978         1997      2009              0
West Tennessee Waiting List Demographics                              Jul-09      Aug-09        Sep-09       Oct-09       Nov-09        Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10         Jun-10
 22 # of Individuals Classified as Crisis                                 20          24            28           27           33            28           25          23            26           20        31
 23 # of Individuals Classified as Urgent                                 94          93            90           84           84            83           84          85            84           85        83
 24 # of Individuals Classified as Active                              1648         1640         1,657        1,661        1,666         1,679        1,675       1,678         1,682        1,691     1,684
 25 # of Individuals Classified as Deferred                             219          219           211          215          218           229          242         244           251          272       276
 26                 # of Individuals Added to the Waiting List            39          20            32           14           26            25           21          21            28           33        12
 27 # of Individuals Removed to SD Waiver                                  0           5             3            2            0             2            1           1             1            0         0
 28 # of Individuals Removed - to HCBS Waiver                              2           5             7            5            1             5            6           3             8            3         3
 29 # of Individuals Removed - to Arlington Waiver                         0           0             0            0            0             0            0           0             0            0         0
 30 # of Individuals Removed - Other Reasons                              13          15            12            6           11             1            7          13             7            5         3             0
 31                                   Total Number Removed                15          25            22           13           12             8           14          17            16            8         6
 32 Total Number on WTRO Waiting List                                  1981         1976          1986         1987         2001          2019         2026        2030          2043         2068      2074             0




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C     Waiting List Demographics

Statewide Waiting List Demographics                                Jul-09   Aug-09   Sep-09     Oct-09        Nov-09   Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
 33 # of Individuals Classified as Crisis                              51       64       70         66            81       75       71       69       69       77       91
 34 # of Individuals Classified as Urgent                            713       707      725       724            732      736      730      742     751      751       749
 35 # of Individuals Classified as Active                           4257     4,260     4297      4329           4357     4374     4391     4415    4440     4460     4459
 36 # of Individuals Classified as Deferred                          995     1,006      999      1007           1017     1033     1039     1044    1064     1096     1104
                                                          Total     6016      6037     6091      6126           6187     6218     6231     6270    6324     6384     6403
 37                   # of Individuals Added to the Waiting List       91       75       91         65            82       59       46       75       94       92       39
 38   # of Individuals Removed to SD Waiver                             1        6        3          2             1        3        5        2        2        3        1
 39   # of Individuals Removed - to HCBS Waiver                         6       12       10         13             7       11       11        7       21        9        7
 40   # of Individuals Removed - to Arlington Waiver                    0        0        0          0             0        0        0        0        0        0        0
 41   # of Individuals Removed - Other Reasons                         46       36       24         15            13       15       17       27       18       20       12
 42                                     Total Number Removed           53       54       37         30            21       29       33       36       41       32       20
 43   Total Number on Statewide Waiting List                        6016      6037     6091      6126           6187     6218     6231     6270    6324     6384     6403        0

                                                                   Jul-09   Aug-09   Sep-09     Oct-09        Nov-09   Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
 46                          Net Change from Previous Month          +36       +21      +54       +35            +61     +31       +14       39       54       60       19

Wait List by Region                                                Jul-09   Aug-09   Sep-09     Oct-09        Nov-09   Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
 47                                                       East      2156      2174     2200      2208           2244     2249     2253     2274    2303     2319     2320
 48                                                     Middle      1879      1887     1905      1931           1942     1950     1952     1966    1978     1997     2009
 49                                                      West       1981      1976     1986      1987           2001     2019     2026     2030    2043     2068     2074
 50                                                  Statewide      6016      6037     6091      6126           6187     6218     6231     6270    6324     6384     6403




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Wait List by Region                                                       Wait List by Category of Need       # of Individuals
                                                                                                          Classified as Crisis, 91,
                                                                                                                     1%
                                                                                                                                         # of Individuals
                                                                                                                                      Classified as Urgent,
                                                                                                                                            749, 12%
                                                                         # of Individuals
                                                                      Classified as Deferred,
                                                                            1104, 17%
                                          East, 2320, 36%

West, 2074, 32%




                                                                                   # of Individuals
                                                                                 Classified as Active,
                                                                                     4459, 70%

                      Middle, 2009, 31%




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C       Waiting List Populations

                                                                      Jul-09       Aug-09        Sep-09       Oct-09        Nov-09       Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10       Jun-10
    1   School Age                                                     2963          2955          2966        2970           2990         2983         2714         2727        2750          2770      2753
    2   DCS                                                               90           90            92           90            91           89           95           91           97            98        96
    3   NH                                                                32           35            34           33            33           34           31           33           34            36        35
    4   RMHI                                                               7           17            18           25            25           25           23           22           22            22        22
    5   State Funded                                                      20           21            22           23            23           23           23           22           23            22        23
    6   Adults with no Services                                        2904          2919          2959        2985           3025         3064         3345         3375        3398          3436      3474
    7   Total                                                          6016          6037          6091        6126           6187         6218         6231         6270        6324          6384      6403            0


                                                                                              Wait List Demographics

        3500
                             2753, 43%                                                                                                                                                          3474, 54%
        3000

        2500

        2000

        1500

        1000

          500
                                                            96, 2%                            35, 1%                           22, <1%                          23, <1%
              0
                              School Age                      DCS                                NH                              RMHI                          State Funded                Adults with no Services


Analysis:

The Wait List for May 2010 was 6403 statewide. This is an increase of 19 additional people since April 2010. Regionally, East was at 2320 (36%) of the list, Middle was at 2009 (31%) and West was at 2074 (32%). 70% of the
list are individuals identified in the Active category, 12% are in the Urgent category, 17% are Deferred and 1% is identified as Crisis. There were 2753 school aged children making up 43% of the list, DCS had 96 children making
up 2%, persons in Nursing Homes were 35 or 1% of the list, persons in Regional Mental Health Institutes and State Funded services make up less than 1% each on the list, and Adults with no Services was at 3474 making up
54% of the list.




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    Protection From Harm/ Complaint Resolution
G
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-09      Aug-09       Sep-09        Oct-09         Nov-09      Dec-09       Jan-10      Feb-10        Mar-10        Apr-10    May-10     Jun-10     YTD
  1 Total # of Complaints                                                 2           1             0             0             3            0           1            0            6             1         0                  14
  2 # from TennCare                                                       0           0             0             0             0            0           0            0            0             0         0                   0
  3 % from TennCare                                                   0.0%         0.0%     #DIV/0!       #DIV/0!            0.0%    #DIV/0!         0.0%     #DIV/0!          0.0%          0.0%      0.0%    #DIV/0!     0.0%
  4 # from a Concerned Citizen                                            0           0             0             0             0            0           0            0            0             0         0                   0
  5 % from a Concerned Citizen                                        0.0%         0.0%     #DIV/0!       #DIV/0!            0.0%    #DIV/0!         0.0%     #DIV/0!          0.0%          0.0%      0.0%    #DIV/0!     0.0%
  6 # from the Waiver Participant                                         0           0             0             0             0            0           0            0            0             0         0                   0
  7 % from the Waiver Participant                                     0.0%         0.0%     #DIV/0!       #DIV/0!            0.0%    #DIV/0!         0.0%     #DIV/0!          0.0%          0.0%      0.0%    #DIV/0!     0.0%
  8 # from a Family Member                                                0           0             0             0             1            0           0            0            5             1         0                   7
  9 % from a Family Member                                            0.0%         0.0%         0.0%          0.0%           0.0%        0.0%        0.0%         0.0%        83.3%        100.0%      0.0%    #DIV/0!    50.0%
 10 # from Conservator                                                    2           1             0             0             1            0           0            0            0             0         0                   4
 11 % from Conservator                                              100.0%       100.0%     #DIV/0!       #DIV/0!           33.3%    #DIV/0!         0.0%     #DIV/0!          0.0%          0.0%      0.0%    #DIV/0!    28.6%
 13 # Advocate (Paid)                                                     0           0             0             0             0            0           0            0            0             0         0                   0
 14 % from Advocate (Paid)                                            0.0%         0.0%     #DIV/0!       #DIV/0!            0.0%    #DIV/0!         0.0%     #DIV/0!          0.0%          0.0%      0.0%    #DIV/0!     0.0%
 15 # from PTP Interview                                                  0           0             0             0             1            0           0            0            1             0         0                   2
 16 % from PTP Interview                                              0.0%         0.0%           0%            0%          33.3%          0%          0%           0%        16.7%          0.0%      0.0%    #DIV/0!    14.3%


Complaints by Source - Statewide Waiver                              Jul-09       Aug-09       Sep-09       Oct-09         Nov-09      Dec-09       Jan-10       Feb-10       Mar-10        Apr-10    May-10     Jun-10     YTD
 20 Total # of Complaints                                                24            40           36          16              12         16           26           18           18            20         9                 235
 21 # from TennCare                                                       0             0            0           0               0          0            0            0            0             0         0                   0
 21 % from TennCare                                                   0.0%          0.0%         0.0%        0.0%            0.0%       0.0%         0.0%         0.0%         0.0%          0.0%       0.0%   #DIV/0!     0.0%
 22 # from a Concerned Citizen                                            1             4            4           3               0          0            0            1            0             5         0                  18
 23 % from a Concerned Citizen                                        4.2%         10.0%        11.1%       18.8%            0.0%       0.0%         0.0%         5.6%         0.0%         25.0%       0.0%   #DIV/0!     7.7%
 24 # from the Waiver Participant                                         0             7            2           0               0          0            4            1            0             0         3                  17
 25 % from the Waiver Participant                                     0.0%         17.5%         5.6%        0.0%            0.0%       0.0%        15.4%         5.6%         0.0%          0.0%      33.3%   #DIV/0!     7.2%
 26 # from a Family Member                                                1             8            9           4               4          6            4            2            8             6         2                  54
 27 % from a Family Member                                            4.2%         20.0%        25.0%       25.0%           33.3%      37.5%        15.4%        11.1%        44.4%         30.0%      22.2%   #DIV/0!    23.0%
 28 # from Conservator                                                   15            18           20           1               6          9            5           13            8             8         4                 107
 29 % from Conservator                                               62.5%         45.0%        55.6%        6.3%           50.0%      56.3%        19.2%        72.2%        44.4%         40.0%      44.4%   #DIV/0!    45.5%
 31 # Advocate (Paid)                                                     1             0            0           6               1          0            0            0            0             0         0                   8
 32 % from Advocate (Paid)                                            4.2%          0.0%           0%         38%            8.3%       0.0%         0.0%         0.0%         0.0%          0.0%       0.0%   #DIV/0!     3.4%
 33 # from PTP Interview                                                  6             3            1           1               1          1           13            1            2             1         0                  30
 34 % from PTP Interview                                             25.0%          7.5%         2.8%        6.3%            8.3%       6.3%        50.0%         5.6%        11.1%          5.0%       0.0%   #DIV/0!    12.8%


Complaints by Source - Arlington Waiver                              Jul-09      Aug-09        Sep-09       Oct-09         Nov-09      Dec-09       Jan-10       Feb-10       Mar-10        Apr-10   May-10      Jun-10     YTD
 38 Total # of Complaints                                                 1           3             3           10              1           7            5            2            4            11        4                   51
 39 # from TennCare                                                       0           0             0            0              0           0            0            0            0             0        0                    0
 40 % from TennCare                                                   0.0%         0.0%          0.0%        0.0%            0.0%       0.0%         0.0%         0.0%         0.0%          0.0%      0.0%    #DIV/0!     0.0%
 41 # from a Concerned Citizen                                            0           0             2            0              0           0            0            0            0             3        0                    5
 42 % from a Concerned Citizen                                        0.0%         0.0%         66.7%        0.0%            0.0%       0.0%         0.0%         0.0%         0.0%         27.3%      0.0%    #DIV/0!     9.8%
 43 # from the Waiver Participant                                         0           0             0            3              1           5            3            1            1             1        0                   15
 44 % from the Waiver Participant                                     0.0%         0.0%          0.0%       30.0%          100.0%      71.4%        60.0%        50.0%        25.0%          9.1%      0.0%    #DIV/0!    29.4%
 45 # from a Family Member                                                0           0             0            0              0           1            1            0            0             0        0                    2
 46 % from a Family Member                                            0.0%         0.0%          0.0%        0.0%            0.0%      14.3%        20.0%         0.0%         0.0%          0.0%      0.0%    #DIV/0!     3.9%
 47 # from Conservator                                                    1           3             0            1              0           1            1            1            3             7        4                   22
 48 % from Conservator                                              100.0%       100.0%          0.0%       10.0%            0.0%      14.3%        20.0%        50.0%        75.0%         63.6%    100.0%    #DIV/0!    43.1%
 50 # Advocate (Paid)                                                     0           0             1            6              0           0            0            0            0             0        0                    7
 51 % from Advocate (Paid)                                            0.0%         0.0%         33.3%       60.0%            0.0%       0.0%         0.0%         0.0%         0.0%          0.0%      0.0%    #DIV/0!    13.7%
 52 # from PTP Interview                                                  0           0             0            0              0           0            0            0            0             0        0                    0
 53 % from PTP Interview                                              0.0%         0.0%          0.0%        0.0%            0.0%       0.0%         0.0%         0.0%         0.0%          0.0%      0.0%    #DIV/0!     0.0%




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Complaints by Issue- Self Determination Waiver    Jul-09   Aug-09   Sep-09     Oct-09        Nov-09   Dec-09    Jan-10   Feb-10   Mar-10    Apr-10   May-10    Jun-10     YTD
   Total Number of Complaints                          2        1        0          0             3        0         1        0        6         1        0                 14
   # Behavior Issues                                   0        0        0          0             0        0         0        0        0         0        0                  0
   % Behavior Issues                               0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%
    # Day Service Issues                               0        0        0          0             0        0         0        0        0         0        0                  0
   % Day Service Issues                            0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!   35.7%
   # Environmental Issues                              0        0        0          0             0        0         0        0        1         0        0                  1
   % Environmental Issues                          0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%    16.7%      0.0%     0.0%    #DIV/0!    7.1%
   # Financial Issues                                  0        0        0          0             0        0         0        0        1         0        0                  1
   % Financial Issues                              0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%    16.7%      0.0%     0.0%    #DIV/0!    7.1%
   # Health Issues                                     0        0        0          0             0        0         0        0        0         0        0                  0
   % Health Issues                                 0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%
   # Human Rights Issues                               0        1        0          0             1        0         0        0        0         0        0                  2
   % Human Rights Issues                           0.0%    100.0%    0.0%       0.0%          33.3%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!   14.3%
   # ISC Issues                                        0        0        0          0             0        0         0        0        0         0        0                  0
   % ISC Issues                                    0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%
   # ISP Issues                                        0        0        0          0             0        0         0        0        0         0        0                  0
   % ISP Issues                                    0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%
   # Staffing Issues                                   0        0        0          0             0        0         1        0        3         0        0                  4
   % Staffing Issues                               0.0%      0.0%    0.0%       0.0%           0.0%    0.0%    100.0%     0.0%    50.0%      0.0%     0.0%    #DIV/0!   28.6%
   # Therapy Issues                                    0        0        0          0             0        0         0        0        0         0        0                  0
   % Therapy Issues                                0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%
   # Transportation Issues                             2        0        0          0             1        0         0        0        1         1        0                  5
   % Transportation Issues                       100.0%      0.0%    0.0%       0.0%          33.3%    0.0%      0.0%     0.0%    16.7%    100.0%     0.0%    #DIV/0!   35.7%
   # Case Management Issues                            0        0        0          0             1        0         0        0        0         0        0                  1
   % Case Management Issues                        0.0%      0.0%    0.0%       0.0%          33.3%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    7.1%
   # Other Issues                                      0        0        0          0             0        0         0        0        0         0        0                  0
   % Other Issues                                  0.0%      0.0%    0.0%       0.0%           0.0%    0.0%      0.0%     0.0%     0.0%      0.0%     0.0%    #DIV/0!    0.0%




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Complaints by Issue - Statewide Waiver   Jul-09   Aug-09    Sep-09      Oct-09        Nov-09    Dec-09    Jan-10   Feb-10    Mar-10   Apr-10   May-10    Jun-10     YTD
   Total Number of Complaints                24        40        36         16             12        16       26        18       18       20        9                235
   # Behavior Issues                          0         0         0          0              0         0        0         0        1        0        0                  1
   % Behavior Issues                      0.0%      0.0%      0.0%       0.0%           0.0%      0.0%     0.0%      0.0%     5.6%     0.0%      0.0%   #DIV/0!    0.4%
    # Day Service Issues                      2         4         2          0              0         0        2         1        0        0        0                 11
   % Day Service Issues                   8.3%     10.0%      5.6%       0.0%           0.0%      0.0%     7.7%      5.6%     0.0%     0.0%      0.0%   #DIV/0!    4.7%
   # Environmental Issues                     4         8         3          1              0         1        0         2        1        2        0                 22
   % Environmental Issues                16.7%     20.0%      8.3%       6.3%           0.0%      6.3%     0.0%     11.1%     5.6%    10.0%      0.0%   #DIV/0!    9.4%
   # Financial Issues                         4         4         5          1              0         2        1         3        1        1        2                 24
   % Financial Issues                    16.7%     10.0%     13.9%       6.3%           0.0%     12.5%     3.8%     16.7%     5.6%     5.0%     22.2%   #DIV/0!   10.2%
   # Health Issues                            0         0         3          2              3         0        1         1        0        1        1                 12
   % Health Issues                        0.0%      0.0%      8.3%      12.5%          25.0%      0.0%     3.8%      5.6%     0.0%     5.0%     11.1%   #DIV/0!    5.1%
   # Human Rights Issues                      0         2         2          5              1         0        9         1        3        1        2                 26
   % Human Rights Issues                  0.0%      5.0%      5.6%      31.3%           8.3%      0.0%    34.6%      5.6%    16.7%     5.0%     22.2%   #DIV/0!   11.1%
   # ISC Issues                               2         3         2          0              0         2        1         4        0        2        0                 16
   % ISC Issues                           8.3%      7.5%      5.6%       0.0%           0.0%     12.5%     3.8%     22.2%     0.0%    10.0%      0.0%   #DIV/0!    6.8%
   # ISP Issues                               0         0         0          0              0         0        1         0        0        0        0                  1
   % ISP Issues                           0.0%      0.0%      0.0%       0.0%           0.0%      0.0%     3.8%      0.0%     0.0%     0.0%      0.0%   #DIV/0!    0.4%
   # Staffing Issues                          5        19        14          4              8        10        9         4       11       12        2                 98
   % Staffing Issues                     20.8%     47.5%     38.9%      25.0%          66.7%     62.5%    34.6%     22.2%    61.1%    60.0%     22.2%   #DIV/0!   41.7%
   # Therapy Issues                           3         0         2          0              0         0        0         0        0        1        0                  6
   % Therapy Issues                      12.5%      0.0%      5.6%       0.0%           0.0%      0.0%     0.0%      0.0%     0.0%     5.0%      0.0%   #DIV/0!    2.6%
   # Transportation Issues                    3         0         3          3              0         1        2         2        1        0        1                 16
   % Transportation Issues               12.5%      0.0%      8.3%      18.8%           0.0%      6.3%     7.7%     11.1%     5.6%     0.0%     11.1%   #DIV/0!    6.8%
   # Case Management Issues                   0         0         0          0              0         0        0         0   0.00%    0.00%     0.00%                  0
   % Case Management Issues               0.0%      0.0%      0.0%       0.0%           0.0%      0.0%     0.0%      0.0%     0.0%     0.0%      0.0%   #DIV/0!    0.0%
   # Other Issues                             0         0         0          0              0         0        0         0        0        0        0                  0
   % Other Issues                         0.0%      0.0%      0.0%       0.0%           0.0%      0.0%     0.0%      0.0%     0.0%     0.0%      0.0%   #DIV/0!    0.0%




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Complaints by Issue - Arlington Waiver    Jul-09   Aug-09   Sep-09     Oct-09        Nov-09   Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10    Jun-10     YTD
   Total Number of Complaints                  1        3        3         10             1        7        5        2        4       11        4                 51
   # Behavior Issues                           0        0        0          0             0        0        0        0        0        0        0                  0
   % Behavior Issues                       0.0%      0.0%     0.0%      0.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    0.0%
    # Day Service Issues                       0        0        0          1             0        0        0        0        0        0        0                  1
   % Day Service Issues                    0.0%      0.0%     0.0%     10.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    2.0%
   # Environmental Issues                      0        0        0          3             0        4        1        0        1        5        0                 14
   % Environmental Issues                  0.0%      0.0%     0.0%     30.0%           0.0%    57.1%   20.0%      0.0%   25.0%    45.5%      0.0%   #DIV/0!   27.5%
   # Financial Issues                          0        0        2          0             0        0        0        0        1        0        0                  3
   % Financial Issues                      0.0%      0.0%    66.7%      0.0%           0.0%     0.0%    0.0%      0.0%   25.0%     0.0%      0.0%   #DIV/0!    5.9%
   # Health Issues                             1        0        1          2             0        0        0        0        1        0        1                  6
   % Health Issues                       100.0%      0.0%    33.3%     20.0%           0.0%     0.0%    0.0%      0.0%   25.0%     0.0%     25.0%   #DIV/0!   11.8%
   # Human Rights Issues                       0        0        0          1             0        0        1        0        0        0        1                  3
   % Human Rights Issues                   0.0%      0.0%     0.0%     10.0%           0.0%     0.0%   20.0%      0.0%    0.0%     0.0%     25.0%   #DIV/0!    5.9%
   # ISC Issues                                0        0        0          0             0        1        0        0        0        0        0                  1
   % ISC Issues                            0.0%      0.0%     0.0%      0.0%           0.0%    14.3%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    2.0%
   # ISP Issues                                0        0        0          0             0        0        0        0        0        0        0                  0
   % ISP Issues                            0.0%      0.0%     0.0%      0.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    0.0%
   # Staffing Issues                           0        3        0          3             1        2        2        2        1        6        2                 22
   % Staffing Issues                       0.0%    100.0%     0.0%     30.0%         100.0%    28.6%   40.0%    100.0%   25.0%    54.5%     50.0%   #DIV/0!   43.1%
   # Therapy Issues                            0        0        0          0             0        0        0        0        0        0        0                  0
   % Therapy Issues                        0.0%      0.0%     0.0%      0.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    0.0%
   # Transportation Issues                     0        0        0          0             0        0        1        0        0        0        0                  1
   % Transportation Issues                 0.0%      0.0%     0.0%      0.0%           0.0%     0.0%   20.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    2.0%
   # Case Management Issues                    0        0        0          0             0        0        0        0        0        0        0                  0
   % Case Management Issues                0.0%      0.0%     0.0%      0.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    0.0%
   # Other Issues                              0        0        0          0             0        0        0        0        0        0        0                  0
   % Other Issues                          0.0%      0.0%     0.0%      0.0%           0.0%     0.0%    0.0%      0.0%    0.0%     0.0%      0.0%   #DIV/0!    0.0%




                                                                                16
                                                                                                                            Data Management Report
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Complaint Resolution-Self Determination Waiver                                  Jul-09        Aug-09         Sep-09          Oct-09          Nov-09         Dec-09            Jan-10        Feb-10          Mar-10          Apr-10      May-10        Jun-10 YTD
   Total # of Complaints                                                             2             1               0               0              3               0                1             0               6               1           0                       14
   Resolved Within 30 Days                                                           2             1               0               0              3               0                1             0               6               1           0                       14
   # Pending                                                                         0             0               0               0              0               0                0             0               0               0           0                        0
   # Pending > than 31 to 60 days                                                    0             0               0               0              0               0                0             0               0               0           0                        0
   # Resolved > than 31 to 60 days                                                   0             0               0               0              0               0                0             0               0               0           0                        0
   # Pending > than 61 days                                                          0             1               0               0              0               0                0             0               0               0           0                        1
   # Resolved > than 61 days                                                         0             0               0               0              0               0                0             0               0               0           0                        0
   % Resolved within 30 Days                                                    100%           100%        #DIV/0!         #DIV/0!            100%        #DIV/0!              100%            N/A           100%            100%          N/A                    100%

Complaint Resolution-Statewide Waiver                                           Jul-09        Aug-09           Sep-09         Oct-09         Nov-09           Dec-09          Jan-10        Feb-10          Mar-10          Apr-10      May-10        Jun-10 YTD
   Total # of Complaints                                                            24            37               36             16             12               16              26            18              18              20           9                   232
   Resolved Within 30 Days                                                          24            37               35             16             12               16              26            18              18              20           9                   231
   # Pending                                                                         0             0                0              0              2                0               0             0               0               0           0                     2
   # Pending > than 31 to 60 days                                                    0             0                1              0              0                0               0             0               0               0           0                     0
   # Resolved > than 31 to 60 days                                                   0             0                1              0              0                0               0             0               0               0           0                     0
   # Pending > than 61 days                                                          0             0                0              0              0                0               0             0               0               0           0                     0
   # Resolved > than 61 days                                                         0             0                0              0              0                0               0             0               0               0           0                     0
   % Resolved within 30 Days                                                    100%           100%              97%           100%           100%             100%            100%          100%            100%            100%        100%                  100%


Complaint Resolution-Arlington Waiver                                           Jul-09        Aug-09         Sep-09           Oct-09         Nov-09           Dec-09          Jan-10        Feb-10          Mar-10          Apr-10      May-10        Jun-10 YTD
   Total # of Complaints                                                             2             1               0              10              1                7               5             2               4              11           4                       47
   Resolved Within 30 Days                                                           2             1               0              10              1                7               5             2               4              11           4                       47
   # Pending                                                                         0             0               0               0              0                1               0             0               0               0           0                        1
   # Pending > than 31 to 60 days                                                    0             0               0               0              0                0               0             0               0               0           0                        0
   # Resolved > than 31 to 60 days                                                   0             0               0               0              0                0               0             0               0               0           0                        0
   # Pending > than 61 days                                                          0             1               0               0              0                0               0             0               0               0           0                        0
   # Resolved > than 61 days                                                         0             0               0               0              0                0               0             0               0               0           0                        0
   % Resolved within 30 Days                                                    100%           100%        #DIV/0!             100%           100%             100%            100%          100%            100%            100%        100%                     100%

    Analysis:
   1. 13 complaints statewide
          AW: 4
          SD: 0
         MW: 9

   2. Most of the Complaints were made by Conservators (8\13).
   3. The most frequent complaint was about Staffing issues(4\13) followed by Human Rights issues(3\13)
   4. Resolved in 30 days : All 13 complaints were resolved within 30 days.
   5. 16 statewide interventions\mediations
   6. 1 complaint was received from Tenn Care and the same complaint came through MTRO Complaints and to Tom O’Brien directly. It was satisfactorily resolved within 30 days.
   7. There were no PTP complaints.
   8. CRS continues to schedule informational sessions with providers and families.
   9. TRENDING: Year to date for 2010 most of the complaints were about staff communication. CRS has developed strategies to educate providers about establishing more effective communication systems with their customers. That has been the ongoing focus of
   family meetings and will continue to be the training component of our annual provider meetings.
   Accessibility: CRS wanted to insure that service recipients felt comfortable calling CRS staff to make complaints. We have shown a dramatic increase per month in the number of recipients who call CRS to either ask questions or ask for help with a complaint.




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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-09      Aug-09        Sep-09       Oct-09         Nov-09      Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10
  1 # of Reportable Incidents                                          377          418           365          402            347         366          373         342           430          420
  2 Rate of Reportable Incidents per 100 people                       12.5         13.9          11.4         12.6           10.9        11.5         11.7        10.7          13.5         13.2
  3 # of Serious Injuries                                                36          24            29           29             18          20           15          13            21           24
     Rate of Incidents that were Serious Injuries per 100
  4 people                                                              1.2          0.8          0.91        0.91            0.56        0.63        0.47         0.41         0.66          0.76
  5 # of Incidents that were Falls                                       40           29            25          34              24          37          25           20           29            32
  6 Rate of Falls per 100 people                                       1.20         0.97          0.78        1.06            0.75        1.16        0.79         0.63         0.91          1.01
  7 # of Falls resulting in serious injury                               15           11            11          11               5          10           4            4           10            10
  8 % of serious injuries due to falls                               41.7%        45.8%         37.9%       44.8%           27.8%       50.0%       26.7%        30.8%        47.6%        41.70%
Incidents / Middle                                                   Jul-09      Aug-09        Sep-09       Oct-09         Nov-09      Dec-09       Jan-10      Feb-10        Mar-10        Apr-10   May-10
 15 # of Reportable Incidents                                           416          403           413         380             358         330         368          344          431           422
 16 Rate of Reportable Incidents per 100 people                        14.4         13.9          14.3        13.1            12.4        11.4        12.8           11         13.8          13.5
 17 # of Serious Injuries                                                24           34            22          20              27          29          25           23           22            25
     Rate of Incidents that were Serious Injuries per 100
 18 people                                                             0.83         1.18          0.76        0.69            0.94           1        0.87         0.73          0.7          0.8
 19 # of Incidents that were Falls                                       29           15            22          29              33          23          45           39           29           40
 20 Rate of Falls per 100 people                                       1.00         1.18          0.76        1.00            1.14        0.80        1.56         1.24         0.93         1.28
 21 # of Falls resulting in serious injury                               10           15            11          11              16          14          18           14           11           11
 22 % of serious injuries due to falls                               45.5%        44.1%         50.0%       55.0%           59.3%       48.3%       72.0%        60.9%        50.0%        44.0%
Incidents / West                                                     Jul-09      Aug-09        Sep-09       Oct-09         Nov-09      Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10
 29 # of Reportable Incidents                                           318          328           307         305             305         302         281          239          294          311
 30 Rate of Reportable Incidents per 100 people                        13.8         14.3          13.4        13.2            13.3        13.2        12.3         10.4         12.8         13.6
 31 # of Serious Injuries                                                13            9            16          20              16          13          14           17           13           27
     Rate of Incidents that were Serious Injuries per 100
 33 people                                                             0.57         0.39           0.7         0.87           0.7         0.57         0.61        1.18          0.57         1.18
 37 # of Incidents that were Falls                                       17           17            28           17            20           18           27          17            25           18
 39 Rate of Falls per 100 people                                       0.74         0.74          1.22         0.74          0.87         0.78         1.18        0.74          1.09         0.79
 40 # of Falls resulting in serious injury                                5            3             9            8             8            4            7           4            11           10
 41 % of serious injuries due to falls                               38.5%        33.3%         56.3%        40.0%         50.0%        30.8%        50.0%       14.8%         84.6%        37.0%

D   Protection From Harm/Incident Management

Incidents / Statewide                                                Jul-09      Aug-09        Sep-09       Oct-09         Nov-09      Dec-09       Jan-10      Feb-10        Mar-10       Apr-10    May-10
  44 # of Reportable Incidents                                        1111         1149          1085        1087            1007         998         1022         925         1155         1153
 45 Rate of Reportable Incidents per 100 people                       13.6           14            13           13             12        11.9         12.2        10.7          13.4         13.4
 46 # of Serious Injuries                                                73          67            67           69             61          62           54          53            56           76
     Rate of Incidents that were Serious Injuries per 100
 47 people                                                             0.89         0.82           0.8         0.82          0.73         0.74         0.65        0.62          0.65         0.88
 48 # of Incidents that were Falls                                       86           80            75           80            77           78           97          73            83           90
 49 Rate of Falls per 100 people                                       1.05         0.98           0.8         0.95          0.92         0.93         1.16        0.85          0.97         1.05
 50 # of Falls resulting in serious injury                               30           29            31           32            29           28           29          22           323           31
 51 % of serious injuries due to falls                               41.1%        43.3%         46.3%        46.4%         47.5%        45.2%        53.7%       34.9%         57.1%        40.8%




                                                                                                                      18
                                                                                                                                         Data Management Report
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                                                                                                             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
                                                                                           East ICF/MR added

                                   8.0
                                                                                                                                                                                         Middle ICF/MR added
                                   6.0
                                                                                                                                                                                                                                   Reportable Incident Rate
                                   4.0
                                                                                                                                                                                                                                   Serious Injury Rate
                                   2.0


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




D                                  Protection From Harm/Incident Management

Analysis:



Chart: Monthly Rate: Reportable Incidents and Serious Injuries.
The monthly statewide rate of Reportable Incidents per 100 service recipients for April 2010 (the last point on the line graph at the top of the chart) is virtually the same as the previous month.

The monthly rate of Reportable Incidents per 100 service recipients has shown slight variation from month to month. During the past 12 months, this rate has ranged from the high of 14.0 incidents per 100 services
recipients per month for August 2009 to a low of 10.7 for February 2010.
The April 2010 statewide rate of Serious Injuries per 100 service recipients shows an approximately 36 percent increase 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 lower number and rate of serious
injuries. (Approximately 6-7% of Reportable Incidents are associated with a Serious Injury.) During the past twelve months, the Serious Injury rate ranged from a high of 0.89 Serious Injuries per 100 services recipients
per month (July 2009) 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 was conducted in April and April 2010 and included a presentation on the State of Tennessee Elder and Vulnerable Adult Abuse registry, and two group activities. One group activity involved reviewing and
discussing 5 years of data on choking incidents involving service recipients. The other activity involved reviewing and discussing anonymous sample incidents.
Specific remediation efforts addressed at reducing falls and choking continue. Also, identification of “vulnerable persons” (service recipients), based on multiple incidents of abuse and neglect, serious injury, among
other types of incidents, have been identified for Fiscal Year 2009, for Calendar Year 2009, and most recently for the twelve months ending March 31, 2010. This information has been forwarded to the D.I.D.S. Regional
Incident Management Coordinators to identify/confirm what risk prevention interventions the relevant providers and/or D.I.D.S. clinical staff may have already implemented, to help identify further interventions that may
be needed, etc. Follow-up has determined that most persons identified through this process have already been identified (through use of incident reports and other information) as high risk by both the relevant service
provider(s) and Regional Office specialists.




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D       Protection From Harm/Investigations
        East Region                                           Jul-09   Aug-09   Sep-09   Oct-09        Nov-09     Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
    1   Census                                                3005      3004     3192     3193          3188       3185     3179     3185     3178     3178
    2   # of Investigations                                     49       65       49       55            69         52       51       61       65       61
    3   Rate of Investigations per 100 people                  1.63     2.16     1.54     1.72          2.16       1.63     1.60     1.92     2.05     1.92
    4   # of Substantiated Investigations                       15       22       23       24            27         21       21       21       26       19
    5   Rate of Substantiated Investigations per 100 people    0.50     0.73     0.72     0.75          0.85       0.66     0.66     0.66     0.82     0.60
    6   Percentage of Investigations Substantiated             31%      34%      47%      44%           39%        40%      41%      34%      40%      31%

 7      Middle Region                                         Jul-09   Aug-09   Sep-09   Oct-09        Nov-09     Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
 8      Census                                                2891      2891     2886     2892          2886       2889     2882     3116     3132     3122
 9      # of Investigations                                     72       97       75       61            63         62       62       62       93       85
10      Rate of Investigations per 100 people                  2.49     3.36     2.60     2.11          2.18       2.15     2.15     1.99     2.97     2.72
11      # of Substantiated Investigations                       18       35       28       21            19         12       24       22       43       24
12      Rate of Substantiated Investigations per 100 people    0.62     1.21     0.97     0.73          0.66       0.42     0.83     0.71     1.37     0.77
13      Percentage of Investigations Substantiated             25%      36%      37%      34%           30%        19%      39%      35%      46%      28%

        West Region                                           Jul-09   Aug-09   Sep-09   Oct-09        Nov-09     Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
14      Census                                                2297      2295     2298     2302          2299       2307     2297     2295     2290     2304
15      # of Investigations                                     75       60       63       67            66         51       57       51       55       69
16      Rate of Investigations per 100 people                  3.27     2.61     2.74     2.91          2.87       2.21     2.48     2.22     2.40     2.99
17      # of Substantiated Investigations                       31       26       24       32            21         25       23       18       19       33
18      Rate of Substantiated Investigations per 100 people    1.35     1.13     1.04     1.39          0.91       1.08     1.00     0.78     0.83     1.43
19      Percentage of Investigations Substantiated             41%      43%      38%      48%           32%        49%      40%      35%      35%      48%

        Statewide                                             Jul-09   Aug-09   Sep-09   Oct-09        Nov-09     Dec-09   Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10
20      Census                                                8193      8190     8376     8387          8373       8381     8358     8596     8600     8604      0        0
21      # of Investigations                                    196       222      187      183           198        165      170      174      213      215      0        0
22      Rate of Investigations per 100 people                  2.39     2.71     2.23     2.18          2.36       1.97     2.03     2.02     2.48     2.50
23      # of Substantiated Investigations                       64       83        75      77             67        58        68      61       88        76      0        0
24      Rate of Substantiated Investigations per 100 people    0.78     1.01     0.90     0.92          0.80       0.69     0.81     0.71     1.02     0.88
25      Percentage of Investigations Substantiated             33%      37%      40%      42%           34%        35%      40%      35%      41%      35%




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                                                                                                                                     Data Management Report
                                                                                                                                          June 25, 2010




                                                                                            Monthly DIDS Abuse, Neglect, & Exploitation Investigation and Substantiation Rates
                                                                                                     All DIDS Community and eligible Private ICF/MR Service Recipients
                                              3
 Rate per 100 Service Recipients per Month




                                             2.5



                                              2

                                                                                                                                                                                      Investigation Rate
                                             1.5
                                                                                                                                                                                      Substantiated Investigation Rate


                                              1



                                             0.5



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


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

215 investigations were opened (statewide) during the month of April 2010. Of these 215 investigations opened, 76 (or 35%) were substantiated for abuse, neglect or exploitation. Statewide, investigations were opened
at a rate 2.50 investigations per 100 people served and were substantiated at a rate of .88 per 100 people served.
The Middle Region opened the highest number of investigations during this reporting period (85) for a rate of 2.72 investigations opened per 100 people served. The Middle region substantiated 24 (or 28%) of the
investigations that were opened during April 2010. The rate of substantiated investigations per 100 people in the Middle Region dropped significantly during this period (.77), as compared to the prior period (1.37).

The West Region opened 69 investigations during this reporting period and had the highest rate of investigations opened per 100 people served (2.99). 33 of these investigations (48%) were substantiated for a rate of
1.43 substantiated investigations per 100 people served in the West Region.

The East Region opened the fewest number of cases during this reporting period (61). The rate of investigations per 100 people served was 1.92. There were only 19 investigations that were substantiated for abuse,
neglect or exploitation (31%) for a rate of .60 substantiated investigations per 100 people served in the East Region.




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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 5/10                                 Cumulative / Statewide 5/10
    1 # of Day and Residential Providers Monitored this                                   10                                                   45
      Month
    2 Total Census of Providers Surveyed                                                 453                                                  2535
    3 # of Sample Size                                                                    78                                                  426
    4 % of Individuals Surveyed                                                          17%                                                  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 unique             70%          30%            0%           0%         84%           13%              2%          0%
      needs, expressed preferences and decisions.

  7 Outcome B. Services and supports are provided                         70%          30%            0%           0%         73%           20%              6%          0%
    according to the person’s plan.
  8 Outcome C. Individual risk is assessed and adequate,                  90%            0%           0%         10%          82%             8%             2%          6%
    timely intervention is provided.
  9 Outcome D. The person’s plan and services are                         40%          40%           10%         10%          51%           26%            13%           8%
    monitored for continued appropriateness and revised as
    needed.
 10 Domain 3: Safety and Security
 11 Outcome A. Where the person lives and works is safe.                  70%          30%            0%           0%         71%           26%              2%          0%

 12 Outcome B. The person has a sanitary and comfortable                  70%          30%            0%           0%         88%           11%              0%          0%
    living arrangement.
 13 Outcome C. Safeguards are in place to protect the                     50%          50%            0%           0%         40%           53%              4%          2%
    person from harm.
 14 Domain 4: Rights, Respect and Dignity
 15 Outcome A. The person is valued, respected and                       100%            0%           0%           0%         95%             4%             0%          0%
    treated with dignity.
 16 Outcome B. The person has a positive image in the                    100%            0%           0%           0%        100%             0%             0%          0%
    community.
 17 Outcome C. The person exercises his or her rights.                   100%           0%            0%          0%          95%            4%              0%          0%
 18 Outcome D. Restricted interventions are imposed only                  70%          10%            0%         20%          71%           19%              2%          7%
    with due process.
 19 Domain 5: Health
 20 Outcome A. The person has the best possible health.                   60%          30%            0%         10%          68%           20%              2%          8%

 21 Outcome B. The person takes medications as                            40%          20%           20%         20%          47%           31%            11%           9%
    prescribed.
 22 Outcome C. The person's dietary and nutritional needs                 80%          10%           10%           0%         91%             4%             2%          2%
    are adequately met.




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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                        100%            0%           0%           0%         97%             2%            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%         97%             2%            0%          0%
   community life rather than just being present.
29 Outcome C. The person has a valued role in the                      100%            0%           0%           0%         97%             2%            0%          0%
   community.
30 Domain 8: Opportunities for Work
31 Outcome A. The person has a meaningful job in the                   100%            0%           0%           0%         86%           10%             3%          0%
   community.
32 Outcome B. The person's day service leads to                        100%            0%           0%           0%         91%             8%            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                          80%          10%           10%           0%         66%           24%             6%          2%
   compliance with applicable licensure and provider
   agreement requirements.
35 Indicator 9.A.1.: The provider meets and maintains                  100%                                      0%         97%                                       2%
   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 implements              100%                                      0%        100%                                       0%
   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 job                   70%          30%            0%           0%         66%           26%             2%          4%
   specific qualifications.
39 Indicator 9.B.2.: Provider staff have received                       70%                                    30%          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 supported.                  70%          20%           10%           0%         64%           24%             6%          4%

41 Outcome D. Organizations receive guidance from a                     90%            0%           0%         10%          88%             6%            2%          2%
   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                       100%            0%           0%           0%         86%           13%             0%          0%
   requirements related to the services and supports that
   they provide.
44 Outcome B. People’s personal funds are managed                       55%          44%            0%           0%         53%           41%             2%          2%
   appropriately.




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                                                                           Cumulative Performance Ratings Across All Regions- Day/Residential

               Number of Agencies   14

                                    12                                                                                                                                                           Exceptional Performance
                                    10
                                                                                                                                                                                                 Proficient
                                    8

                                    6
                                                                                                                                                                                                 Fair

                                    4                                                                                                                                                            Significant Concerns
                                    2
                                                                                                                                                                                                 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: Cerebral Palsy Center, Frontier Health, Tri-County Center; Middle- Connexus, Hilltoppers, Middle Tennessee Supported Living, Preferred Alternatives, Volunteer Staffing / The Access
Program; West- Tim’s Place, West Tennessee Family Solutions.
In the East Region:
Frontier Health, Inc. - The survey resulted in an overall performance rating of Exceptional with the highest potential score of 54. This agency continues to maintain a high level of performance with all Outcomes, as well
as Domains, resulting in SC. In Domain 2, good documentation systems were in place which were thorough and effectively supported plan implementation and oversight. Improvement was noted in Domain 5 which
increased to SC from PC on the previous survey, 12/07; there was no survey in the 0809 fiscal year due to having achieved Star status. This agency has scored no less than 50 on a QA survey report since 3/05.

Tri-County Center - The survey resulted in an overall performance rating of Exceptional, score of 52, and reflects continued maintenance of a high level of performance. Domain 5 resulted in PC, a decrease from SC on
the previous (2-08) survey as some issues regarding the provision of blood pressure checks were identified (immediate actions were taken to resolve) and some improvements in the agency's processes for MAR and
dietary oversight were indicated. All other applicable Domains resulted in SC. This agency has scored no less than 50 on a QA survey report since 3/05.

Cerebral Palsy Center, Inc. - The survey resulted in an overall performance rating of Significant Concerns, score of 34, which is a slight decrease from the previous score of 36 and overall performance of Fair. Declines
in performance are most notable in Domains 2 and 5 which both dropped to NC from previous ratings of MC on the 7/09 survey and a continued decline from PC on the 6/08 survey. In Domain 2, repeat issues most
notable in Outcomes C, regarding risk identification, and D, pertaining to plan monitoring and resolution of problematic issues, were noted. In Domain 5, implementation of the agency's health care management and
oversight policies and procedures continue to be problematic as evidenced in previous survey reports, repeat issues were found regarding lack of staff knowledge of health care issues and the identification of emerging
issues, medication administration and consistent implementation of mealtime instructions. The lack of improvement in these areas also impacted Domain 9 which decreased from PC to MC. Domain 3 was maintained
at PC and Domains 6, 7 and 8 were maintained at SC. The identification of some improvements resulted in an increase in score from MC to PC in Domain 10 and from PC to SC in Domain 4.

In the Middle Region:
PAI- Scored Fair overall with no Domains scoring less than Partial Compliance. However, Outcome 5.B. scored Minimal Compliance due to several issues identified with the medication administration process. Issues
were identified with the timeliness of implementing medication changes, medication variances were not being addressed as required and correct dosages of medication were not being given as ordered, inaccurate or
inadequate information was on MARs and one staff had continued to administer medications after the med certification had expired. For 80 new hires, personnel checks had an 83.8% compliance with registry checks
being completed late and training was at 99% compliance.
Connexus- Scored Fair overall with a Minimal Compliance score in Domain 5 due to issues with the lack of physician's orders, no self-administration plans, not ensuring medications were available & administered as
ordered and medication administration certification had expired and staff had continued to administer meds for 2 months and the MARs were not consistently documented correctly. Outcome 9.D. scored Non
Compliance due to issues with Board composition, lack of orientation for new members and inadequate frequency of board meetings. Personnel checks and training reviews for 22 new hires were above 85%
compliance.
Hilltoppers- Scored Exceptional Performance (perfect score) with no concerns identified. For 35 new hires, training was at 100% compliance and personnel checks were at 97% compliance. Tenured staff (20) training
was at 100% compliance.

Volunteer Staffing- Scored Proficient with no Domains scoring less than Partial Compliance. No systemic concerns noted. Training and personnel checks for 51 new employees was above 85% compliance and for
tenured staff (20), 2 people had taken CPR on-line and one had taken First-Aid on-line. Appropriate retraining was required before those staff could work alone with individuals.
Mid-TN Supported Living- Scored Proficient on the QA survey. No Domains scored less than Partial Compliance. One agency nurse was incorrectly administering the sliding scale insulin for an individual, however no
overall systemic concerns were noted. Personnel reviews for new hire checks were at 100% compliance, however training review for new staff had some issues needing remediation. Also tenured staff (20) have some
late recertification for CPR and one late for Medication Administration recertification.

Fulfillment Tender Care- Initial Consult- Personnel and training reviewed and feedback given. No major concerns identified during the systems and process review.




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In the West Region:
West TN Family Solutions – This Day/Res provider scored 52 of 54/Exceptional; no Domain or Outcome scored less than PC. Areas needing attention include 3C6 (background check scope not always sufficient and
majority of checks were completed early; a few late registry checks but compliance for each registry check was >85%) and 9B2 (for new staff, repeat issue of incomplete documentation with some training late or not
evident; for tenured staff repeat issue of late training).
Tim’s Place – This Day/Res micro-board scored 50 of 54/Proficient; no Domain scored less than PC; Outcome 4D scored NC as not all psychotropic medications taken had informed consent and HRC review; and the
provider started locking a freezer in the home where some of the person’s food is kept without HRC review of the restriction. The only other area identified as needing attention was 9C2 (documentation does not support
completion of unannounced supervisory visits as required).
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 May 2010, 70% achieved Substantial Compliance with this Outcome. Cumulative performance is at 73% 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 May 2010, 40% achieved Substantial Compliance with this Outcome. Cumulative performance is at 51% 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 May 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 May 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.) The providers surveyed in May 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.) Of the providers surveyed in May 2010, 70% achieved Substantial Compliance
with this Indicator. Cumulative performance is at 66% Substantial Compliance for the providers surveyed this year.

As represented in the graph, 15 (33%) Day-Residential providers have performed in the Exceptional Performance category, 19 (42%) have performed in the Proficient category, 7 (16%) are in the Fair category and 4
(9%) 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.




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E       Provider Qualifications / Monitoring (II.H., II.K.)
        Personal Assistance                                                         Statewide 5/10                                 Cumulative / Statewide 5/10
    1   # of Day and Residential Providers Monitored this
                                                                                          1                                                        5
        Month
    2   Total Census of Providers Surveyed                                                68                                                  235
    3   # of Sample Size                                                                  15                                                   43
    4   % of Individuals Surveyed                                                        22%                                                  18%
    5   # of Additional Focused Files Reviewed                                            0                                                    0
                                                                Substantial     Partial      Minimal      Non-         Substantial  Partial            Minimal      Non-
                                                                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 unique            100%            0%           0%           0%         80%             0%              20%           0%
      needs, expressed preferences and decisions.

 9 Outcome B. Services and supports are provided                           0%         100%            0%           0%         20%           80%                 0%          0%
   according to the person’s plan.
10 Outcome C. Individual risk is assessed and adequate,                  100%            0%           0%           0%        100%             0%                0%          0%
   timely intervention is provided.
11 Outcome D. The person’s plan and services are                         100%            0%           0%           0%         60%           20%                 0%         20%
   monitored for continued appropriateness and revised as
   needed.
12 Domain 3: Safety and Security
13 Outcome A. Where the person lives and works is safe.                  100%            0%           0%           0%        100%             0%                0%          0%

15 Outcome C. Safeguards are in place to protect the                       0%         100%            0%           0%           0%         100%                 0%          0%
   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 the                     100%            0%           0%           0%        100%             0%                0%          0%
   community.
19 Outcome C. The person exercises his or her rights.                    100%            0%           0%           0%        100%             0%                0%          0%
20 Outcome D. Restricted interventions are imposed only                  100%            0%           0%           0%        100%             0%                0%          0%
   with due process.
21 Domain 5: Health
22 Outcome A. The person has the best possible health.                   100%            0%           0%           0%         80%           20%                 0%          0%

23 Outcome B. The person takes medications as                            100%            0%           0%           0%         75%           25%                 0%          0%
   prescribed.
24 Outcome C. The person's dietary and nutritional needs                 100%            0%           0%           0%        100%             0%                0%          0%
   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.




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E   Provider Qualifications / Monitoring (II.H., II.K.)      Substantial     Partial      Minimal      Non-         Substantial  Partial        Minimal      Non-
                                                             Compliance %    Compliance % Compliance % compliance % Compliance % Compliance %   Compliance % compliance %
35 Domain 9: Provider Capabilities and Qualifications

36 Outcome A. The provider meets and maintains                          0%         100%            0%           0%         40%           40%             0%         20%
   compliance with applicable licensure and provider
   agreement requirements.
37 Indicator 9.A.1.: The provider meets and maintains                 100%                                      0%        100%                                       0%
   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 implements             100%                                      0%         80%                                      20%
   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 job                 100%            0%           0%           0%         40%           40%           20%           0%
   specific qualifications.
41 Indicator 9.B.2.: Provider staff have received                     100%                                      0%         40%                                      60%
   appropriate training and, as needed, focused or
   additional training to meet the needs of the person.
42 Outcome C. Provider staff are adequately supported.                  0%         100%            0%           0%         20%           80%             0%          0%

43 Outcome D. Organizations receive guidance from a                   100%            0%           0%           0%         80%           20%             0%          0%
   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                        0%         100%            0%           0%         80%           20%             0%          0%
   requirements related to the services and supports that
   they provide.




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                                                                        Cumulative Performance Ratings Across All Regions- Personal Assistance

                                    4
                                                                                                                                                                                              Exceptional Performance
               Number of Agencies


                                    3
                                                                                                                                                                                              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: East- no reviews; Middle- no reviews; West- Tennessee Personal Assistance.
In the West Region:
Tennessee Personal Assistance – this PA provider scored 46 of 54/ Proficient; no Domain or Outcome scored less than PC. Areas needing attention include 2B3 (provision of nursing services as authorized); 3C6
(timeliness of registry and background checks; 3C10 – late reporting of incidents and incomplete RIFs); 9A6 (utilization of all self assessment findings in quality improvement planning); 9C2 (inconsistent completion of
supervisory visits); and 10A1 (billing for nursing for 2 people).

The following Outcomes are being studied by DIDS.
Domain 2, Outcome B (Services and Supports are provided according to the person’s plan.)
The provider surveyed in May 2010 was not in Substantial Compliance with this Outcome. Cumulative performance is at 20% 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.)
The provider surveyed in May 2010 achieved Substantial Compliance with this Outcome. Cumulative performance is at 60% 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 provider surveyed in May 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 provider surveyed in May 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 provider surveyed in May 2010 achieved Substantial Compliance with this Indicator. Cumulative performance is at 80% 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 provider surveyed in May 2010 achieved Substantial Compliance with this
Indicator. Cumulative performance is at 40% Substantial Compliance for the providers surveyed this year.

As represented in the graph, 1 (20%) provider has performed in the Exceptional Performance category, 3 (60%) have performed in the Proficient category, and 1 (20%) is 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.




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

        ISC Providers                                                            Statewide 4/10                                Cumulative / Statewide 4/10
    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.




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




                                                                                                                                                                           1 Exceptional Performance

                      1                                                                                                                                                    2 Proficient

                                                                                                                                                                           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.




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E       Clinical Providers- Behavioral                                            Statewide 5/10                                Cumulative / Statewide 5/10
    1   # of Clinical Providers Monitored for the month                                 5                                                    7
    2   Total Census of Providers Surveyed                                              47                                                  64
    3   # of Sample Size                                                                14                                                  21
    4   % of Individuals Surveyed                                                      30%                                                 33%
        # 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 his or her                 100%            0%           0%          0%        100%             0%           0%           0%
      unique needs, expressed preferences and decisions.

 7 Outcome B. Services and supports are provided                       100%            0%           0%          0%          85%            0%          14%           0%
   according to the person's plan.
 8 Outcome C. Individual risk is assessed and adequate,                 80%          20%            0%          0%          71%           14%          14%           0%
   timely intervention is provided.
 9 Outcome D. The person's plan and services are                       100%            0%           0%          0%        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 safe.                100%            0%           0%          0%        100%             0%           0%           0%

12 Outcome C. Safeguards are in place to protect the                    60%          40%            0%          0%          57%           28%          14%           0%
   person from harm.
13 Domain 4: Rights, Respect and Dignity
14 Outcome A. The person is valued, respected, and                     100%            0%           0%          0%        100%             0%           0%           0%
   treated with dignity.
15 Outcome D. Restricted interventions are imposed only                100%            0%           0%          0%        100%             0%           0%           0%
   with due process.
16 Domain 6: Choice and Decision-Making
17 Outcome A. The person and family members are                        100%            0%           0%          0%          85%            0%           0%          14%
   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                          20%          80%            0%          0%          14%           71%          14%           0%
   compliance with applicable licensure and provider
   agreement requirements.
20 Indicator 9.A.1.: The provider meets and maintains                  100%                                     0%        100%                                       0%
   compliance with applicable licensure, certification and
   contract requirements.
21 Indicator 9.A.2.: The provider complies with                         80%                                    20%          85%                                     14%
   requirements in the provider agreement.
22 Outcome B. Provider staff are trained and meet job                  100%            0%           0%          0%        100%             0%           0%           0%
   specific qualifications.
23 Indicator 9.B.2.: Provider staff have received                      100%                                     0%        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 supported.                 100%            0%           0%          0%        100%             0%           0%           0%
25 Domain 10: Administrative Authority and Financial
   Accountability
26 Outcome A. Providers are accountable for DIDS                       100%            0%           0%          0%          85%            0%          14%           0%
   requirements related to the services and supports that
   they provide.




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                                                                         Cumulative Performance Ratings Across All Regions- Clinical- Behavioral

                                    3
                                                                                                                                                                                              1 Exceptional Performance
               Number of Agencies




                                                                                                                                                                                              2 Proficient
                                    2

                                                                                                                                                                                              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: East: JKP Analysts, Samantha Edwards; Middle: no reviews; West: Irfa Karmali, Sympathetic Steps to Success, Yvonne Randolph.
In the East Region:
JKP Analysts, LLC- The survey resulted in an overall performance rating of Exceptional Performance, score of 36, the highest possible score with all Domains resulting in SC. Out of a total of 33 applicable Indicators, 4
were found to be in less than full compliance: timeliness of RIIT completion, need to expand PFH and Complaint Resolution policies and the need to obtain prior written approval of DIDS for the one subcontracted staff of
the agency; the provider has taken actions to correct this. At the time of the survey, services were being provided to two people.
Samantha Edwards, BA - The survey resulted in an overall performance rating of Exceptional, score of 36, the highest possible score with all applicable Domains resulting in SC. Additionally for this independent
provider, all applicable Indicators were found to be in compliance and, subsequently, all Outcomes resulted in SC. At the time of the survey, services were being provided to three people.
In the Middle Region:
Beacon Behavior Consultants- Billing only completed as they are no longer providing services. No issues identified with documentation supporting the units billed.

In the West Region:
Irfa Karmali – This independent BA scored 34 of 36/Exceptional; the only areas identified as needing attention were 9A5 & 6 (self-assessment process does not include a review of agency systems, only individual
records).

Sympathetic Steps to Success – This behavior provider scored 32 of 36/Proficient on its initial survey; no Domain or outcome scored than PC. Areas needing attention include 3C6 (background check timeliness and
scope; completion of sufficient and timely registry checks; accurate completion of 1 of 1 RIF and late notifications) and 9A5 & 6 (self-assessment checklist developed but not yet implemented; all monitoring results have
not been considered re: need for change in services/ agency systems).
Yvonne Randolph – This independent BA scored 34 of 36/Exceptional; the only areas identified as needing attention were9A5 & 6 (the provider continues to not have completed developing her system for self-
assessment though there was improvement since last year; all monitoring results have not been considered re: need for change in services/ agency systems).

As shown in the graph, the 5 (71%) of the providers reviewed thus far this year are in the Exceptional Performance category, 1 (14%) is in the Proficient category, and 1 (14%) is in the Serious Deficiencies category.


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 May 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.) Of the providers surveyed in May 2010, 80% achieved Substantial Compliance with this
Indicator. Cumulative performance is at 85% 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 May 2010 were in Substantial Compliance.
Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.

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.


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E       Clinical Providers- Nursing                                              Statewide 5/10                                Cumulative / Statewide 5/10
    1 # of Clinical Providers Monitored for the month                                                                                       3
    2 Total Census of Providers Surveyed                                                                                                   58
    3 # of Sample Size                                                                                                                      9
    4 % of Individuals Surveyed                                                                                                           16%
      # 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 unique                                                                100%             0%           0%           0%
      needs, expressed preferences and decisions.
 7 Outcome B. Services and supports are provided                                                                           66%           33%           0%           0%
   according to the person's plan.
 8 Outcome C. Individual risk is assessed and adequate,                                                                  100%             0%           0%           0%
   timely intervention is provided.
 9 Outcome D. The person's plan and services are                                                                           66%           33%           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 safe.                                                                  100%             0%           0%           0%
12 Outcome C. Safeguards are in place to protect the                                                                        0%         100%            0%           0%
   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 only
   with due process.
16 Domain 5: Health
17 Outcome A. The person has the best possible health.                                                                   100%             0%           0%           0%
18 Outcome B. The person takes medications as                                                                             66%            33%           0%           0%
   prescribed.
19 Outcome C. The person’s dietary and nutritional needs                                                                 100%             0%           0%           0%
   are adequately met.
20 Domain 6: Choice and Decision-Making
21 Outcome A. The person and family members are                                                                          100%             0%           0%           0%
   involved in decision-making at all levels of the system.
22 Domain 9: Provider Capabilities and Qualifications

23 Outcome A. The provider meets and maintains                                                                             66%           33%           0%           0%
   compliance with applicable licensure and provider
   agreement requirements.
24 Indicator 9.A.1.: The provider meets and maintains                                                                    100%                                       0%
   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 job                                                                      66%           33%           0%           0%
   specific qualifications.
27 Indicator 9.B.2.: Provider staff have received                                                                          66%                                     33%
   appropriate training and, as needed, focused or
   additional training to meet the needs of the person.
28 Outcome C. Provider staff are adequately supported.                                                                   100%             0%           0%           0%
29 Domain 10: Administrative Authority and Financial
   Accountability
30 Outcome A. Providers are accountable for DIDS                                                                         100%             0%           0%           0%
   requirements related to the services and supports that
   they provide.




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                                                                 Cumulative Performance Ratings Across All Regions- Clinical- Nursing

                          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:
Nursing: None
In the Middle Region:
Nurse One/Team One-Billing only completed as they are no longer providing services. No issues identified with documentation supporting units billed.
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.




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E       Clinical Providers- Therapy                                               Statewide 5/10                                Cumulative / Statewide 5/10
    1   # of Clinical Providers Monitored for the month                                 3                                                    9
    2   Total Census of Providers Surveyed                                             153                                                 409
    3   # of Sample Size                                                                20                                                  56
    4   % of Individuals Surveyed                                                      13%                                                 14%
    5   # of Additional Focused Files Reviewed                                          0                                                    0

                                                              Substantial     Partial      Minimal      Non-        Substantial  Partial        Minimal      Non-
                                                              Compliance %    Compliance % Compliance % compliance% Compliance % Compliance %   Compliance % compliance%

 6 Domain 2: Individual Planning and Implementation
   Outcome A. The person's plan reflects or her unique
 7 needs, expressed preferences and decisions.                        100%            0%            0%          0%          88%          11%            0%           0%
   Outcome B. Services and supports are provided
 8 according to the person's plan.                                      66%           0%           33%          0%          44%          33%           22%           0%
   Outcome C. Individual risk is assessed and adequate,
 9 timely intervention is provided.                                     66%          33%            0%          0%          55%          33%           11%           0%
   Outcome D. The person's plan and services are
   monitored for continued appropriateness and revised as
10 needed.                                                              66%           0%           33%          0%          44%          33%           22%           0%
11 Domain 3: Safety and Security

12 Outcome A. Where the person lives and works is safe.               100%            0%            0%          0%        100%             0%           0%           0%
   Outcome C. Safeguards are in place to protect the
13 person from harm.                                                  100%            0%            0%          0%          88%          11%            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 only               100%            0%            0%          0%        100%             0%           0%           0%
16 with due process.
17 Domain 6: Choice and Decision-Making

   Outcome A. The person and family members are
18 involved in decision-making at all levels of the system.           100%            0%            0%          0%        100%             0%           0%           0%

19 Domain 9: Provider Capabilities and Qualifications
   Outcome A. The provider meets and maintains
   compliance with applicable licensure and provider
20 agreement requirements.                                              66%          33%            0%          0%         55%           44%            0%           0%
   Indicator 9.A.1.: The provider meets and maintains                  100%                                     0%        100%                                       0%
   compliance with applicable licensure, certification and
21 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 job
23 specific qualifications.                                           100%            0%            0%          0%        100%             0%           0%           0%
   Indicator 9.B.2.: Provider staff have received                                                                         100%                                       0%
   appropriate training and, as needed, focused or
24 additional training to meet the needs of the person.
25 Outcome C. Provider staff are adequately supported.                 100%            0%           0%          0%        100%             0%           0%           0%
   Domain 10: Administrative Authority and Financial
26 Accountability
   Outcome A. Providers are accountable for DIDS
   requirements related to the services and supports that
27 they provide.                                                        66%          33%            0%          0%          77%          22%            0%           0%




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                                                                          Cumulative Performance Ratings Across All Regions- Clinical- Therapy

                                    4
                                                                                                                                                                                              1 Exceptional Performance
               Number of Agencies

                                    3
                                                                                                                                                                                              2 Proficient

                                    2                                                                                                                                                         3 Fair

                                                                                                                                                                                              4 Significant Concerns
                                    1

                                                                                                                                                                                              5 Serious Deficiencies
                                    0
                                                  East                                              Middle                                               West
                                                                                              Performance Ratings


Analysis:
Reviews: East: no reviews; Middle: Full Circle Therapy, Nina Ingham; West: Independent Therapy Network.
In the Middle Region:
Nina Ingham- O&M- Scored Exceptional Performance (perfect score). No issues and met criteria for 4-Star status.

Full Circle- PT-Score Fair on the QA survey with a Minimal Compliance score in Domain 2. Issues identified were inadequate documentation pertaining to equipment, inadequate documentation in contact notes at times
making it difficult to determine the skilled services provided, and the monthly reviews did not contain all required components, required training, service dates or contact with the ISC to amend ISP to include new goals.
Domain 10 received a Partial Compliance rating overall, however a warning was given about the need to improve documentation required for billing purposes.
In the West Region:
Independent Therapy Network – This Clinical/Therapy provider scored 36 of 36/Exceptional. No areas of noncompliance were noted.

As shown in the graph, the 5 (56%) of the providers reviewed thus far this year are in the Exceptional Performance category, 1 (11%) is in the Proficient category, and 3 (33%) are performing in the Fair category.


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 May 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 provider surveyed in May 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.) This Indicator was not applicable to the provider surveyed in May 2010.
Cumulative performance is at 100% Substantial Compliance for the providers surveyed this year.

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.




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                                                                                                          Data Management Report
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                                                                            Cumulative Performance Ratings Across All Regions / All Types

                        14

                        12
   Number of Agencies




                        10                                                                                                                                                                Exceptional Performance

                         8                                                                                                                                                                Proficient
                                                                                                                                                                                          Fair
                         6                                                                                                                                                                Significant Concerns
                                                                                                                                                                                          Serious Deficiencies
                         4

                         2

                         0
                                    East                                                  Middle                                                  West
                                                                                   Performance Ratings


Graph of all Providers:

As represented in the graph, 27 providers (39%) have performed at the level of Exceptional Performance, 25 providers (36%) have performed at the Proficient level, 12 providers (17%) have performed in the Fair
category, 4 (6%) are in the category of Significant Concerns and one provider (1%) is in the category of Serious Deficiencies.




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                                                                                                        Data Management Report
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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-09     Aug-09        Sep-09       Oct-09      Nov-09      Dec-09        Jan-10       Feb-10    Mar-10     Apr-10 May-10      Jun-10
    1 # of Individual Personal Funds Accounts Reviewed                                             15         15            11           33          13           9            15            8        30         25     16
      # of Individual Personal Funds Accounts Fully
    2 Accounted For                                                                               8           10            9            32           9           6            12           4          27           24      16
    3 # of Personal Funds Accounts Found Deficient                                                7            5            2             1           4           3             3           4           3            1       0
    4 % of Personal Funds Fully Accounted for                                                   53%         67%           82%          97%          69%         67%          80%          50%        90%          96%    100% #DIV/0!
    5 % of Personal Funds Found Deficient                                                       47%         33%           18%           3%          31%         33%          20%          50%        10%           4%      0% #DIV/0!

    Personal Funds - Middle                                                                    Jul-09     Aug-09        Sep-09       Oct-09      Nov-09      Dec-09        Jan-10       Feb-10    Mar-10     Apr-10 May-10      Jun-10
  6 # of Individual Personal Funds Accounts Reviewed                                               15         11            15           22          14          12             2           16        20         10     19
    # of Individual Personal Funds Accounts Fully
  7 Accounted For                                                                                 7           8             10           11           10           2           2            11         17           6      12
  8 # of Personal Funds Accounts Found Deficient                                                  8           3              5           11            4          10           0             5          3           4       7
  9 % of Personal Funds Fully Accounted for                                                     47%         73%           67%          50%          71%         17%         100%          69%        85%          60%    63% #DIV/0!
 10 % of Personal Funds Found Deficient                                                         53%         27%           33%          50%          29%         83%           0%          31%        15%          40%    37% #DIV/0!

    Personal Funds - West                                                                      Jul-09     Aug-09        Sep-09       Oct-09      Nov-09      Dec-09        Jan-10       Feb-10    Mar-10     Apr-10 May-10      Jun-10
 11 # of Individual Personal Funds Accounts Reviewed                                                7          0             8           20           0          18             0            4         2          9     10
    # of Individual Personal Funds Accounts Fully
 12 Accounted For                                                                                 5           NA            8            20          NA           13            0           4          1         9          10
 13 # of Personal Funds Accounts Found Deficient                                                  2           NA            0             0          NA            5            0           0          1         0           0
 14 % of Personal Funds Fully Accounted for                                                     71%           NA         100%         100%           NA         72%            NA        100%        50%      100%       100% #DIV/0!
 15 % of Personal Funds Found Deficient                                                         29%           NA           0%           0%           NA         28%            NA          0%        50%        0%         0% #DIV/0!

    Personal Funds - Statewide                                                                 Jul-09     Aug-09        Sep-09       Oct-09      Nov-09      Dec-09        Jan-10       Feb-10    Mar-10     Apr-10 May-10      Jun-10
 16 # of Individual Personal Funds Accounts Reviewed                                               37         26            34           75          27          39            17           28        52         44     45
    # of Individual Personal Funds Accounts Fully
 17 Accounted For                                                                                 20          18            27           63           19          21           14           19         45           39     38
 18 # of Personal Funds Accounts Found Deficient                                                  17           8             7           12            8          18            3            9          7            5      7
 19 % of Personal Funds Fully Accounted For                                                     54%         69%           79%          84%          70%         54%          82%          68%        87%          89%    84% #DIV/0!
 20 % of Personal Funds Found Deficient                                                         46%         31%           21%          16%          30%         46%          18%          32%        13%          11%    16% #DIV/0!


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


 21 Cumulative Funds Data                                                        Jul-09       Aug-09      Sep-09        Oct-09       Nov-09      Dec-09       Jan-10       Feb-10       Mar-10    Apr-10     May-10 Jun-10
 22 # of Individual Personal Funds Accounts Reviewed                                 37           63          97          172           199        238            17           45           97      141        146
    # of Individual Personal Funds Accounts Fully
 23 Accounted For                                                                    20           38          65           128          147          168          14           33           78        117          118
 24 # of Personal Funds Accounts Found Deficient                                     17           25          32            44           52           70           3           12           19         24           24
 25 % Funds Accounted for, Cumulatively                                            54%          60%         67%           74%          74%          71%         82%          73%          80%        83%          81% #DIV/0!
 26 % Funds Deficient, Cumulatively                                                46%          40%         33%           26%          26%          29%         18%          27%          20%        17%          17% #DIV/0!




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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, 100% of personal funds were fully accounted for.
In the Middle Region, 63% of personal funds were fully accounted for.
In the West Region, 100% of personal funds were fully accounted for.
Statewide, 84% of funds were fully accounted for in May 2010.
Among the issues identified with personal funds management included:
East Region:
Frontier Health: Of the 6 accounts reviewed, all 6 were considered to be fully accounted for with no issues noted.

Tri-County Center: Of the 5 accounts reviewed, all 5 were considered to be fully accounted for with some issues noted: Each person is authorized to sign their own checks; no logs are being maintained for cash
spending and Food Stamps and no signatures are being retained for withdrawal or spending; inventories lacked details for some personal property.

Cerebral Palsy Center: Of the 5 accounts reviewed, all 5 were considered to be fully accounted for with some issues noted: Spending logs were not accurate, some problems with duplicate payments and unequal splits
between roommates and inventories lacked details for some personal property.
Middle Region:
PAI- For all 5 of the individuals reviewed, issues were identified. Many had account debits without supporting receipts requiring reimbursement to the individual, a stop payment charge for a lost check had been paid by
an individual and several had monies applied to accounts receivable that had been written off by the agency as of 7/1/09.

Connexus- For the 3 people reviewed, 1 required the reimbursement of funds by the agency to the individual for failure to maintain receipts. Also all 3 reviewed had incurred debt to the agency.

Hilltoppers- All 5 people reviewed had appropriate documentation to support spending.

Volunteer Staffing- All 3 people reviewed had personal funds accounted for properly.
West Region:
WTFS- Personal funds documentation was very well organized and policies and procedures for the management of personal funds comply with DIDS requirements. The provider generally kept the appropriate receipts
for expenditures and kept up with the person’s income, expenses, and resources. Personal allowances were tracked through an established system, and reconciled monthly. The provider showed evidence of monthly
reconciliation of bank statements and checkbooks. In addition, the provider has a system for monitoring resources including Social Security allotments and food stamp awards. Lease agreements for four of the six
persons reviewed did not include the Division’s policy requirement of a 60-day notice for an increase in rent.
Tennessee Personal Assistance- This PA agency also provides a small amount of SL services. The personal funds were well documented at the agency as well as in the homes. The agency’s personal funds policy
addressed advances. There were bank signature cards and monthly bank statements with reconciliations presented. All rewards letters for Social Security and Food Stamps were present. Inventories were well
documented and were being kept up to date. Surveyors found areas that should be addressed which include appropriate language in leases, the presence of excessive amount of money in the homes, petty cash checks
made out to the house manager rather than the service recipient, and lack of description of the origin of deposits.
Tim's Place- Personal funds management was not reviewed. The service recipient's mother is his representative payee and, though she is agency Director and a member of the Board, she is not paid staff nor does she
provide money to paid staff to distribute to the person.
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.




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                                                                                                           Data Management Report
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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 appeals. The

    East Region                                                  Jul-09        Aug-09        Sep-09        Oct-09            Nov-09        Dec-09        Jan-10        Feb-10       Mar-10        Apr-10        May-10   Jun-10
    SERVICE REQUESTS
    Total Service Requests Received                                    2286         2197          2437         2128             1900           1921         2055          2037          2578          2459
    Total Adverse Actions (Incl. Partial Approvals)                     246          230           218          231              253            203          191           198           265           254
    % of Service Requests Resulting in Adverse Actions                 11%          10%            9%          11%              13%            11%           9%           10%           10%           10%
    Total Grier denial letters issued                                   152          135           129          116              103            104           91           118           141           127
    APPEALS RECEIVED
    DELIVERY OF SERVICE
    Delay                                                                 0             0             0             0                 0             0             0             0            0             0
    Termination                                                           0             0             0             0                 0             0             0             0            0             0
    Reduction                                                             0             0             0             0                 0             0             0             0            0             0
    Suspension                                                            0             0             0             0                 0             0             0             0            0             0
    Total Received                                                        0             0             0             0                 0             0             0             0            0             0
    DENIAL OF SERVICE
    Total Received                                                        28            16            21         15                   25            17            18        24               23            28
    Total Grier Appeals Received                                          28            16            21         15                   25            17            18        24               23            28
    Total Non-Grier Appeals Received                                       0             0             0          0                    0             0             0         0                0             0
    Total appeals overturned upon reconsideration                          0             0             0          2                    2             3             2         4                4             2

    TOTAL HEARINGS                                                        3             1             7             8                 2             18            24        23               23            25

    DIRECTIVES
    Directive Due to Notice Content Violation                              0           0               0          0                 0             0                0          0              0             0
    Directive due to ALJ Ruling in Recipient's Favor                       0           1               0          1                 0             1               10          1              2             2
    Other                                                                  1           0               0          4                 3             1                9          3              1             2
    Total Directives Received                                              1           1               0          5                 3             2               19          4              3             4
    Overturned Directives                                                  0           1               0          0                 0             0                0          0              0             0
    MCC Directives                                                         0           0               0          0                 0             0                0          0              0             0
    Cost Avoidance (Estimated)                                            $0     $74,205              $0   $103,131           $57,016      $101,883               $0    $31,006              0             0
    LATE RESPONSES
    Total Late Responses                                                  0             0             0             0                 0             0             0             0            0             0
    Total Days Late                                                       0             0             0             0                 0             0             0             0            0             0
    Total Fines Accrued (Estimated)                                       0             0             0             0                 0             0             0             0            0             0
    DEFECTIVE NOTICES
    Total Defective Notices Received                                       0           3             1            1                    0             0         2             1               0             0
    Total Fines Accrued (Estimated)                                       $0      $1,500          $500         $500                   $0            $0      $600          $500               0             0
    *fine amount is based on timely responses
    PROVISION OF SERVICES
    Delay of Service Notifications Sent (New)                             0             0             0             0                 0             0             0             0            0             0
    Continuing Delay Issues (Unresolved)                                  4             4             4             4                 4             4             4             0            0             0
    Total days service(s) not provided per TennCare
    ORR                                                                   0             0             0             0                 0             0             0             0            0             0
    Total Fines Accrued (Estimated)                                       0             0             0             0                 0             0             0             0            0             0




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                                                                                               Data Management Report
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Middle Region                                        Jul-09        Aug-09        Sep-09        Oct-09            Nov-09        Dec-09        Jan-10        Feb-10       Mar-10        Apr-10        May-10   Jun-10
SERVICE REQUESTS
Total Service Requests Received                           2162         2258          2256         2259              1955           1810         1792          2128          2481          2615
Total Adverse Actions (Incl. Partial Approvals)            294          254           264          272               211            215          238           250           287           253
% of Service Requests Resulting in Adverse Actions        14%          11%           12%          12%               11%            12%          13%           12%           12%           10%
Total Grier denial letters issued                          243          149           216          179               170            151          104           144           175           163
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                         0             0             0             0                 3             1             2             0            0             0
Termination                                                   0             0             0             0                 0             0             0             0            0             0
Reduction                                                     0             0             0             0                 0             0             0             0            0             0
Suspension                                                    0             0             0             0                 0             0             0             0            0             0
Total Received                                                0             0             0             0                 3             1             2             0            0             0
DENIAL OF SERVICE
Total Received                                                23            43            14         21                   21            21            10        14               17            20
Total Grier Appeals Received                                  23            43            14         21                   24            22            12        14               17            20
Total Non-Grier Appeals Received                               0             0             2          0                    1             0             0         0                0             0
Total appeals overturned upon reconsideration                  8            13             4         10                    6             7             6         7                8             8

TOTAL HEARINGS                                                30            29            19         36                   17            18            26        23               13            18

DIRECTIVES
Directive Due to Notice Content Violation                      0             0             0          0                    0             0             0          0              0           0
Directive due to ALJ Ruling in Recipient's Favor               0             0             0          1                    1             0             1          1              0           0
Other                                                          0             1             0          4                    0             0             1          2              3           1
Total Directives Received                                      0             1             0          5                    1             0             2          3              3           1
Overturned Directives                                          0             0             0          0                    0             0             0          0              0           0
MCC Directives                                                 0             0             0          0                    0             0             0          0              0           0
Cost Avoidance (Estimated)                                    $0            $0            $0         $0                   $0            $0            $0     $5,668                   $175,529
LATE RESPONSES
Total Late Responses                                           0             0             0          0                    0          1            0             0             2             1
Total Days Late                                                0             0             0          0                    0          1            0             0             4             3
Total Fines Accrued (Estimated)                               $0            $0            $0         $0                   $0       $100         $100            $0           400           300
DEFECTIVE NOTICES
Total Defective Notices Received                             1            2             1            1                 1              1                0         0                0          1
Total Fines Accrued (Estimated)                           $500       $1,000          $500         $500              $500           $500               $0        $0               $0        500
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                     0             0             0             0                 0             0             0             0            0             1
Continuing Delay Issues (Unresolved)                          1             0             0             0                 0             0             0             0            0             0
Total days service(s) not provided per TennCare
ORR                                                           0             0             0             0                 0             0             0             0            0             0
Total Fines Accrued (Estimated)                               0             0             0             0                 0             0             0             0            0             0




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West Region                                          Jul-09        Aug-09        Sep-09        Oct-09            Nov-09        Dec-09        Jan-10        Feb-10       Mar-10        Apr-10       May-10   Jun-10
SERVICE REQUESTS
Total Service Requests Received                           2120         2474          2412         2149              1998           1887         1456          1827          2129          2006
Total Adverse Actions (Incl. Partial Approvals)            228          302           274          241               227            197          168           149           173            85
% of Service Requests Resulting in Adverse Actions        11%          12%           11%          11%               11%            10%          12%            8%            8%            4%
Total Grier denial letters issued                          145          164           161          151               137            125           67            97            79            78
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                         0             0             0             0                 0             0             0             0            1             0
Termination                                                   0             0             0             0                 0             0             0             0            0             0
Reduction                                                     0             0             0             0                 0             0             0             0            0             0
Suspension                                                    0             0             0             0                 0             0             0             0            0             0
Total Received                                                0             0             0             0                 0             0             0             0            1             0
DENIAL OF SERVICE
Total Received                                                28            17            24         27                   17            11            11            5            13            6
Total Grier Appeals Received                                  28            17            24         27                   17            11            11            5            14            6
Total Non-Grier Appeals Received                               0             0             0          0                    0             0             0            0             0            0
Total appeals overturned upon reconsideration                  6             1             4          7                    5             2             1            0            14            2

TOTAL HEARINGS                                                21            24            21         27                   21            23            16        18               17            5

DIRECTIVES
Directive Due to Notice Content Violation                      0             0             0          1                    0          0                0          0            0               0
Directive due to ALJ Ruling in Recipient's Favor               0             1             3          0                    0          2                0          1            2               2
Other                                                          0             3             0          0                    0          4                3          3            5               0
Total Directives Received                                      0             4             3          1                    0          6                3          4            7               2
Overturned Directives                                          0             0             0          0                    0          0                0          0            0               0
MCC Directives                                                 0             0             0          0                    0          0                0          0            0               0
Cost Avoidance (Estimated)                                    $0            $0            $0         $0                   $0   $212,670               $0    $45,174     $224,531               0
LATE RESPONSES
Total Late Responses                                          0             0             0             0                 0             0             0             0            0             0
Total Days Late                                               0             0             0             0                 0             0             0             0            0             0
Total Fines Accrued (Estimated)                               0             0             0             0                               0             0             0            0             0
DEFECTIVE NOTICES
Total Defective Notices Received                             4            7             2             3                    0          1                0         1             1               0
Total Fines Accrued (Estimated)                         $2,000       $3,500        $1,000        $1,500                   $0       $500               $0      $500          $500               0
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                     1             4             2             4                 4             1             2             2            6             3
Continuing Delay Issues (Unresolved)                          0             0             1             1                 2             2             2             2            2             2
Total days service(s) not provided per TennCare
ORR                                                           0             0             0             0                 0             0             0             0            0             0
Total Fines Accrued (Estimated)                               0             0             0             0                 0             0             0             0            0             0




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                                                                                               Data Management Report
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Statewide                                            Jul-09        Aug-09        Sep-09        Oct-09            Nov-09        Dec-09        Jan-10        Feb-10       Mar-10        Apr-10        May-10   Jun-10
SERVICE REQUESTS
Total Service Requests Received                           6568         6929          7105         6536              5853           5618         5303          5992          7188          7080
Total Adverse Actions (Incl. Partial Approvals)            768          786           756          744               691            615          597           597           725           592
% of Service Requests Resulting in Adverse Actions        12%          11%           11%          11%               12%            11%          11%           10%           10%            8%
Total Grier denial letters issued                          540          448           506          446               410            416          262           359           395           368
APPEALS RECEIVED
DELIVERY OF SERVICE
Delay                                                         0             0             0             0                 3             1             2             0            1             0
Termination                                                   0             0             0             0                 0             0             0             0            0             0
Reduction                                                     0             0             0             0                 0             0             0             0            0             0
Suspension                                                    0             0             0             0                 0             0             0             0            0             0
Total Received                                                0             0             0             0                 3             1             2             0            1             0
DENIAL OF SERVICE
Total Received                                                79            76            59         63                   63            49            39        43               53            54
Total Grier Appeals Received                                  79            76            59         63                   66            50            41        43               54            54
Total Non-Grier Appeals Received                               0             0             2          0                    1             0             0         0                0             0
Total appeals overturned upon reconsideration                 14            14             8         19                   13            12             9        11               26            12

TOTAL HEARINGS                                                54            54            47         71                   40            59            66        64               53            48

DIRECTIVES
Directive Due to Notice Content Violation                      0          0                0          1                 0             0                0          0            0             0
Directive due to ALJ Ruling in Recipient's Favor               0          2                3          2                 1             3               11          3            4             4
Other                                                          1          4                0          8                 3             5               13          8            9             3
Total Directives Received                                      1          6                3         11                 4             8               24         11           13             7
Overturned Directives                                          0          1                0          0                 0             0                0          0            0             0
MCC Directives                                                 0          0                0          0                 0             0                0          0            0             0
Cost Avoidance (Estimated)                                    $0    $74,205               $0   $103,131           $57,016      $314,553               $0    $81,847     $224,531      $175,529
LATE RESPONSES
Total Late Responses                                          0             0             0             0                 0           1               0             0          2             1
Total Days Late                                               0             0             0             0                 0           1               0             0          4             3
Total Fines Accrued (Estimated)                               0             0             0             0                 0     $100.00               0             0        400           300

Total Defective Notices Received                             5           16             4             5                1              2            2              2            1             1
Total Fines Accrued (Estimated)                         $2,500       $6,000        $2,000        $2,500             $500         $2,000         $600         $1,000         $500           500
*fine amount is based on timely responses
PROVISION OF SERVICES
Delay of Service Notifications Sent (New)                     1             4             2             4                 4             1             2             2            6             4
Continuing Delay Issues (Unresolved)                          5             4             5             5                 6             6             6             2            2             2
Total days service(s) not provided per TennCare
ORR                                                           0             0             0             0                 0             0             0             0            0             0
Total Fines Accrued (Estimated)                               0             0             0             0                 0             0             0             0            0             0




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                                                                                                                         Data Management Report
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Appeals:

DIDS received 54 appeals in April which is identical to the previous month.

There were 7080 service requests submitted in April which is a 2% decrease in volume compared to the previous month. The percentage of service requests resulting in adverse actions also experienced a 2%
reduction from the previous month. West data indicates a 4% decrease in adverse actions for the month. This change is contributed to less PA service requests being received this month, resulting in a lower adverse
action percentage (the majority of West region denials regard PA service requests).


Directives:

A total of 7 directives were received statewide in the month of April.

The East region received 4 directives. 2 directives were the result of the ALJ ruling in favor of the recipient.1 appeal rega rded a request for SL6-IND for the ISP year (9/29/09-9/28/10). The Order stated that the
region’s denial was based on the documented aggressive occurrences from midnight to 6am, but that the recipient does not sleep with any regularity (based on sleep data and other documentation presented at
hearing) and that the recipient’s behaviors were sporadic and dangerous. The directive only regarded 5 months of the service, as this was a 2009 appeal which was repeatedly continued and where COB was granted
throughout the appeal. The 2nd directive regarded a request for SL4-3 from 4/25/09-4/24/10. This was an appeal filed on 4/13/09. It was continued repeatedly per the request of Legal Aid of East TN. COB was
approved throughout the appeal.

1 directive was the result of the region approving the request during a period where the record was held open for further review after a hearing date of 3/30/10 (SL6-IND from 12/21/09-12/20/10). The remaining
directive regarded a request for SL6-IND from 9/22/10-9/21/10 where the region approved upon receiving additional information. COB was received throughout the appeal.

The West region received 2 directives. 1 directive was the result of the Single State Agency Unit (SSAU) overturning the ALJ’ s Order in favor of the recipient regarding a request for 23,360 units of PA from 9/16/09-
9/15/10. The remaining directive regarded a request for 26,352 units of PA from 9/28/09-9/27/10 in which the SSAU also overturned the ALJ’s decision in favor of the recipient.

The Middle region received 1 directive regarding an appeal for SL6-IND, CBDay6, 80 units per month in BA and 120 units per month in BS from 11/28/09-11/27/10. The ALJ ruled in favor of DIDS. The region had
approved SL4-2 and CBDay4 for the same duration resulting in a cost avoidance of $175,528.50.

The Division’s estimated cost avoidance for the month of April 2010 is $211,255.08 and is $1,316,335.87 for the year.




Cost Avoidance:


None to report.




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.
The Middle region received 1 defective notice due to incorrect personal facts in relation to the legal basis of denial. In ad dition, the region responded 3 days late to a reconsideration response. These errors resulted
in fines totaling $800.00.




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