pcs business plan
TRANSCRIPT
PREMIERE CONCIERGE SERVICES
Business Plan
Fall 2015 Caroline Foscue, Catherine Pelto, Jay Spafford, Savanna Williams,
Haley Wright
Providing excellence in patient-‐centered care, based on a foundation of knowledge, innovation, and ethical values.
2
TABLE OF CONTENTS
Executive Summary 4
Strategic Planning 6 About Premiere Concierge Services 7 Environmental Analysis 7 Office Layout 11
Marketing 17 Services Offered 18 Distribution of Services 21 Promotion of Services 22 Differential Statement 24 Geographic and Economic Demographics 24
Organization and Design 26 Legal Entity 27 Employment Positions 28 Governance of Organization 28 Coordination of Work 30 Organizational Chart 32
Staffing 33 Recruitment and Retaining 35 Contract Work 36 Staffing Issues 39 Performance Evaluation 40 Member Satisfaction 41 Benefits Package 42 Disciplinary Procedures 42 Termination 42
Regulatory Compliance 43 HIPAA Compliance 44 Drug Testing and background check Policy 45 Regulatory Compliance Policies 45
Finance and Accounting 46 Initial Funding 47 Financial Statements for Fiscal Years 1 and 2 49 Financial Specifications 51
Technology 53 Desired System Functionality 54 Acceptable Systems 54
3
Staff Training Plan 57 Security and Data Backup Plan 58 Technology and Equipment 59
Works Cited 63
Appendix A: Marketing 67 Explanation of services 68 Alabama High School Athletic Association Physical Evaluation Form 73
Appendix B: Staffing 75 Staff Member Performance Evaluation Form 80 Premiere Concierge Services: Member Satisfaction 83 Staff Member Handbook 85
Appendix C: Regulatory Compliance 95 HIPAA Compliance and Confidentiality Statement 96 Privacy Policy 97 Employee Drug Testing Policy 100 Employee Random Drug Testing Policy 106 Employee Background Check Policy 109 Equal Employment Opportunity and Harassment Policy 111 Occupational Safety and Health Program 113 ADA/ADAA Policy 118
Appendix D: Finance and Accounting 121
Appendix E: Furniture and Fixtures 129
Appendix F: Technology and Equipment 136
4
EXECUTIVE SUMMARY
Concierge medicine is a relatively new and upcoming form of providing care to patients. A patient pays an
annual fee or retainer for all or most services that the primary care physician would provide. Additionally, the
physician gives more in depth care and attention to each of his or her patients in comparison to the fifteen-‐
minute office visit that has become so standard. Concierge medicine allows a physician to go back to a more
traditional way of providing healthcare to patients, by building relationships in order to make an overall positive
impact on their health and not just treat a disease or illness.
The increase in the aging Baby Boomer population calls for more health care and services. We believe a
concierge medical facility would be beneficial to Mobile and Baldwin county residents who are retirees or have
dependent children. When it comes to our marketing ventures, our unique services such as our wellness plans
and house calls will help us stand out among various primary care providers who are unable to take the extra
time and effort to exceed a patient’s expectations. Also, we hold importance in being involved in and giving to
our community by supporting local schools and organizations and hope we gain positive attention as a result of
those efforts.
Premiere Concierge Services will be a small LLC organization, employing two physicians, a practice manager, and
two registered nurses. We believe starting small and providing the best possible care to our members should be
how we make our biggest impact before potentially expanding in the future. Having a team-‐like atmosphere in
the office is at the utmost importance to ensure both our staff and members are trusting and satisfied.
Our practice will not submit insurance claims or accept insurance. All revenue will be generated by the various
levels of membership tiers. Under the assumption our practice will not begin generating revenue for the first
sixty days of business, we must generate enough sources of cash to cover operating expenses for that period, in
5
addition to leasehold improvements, technology, and furniture. We will receive two loans from BBVA Compass
and Wells Fargo to finance the leasehold improvements, technology, and furniture. Our two physicians will
finance the remainder of our operating expenses and starts up costs at varying rates.
Premiere Concierge Services desires to obtain practice management and electronic medical record systems that
will tailor to our concierge practice needs. We also see this investment as one that will simplify processes, be
user-‐friendly for both our staff and members, and protect our members' privacy. We hope implementing such
systems will enable our practice to provide the personalized care we promise to give out members. Additionally,
because concierge medicine boasts on the idea that the medical staff is available to care for members anytime
of the day, it is vital our physicians are equipped with phones and other technology that is mobile and can be
taken to someone's home. The care provided in one's home should be of no less quality as the care provided in
our office. The use of information systems and technology will help carry out the unique components of our
concierge practice.
Our hope in creating Premiere Concierge Services is to give physicians the opportunity to care for their patients
in an unhurried and relaxed environment to help foster a true sense of understanding and trust. Focusing on the
individual as a whole to develop long term goals and plans is at the forefront in becoming our members’ partner
for health and well-‐being
6
STRATEGIC PLANNING
7
ABOUT PREMIERE CONCIERGE SERVICES
MISSION STATEMENT
We strive to provide our members with more than just healthcare. Our goal is to modernize the traditional
house call by going above and beyond what the traditional primary care practice offers. Our holistic, proactive
approach to healthcare addresses your physical, mental and emotional well-‐being through one-‐on-‐one
counseling and comprehensive diagnostic testing.
MOTTO
Providing excellence in patient-‐centered care, built on a foundation of knowledge, innovation, and ethical
values.
STRATEGIC GOALS
§ To create a service-‐based company whose primary goal is to exceed customers' expectations.
§ To establish a partnership between PCS and at least two of the top 10 local companies
§ To develop a sustainable home business, surviving off of its own cash flow.
§ To become the concierge practice of choice for Mobile and Baldwin counties.
§ To have a prominent and positive presence in the local community.
ENVIRONMENTAL ANALYSIS
We would like to enter a target market of upper middle class residents in the Mobile and Baldwin counties,
specifically retirees and families with dependent children. The average household income in both Mobile and
Baldwin counties are in the top twenty highest incomes in the state. The following tables display the population,
median household income, average housing value, and average age for the cities in which we believe the
majority of our services will be rendered:
8
The Fairhope area is notably one of the premiere retirement locations in the state. We expect that a large
portion of our patients will be of retirement age, so the retirement population in the Fairhope area would be
beneficial. The Fairhope community is highly family-‐oriented, as can be determined by the vast number of
quality public and private K-‐12 academic institutions in the area. There is market share to be gained due to the
fact that we will be acquiring the only exist concierge physician in the area. She previously performed concierge
medicine in addition to her existing primary care physician role. There has never been a true concierge practice
in the area. The sheer lack of competition would warrant an easy entry into the market as there are currently
few barriers to entry.
Daphne, 23,633
Fairhope, 16,385
Spanish Fort, 7,629
Mobile, 194,899
Population
$54,706
$71,899$62,197
$36,150
$0$10,000$20,000$30,000$40,000$50,000$60,000$70,000$80,000
Daphne Fairhope Spanish Fort
Mobile
Median Household Income
$178,826$197,099 $206,544
$119,300
$0
$50,000
$100,000
$150,000
$200,000
$250,000
Daphne Fairhope Spanish Fort
Mobile
Average Housing Value
3744
4036
0
10
20
30
40
50
Daphne Fairhope Spanish Fort Mobile
Average Age
9
SWOT ANALYSIS
PEST ANALYSIS
10
LOCATION ADVANTAGES
• We will be acquiring the only existing concierge physician in the area, eliminating competition
• Locating the office in Daphne will lower property price compared to Fairhope while still maintaining
access to to all four target cities
• Can service the Daphne, Fairhope, Spanish Fort, and high-‐income areas of Mobile
• Physicians already have privileges at the Mobile Infirmary Health Network (Thomas Hospital)
LOCATION DISADVANTAGES
• Entering a new market, which adds risk, higher marketing costs, and other challenges
• Acquiring patients who have preexisting relationships with local physicians
• Lack of knowledge of concierge medicine as a practice within the community
• Large geographical location to service
11
OFFICE LAYOUT
We would like our waiting room and lobby area to have a very comfortable and warm feel to it, similar to a living
room. Because our practice specializes in home visits, we want our members to feel as though they are in their
own home when they enter our office.
Members will enter the waiting room and lobby area where they will be greeted by our receptionist. In the
event their physician is not immediately available, the member will be invited to wait on one of our comfortable
seating options and offered a beverage and a selection of magazines. Our beverage station will consist of a self-‐
service Keurig connected to a water line so that we do not have to worry about refilling the machine. There will
be a selection of single-‐serve coffee pods. There will also be carafes of chilled, filtered water with a variety of
sliced fruits. We will offer light refreshments at the beverage station such as fresh fruit and small whole grain
pastries. We will have gas-‐powered, electric fireplace which will be lit during the colder months to add to the
homey feel.
Our color scheme consists of light blues, greens, and greys, which we have found to be inviting and not
overwhelming. Our intention is for the space to feel warm and inviting, but not overly bold and harsh.
The office will have two care suites, with each consisting of a consultative and exam room. In the exam room
there will be a comfortable exam table, physician’s stool, and an additional chair for family members. On the
exam side, visual information display and storage coexist, making the most of space and encouraging shared
understanding with information access. The consultative room will have a couch for the member and a swivel
seating for the doctors, to be able to maintain eye contact. There will be a two-‐monitor visual display to increase
the ability for the patient and doctor to understand the full picture of the health context. Both sides of the care
suite will include room for families to participate in learning and decision making.
12
13
14
PATIENT CARE SUITE
15
PATIENT CARE SUITE
16
LEASE, BUY, OR PURCHASE DECISION
Leasing office space in a local office building or complex is the best option for our practice. It is preferable that
we do not buy or build our location because our office space needs are not overly complex compared to the
average business. We will perform minimal procedures in the physical office, so there is no need to many
patient rooms.
Additionally, leasing will allow our business to have more capital in its infancy stages. The more capital we have
in the beginning the better our chances are of success. Leasing removes the complication of being tied to an
office space that we own through buying or building it in the event that our business is unsuccessful.
Maintenance issues in our facility will also be covered in our lease and be an advantage to us to where we do
not have to outsource this. Finally, if we choose to expand our practice in the future, it is easier to do so by
waiting until the termination of the lease and relocating to a new location rather than renovating or adding onto
a bought or built property.
17
MARKETING
18
SERVICES OFFERED
OUR UNIQUE SERVICES
Comprehensive Physicals
Upon a member’s first visit to the office their personal physician will meet with the new member for an hour
and a half in order to provide them with a comprehensive physical. Unlike a traditional primary care practice,
the physician will take the extra time to get to know the member, their lifestyle and their current health. Each
physician will go through the member’s medical history, check their vital signs, perform a heart exam, lung
exam, head and neck exam, abdominal exam, and neurological exam (see Appendix A for descriptions). Through
the comprehensive physical we hope to gain an in-‐depth knowledge of each member’s medical history and their
chronic medical needs, if any exist. Additionally, testing may include: a complete blood count, urine analysis,
body composition test, nutritional assessment, exercise counseling, heart screening, and stroke screening (see
Appendix A for descriptions). Our practice aims to know members as a whole person, rather than as a faceless
name on a chart.
Wellness Plan
Each member’s physician will develop a wellness plan tailored to their unique health goals and lifestyle based on
their comprehensive physical. The physician will support their patient along the way to living a healthier and
more vibrant life. Some of our areas of focus include, heart health, diabetes prevention, sleep, emotional well-‐
being, sexual health, and weight management.
Personalized Grocery Shopping
A service we will provide to our most committed members is personalized grocery shopping trips. One of our
Registered Nurses will go with members to the grocery store in order to help them select healthier foods to
19
fulfill the weight management aspect of their wellness plan. If a physician suggests a diet plan (vegan, paleo,
etc.) for their member, the Registered Nurse will help the patient to find the foods that fit within their plan.
House Calls
Our practice seeks to personalize care to fit the member’s needs, one way in which we do this is through
convenient house calls. Following our member’s comprehensive physical they have the option to elect for at
home services rather than traveling to our office. The member’s physician can provide them with any service
that can be performed in the home without the use of our in-‐office medical equipment.
Similarly, once our practice has established relationships with local companies we hope to offer in-‐office visits.
The companies can opt for discounted membership fees for their employees and our practice will come in for
the day and give employees their comprehensive physicals. This allows busy employees to avoid having to take
time out of their day to travel to our office.
OUR FREQUENT SERVICES
Office Visits
The office visit is one of our member’s most frequent reasons for coming in. The office visit can greatly range in
complexity from a minimal risk problem, such as an insect bite or cold, to a high complexity problem like the
exacerbation of one or more chronic illnesses. Management for office visit problems can range from superficial
dressings to emergency surgery.
20
Vaccinations
Some of the most common types of vaccination we plan to provide to our members are:
• Influenza • Measles, Mumps, Rubella (MMR) • Measles, Mumps, Rubella, Varicella
(MMRV)
• Meningococcal • Pneumococcal • Varicella (Chickenpox) • And Zoster (Shingles)
School Physicals
The school physical helps determine whether it is safe for a member to participate in a particular sport. The
Alabama High School Athletic Association requires the physical prior to the beginning of the season and has
specific requirements (see Appendix A for requirements). The medical history portion can be filled out by a
parent but should be reviewed by a medical professional. The pre-‐participation physical evaluation portion of
the physical is fairly standard and in line with the exams described in the comprehensive physical.
PRICING OF SERVICES
The pricing of all services that a member may need will be included in the annual membership fee they pay to
our practice. There are three levels of membership that new members can buy into. The top level of
membership for our most committed members is the platinum level, this includes all of our unique services such
as, the comprehensive physical, wellness plan, personalized grocery shopping, and house calls. Additionally,
platinum members will have access to a spa and fitness center in Daphne. We will partner with the spa and
fitness center in order to receive discounted services for our members. The annual price for our platinum level
membership is $1,750. Our second level of membership, the gold level includes the comprehensive physical,
wellness plan, and house calls. The annual price for our gold level membership is $1,500. Our third level of
membership, the silver level includes the comprehensive physical and wellness plan. The annual price for our
silver level membership is $1,200. Additionally, all members at every membership level will have access to their
physician’s cell phone numbers to easily text or call them with their medical concerns.
21
Our practice understands the bulk of our clientele will come from two groups, affluent individuals who do not
want to bother with their limiting insurance, who want the extra attention, and personalized services our
practice can offer. Additionally, the other group we plan to serve, the chronically sick who realize our services
can be less expensive, comparatively, for how often they must come in contact with the health care system. Our
goal is to balance these two groups so our practice is still profitable. We recommend that all of our new
members wait until their insurance runs out and instead purchase a high-‐deductible health plan (HDHP), which
can be used in the case of catastrophic emergencies.
DISTRIBUTION OF SERVICES
Our practice’s distribution of services has been broken up per physician. In our first year we plan to have 400
members per physician. Annually we plan to see each member for their comprehensive physical and wellness
plan. Our most common service, the office visit is based upon how many patients the non-‐concierge primary
care physician would see annually, however, we will see less than a quarter of the typical PCP. The distribution
of house calls, one of our unique services, is based off the office visits as it will be used in substitution of the
office visit for some of our members. Vaccinations and school physicals are also based off the distribution of
office visits for the typical PCP.
Service Per(day Per(week Per(month Per(yearComprehensive,Physicals 1 7 28 400Wellness,Plans 1 7 28 400House,Calls 2 14 56 672Office,Visits 5 27 108 1,296Vaccinations 5 35 140 1,680School,Physicals 5 20 20,,,,,,,,,,,,,,,,
Distribution(of(Services(per(Physician
22
PROMOTION OF SERVICES
REFERRALS
Our practice sees referrals from existing members as a crucial means for attracting new members. In order to
keep word-‐of-‐mouth consistently positive, we will make sure each member receives care personalized to their
needs and wants. If a member does not feel their needs and wants have been met, our practice will reach out to
the member to make sure any problems are resolved.
MARKETING
For our internet marketing needs our practice will be outsourcing, the company we will outsource to is A-‐Factor
Marketing. They will meet with us about our practice’s vision for the website and Facebook page, strategize
what will be best for our practice, then they will create and execute our website and Facebook page. They also
will be available to help maintain the website and Facebook page, and make changes whenever needed.
Additionally, for our Facebook page, A-‐Factor will post meaningful articles and health facts to increase page
views. A-‐Factor Marketing will charge $4,000 in the first year and $2,000 in subsequent years for the making and
maintaining of our website and Facebook page, when we plan to make the website active.
ADVERTISING
Brochures
Our practice plans to consistently print and distribute brochures advertising our practice, some of our unique
services, our office hours and location, links to our website and Facebook page, and our office phone number.
We will strategically distribute our brochures at local churches, schools, health food stores, upscale gyms, and
country clubs. By distributing to these specific locations we hope to make contact with the specific clientele that
desire our practice’s personalized care.
23
School Athletics Sponsorship
Our practice is donating $1,000 to each of the following schools: Daphne High School athletics, Fairhope High
School athletics, Spanish Fort High School athletics, McGill-‐Toolen Catholic High School athletics, and St. Paul’s
Episcopal High School athletics. Each of these schools made our practice “Preferred Sponsors” for their booster
club. For our donations these schools will put up banners displaying the Premiere Concierge Services’ logo and
contact information on their football field, baseball field, softball field, and in their basketball gym. The baseball,
softball, and basketball advertisements will begin in the spring of 2016 and football will begin in the fall of 2016.
Club Soccer Sponsorships
Our practice is donating $2,500 to the US Youth Soccer program. We plan to sponsor one boy’s team and one
girl’s team in Daphne, Fairhope, Spanish Fort, in addition to, two boy’s teams and two girl’s teams in Mobile.
Each team will receive a donation of $250. For our donations these teams will wear the Premiere Concierge
Services’ logo on their jerseys.
Type Cost Frequency/per/Year Total/ExpenseBrochures 2,000.00$.. 4 8,000.00$.....School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 15,500.00$///
Advertising/BudgetFor/Year/Ending/December/31,/2016
Type Cost Frequency/per/Year Total/ExpenseBrochures 1,000.00$.. 4 4,000.00$.....School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 11,500.00$//
Advertising/BudgetFor/Year/Ending/December/31,/2017
24
DIFFERENTIAL STATEMENT
Our practice can not be compared to others in the area. While we offer similar services to a primary care
provider, our goal is to go above and beyond our member’s expectations. Our holistic, proactive approach to
healthcare addresses our member’s physical, mental and emotional well-‐being through one-‐on-‐one counseling
and comprehensive diagnostic testing.
Unlike the traditional primary care provider who sees 2,000 patients or more, our practice purposefully limits
our physician’s patient load to 600 in order to better serve and personalize each member’s care. In the first year
we hope to keep our practice relatively small at 400 patients per physician and growing to about 500 in the
second year. . In addition, by limiting the number of patients our physicians see, better quality of care and a
more productive work environment will be focused towards our members.
As mentioned in our pricing of services, our practice includes all services provided in the annual membership fee
so our members and physicians will not have to deal with the hassle of their insurance or Medicare. Our practice
will be all self-‐pay in order to ensure that our member’s have the freedom to see their physician as frequently as
they desire.
GEOGRAPHIC AND ECONOMIC DEMOGRAPHICS
Our physicians will cover Mobile and Baldwin counties specifically Daphne, Fairhope, Spanish Fort, and Mobile.
We hope to service most of Mobile, even if our members live further from our office we have the flexibility to
travel to them in order to provide care. Our physicians have admitting privileges at Thomas Hospital, which is
most convenient for the bulk of our members, as well as, the closest to our office.
The average age for Daphne, Fairhope, Spanish Fort, and Mobile are 37, 44, 40, and 36 respectively. As well, the
Fairhope area is known as one of the premiere retirement locations in the state. This age is ideal for our
25
services, we are targeting older adults and families who have the income for our services which consist of out-‐
of-‐pocket payments. Also, older adults and retirees need more access to their physician and our concierge
practice aims to be with our members as much as they need.
The Average Household Income for Daphne, Fairhope, Spanish Fort, and Mobile is $178,826, $197,099,
$206,544, and $119,300 respectively. Our members are required to pay a yearly membership fee for our
services to ensure adequate time and availability for each patient. Due to the yearly membership fee we expect
most of our patients to have a higher income, which the area in where we plan to enter can support based on
the data previously mentioned.
26
ORGANIZATION AND DESIGN
27
LEGAL ENTITY
Premiere Concierge Services will operate as a Limited Liability Company (LLC). A LLC is defined as liability of a
company’s owners for nothing more than the capital they have invested in the business. A LLC is a legal
structure that combines the limited liability component that corporations have while having the flexibility and
tax benefits of a partnership. Advantages to operating as a LLC include:
• Owner(s) have protection of their assets in the case of lawsuits against the business. No member of the
LLC can be held personally liable for any debts of the company.
• Pass-‐through taxation, which allows the income of the business to be respected as the income of the
owner. This allows the LLC to avoid double taxation since only the owner is taxed on the revenue.
• Owner(s) is self-‐employed and can maintain control over the business operations.
• Limited compliance requirements and small costs/paperwork to set up (compared to corporation start-‐
up costs)
While there is great advantage in forming a LLC, there are some potential drawbacks as well. Some of these
disadvantages include:
• Limited Life: The life of the company is limited to the life of the owners.
• Hard to raise capital: LLCs do not have the ability to issue stocks like corporations can. This can make it
hard to raise capital if it is needed by the organization.
• New Structure: LLC’s are a new model to operate a business as. Because of this, some laws and
regulations are still transitioning. Also, since it is a newer form of business, if the LLC organization goes
to court, it may not be as well recognized as a corporation or partnership would be.
NOTE: A $300 LLC startup fee is shown as a “Professional Services” expense on the income statement.
28
EMPLOYMENT POSITIONS
Premiere Concierge Services’ staff will include two physicians, two Registered Nurses, and a Practice Manager.
The physicians are full-‐time and will practice within our office as well as our members’ homes for house calls.
Both physicians will be owners of PCS. One physician will be appointed as the Director of Medicine, serving as
the lead for the organization. The Registered Nurses will work part-‐time during the weekdays, switching
between Monday/Wednesday/Friday and Tuesday/Thursday shifts. The weekends will be determined according
to appointment times and availability. The Practice Manager will work full-‐time within our office. The Practice
Manager will be responsible for all bookkeeping and reception duties including but not limited to: management,
marketing, finance, taking phone calls, and checking members in at the office.
GOVERNANCE OF ORGANIZATION
GOVERNING STRUCTURE
Premiere Concierge Services will be governed exclusively in-‐house. The Director of Medicine will serve as the
ultimate decision-‐maker when a collective decision cannot be made. The second physician at the practice and
the Practice Manager will answer to the Director of Medicine. However, the Director of Medicine, Practice
Manager, and physician will work together to make decisions that are best for our members and practice. The
Director of Medicine and the other physician will both be owners of Premiere Concierge Medicine, so it is
important that their inputs are integrated into the practice. The Practice Manager will serve as the champion for
the business aspects of the practice such as management, finance, and other administrative duties. The Director
of Medicine will work closely with our Practice Manager to bridge the gap between clinical and clerical
operations. While the Director of Medicine is the main leader for Premiere Concierge Medicine, it is important
that our Practice Manager, who is highly involved in the day-‐to-‐day business operations, be in contact to ensure
the practice is running smoothly as a whole. The Practice Manager will deal directly with employee conduct
29
issues in order to allow the Director of Medicine give most of his or her attention to providing medical care to
our members.
LEADERSHIP STYLE
The Director of Medicine should have a high concern for production when it comes to his or her leadership style.
Our main objective is to provide excellence in high-‐quality, patient-‐centered care. Thus, the mission of our
facility should always be at the forefront of our Director of Medicine’s leadership to ensure the level of care
provided is what our member expects and needs. Our overall hope is the Director of Medicine will have the
confidence to stand alone and lead PCS as a startup health organization, the courage to make tough decisions
that are in the best interest of the practice and our members, and the compassion to listen to the needs of
others in order to create a family-‐like atmosphere with other staff and our members.
RETENTION
While the focus will be on the quality of services and care we provide, we do intend to emphasize on the
importance of having lasting employment among our staff. Our goal is for our employees to build relationships
with our members. A trusting and friendly connection between physician and patient is vital because of our
desire to care for our members’ physical, mental, and emotional well-‐being. PCS believes our members will
benefit from having the same care team throughout their membership in order to get to know them both
professionally and personally and feel comfortable inviting them into their homes. Overall, the desire of PCS is to
create a family-‐type atmosphere between the staff themselves and the staff and members.
The Director of Medicine’s leadership effectiveness in concern with the retention of the other staff members will
rely on his or her genuine and charismatic personality. While this will only come naturally, the goal is that PCS
have a character that encourages and uplifts the staff in order to have satisfaction within the organization. For
30
instance, gatherings during the holiday season as well as occasional parties, outings, and other social events will
help connect staff members outside the office, hopefully creating a more harmonious work environment.
COORDINATION OF WORK
HOURS OF OPERATION
Our office will be open to walk-‐ins and appointments Monday through Friday. Saturdays and Sundays will be
reserved exclusively for appointments.
• Monday -‐ Friday: 8:00am-‐5:00pm
• Saturday -‐ Sunday: 10:00am-‐3:00pm (appointments only)
• Closed for the following holidays:
o New Year’s Day
o Memorial Day
o Independence Day
o Labor Day
o Thanksgiving Day
o Christmas Day
BUSINESS MEETINGS
Staff meetings will be scheduled every Tuesday, but may be cancelled if deemed unnecessary for the week.
Every employee is required to attend all meetings. If an employee must miss a staff meeting, he or she is
required to notify the Practice Manager with his or her excuse or reason. Patient walk-‐ins to the office will be
excused during the course of the meeting time. Staff meetings will occur during lunch hour unless otherwise
noted. Appointments will not be scheduled 30 minutes before or after the scheduled staff meeting time to help
31
ensure staff attendance. Lunch will be catered to all staff members for meetings occurring during lunch hour.
Staff is expected to be flexible with meeting changes or adjustments.
CONFLICT RESOLUTION
Conflict happens in every organization no matter the size or organization structure. Our goal for Premiere
Concierge Services is that our staff become very much of a team, respecting and encouraging one another. If
conflict occurs during operating hours, our staff is expected to try to resolve the issue themselves first, then seek
help from our Practice Manager. With such a small team, it is imperative that our staff works together to
provide the highest quality of care our members expect.
Conflict in an office the size of PCS can easily be spread to other areas of the practice and potentially affect that
quality of care. It is important to prevent that spread as quickly as possible so our members do not suspect a
lack of camaraderie. If a staff member speaks with the Practice Manager about the issue and it still does not get
resolved, the staff member(s) will be subject to sanctions as listed in the employee handbook, which is displayed
in Appendix B.
32
ORGANIZATIONAL CHART
The Director of Medicine is the leader of PCS. The other physician and the Practice Manager will answer to the
Director of Medicine. However, they will collaborate with the Director of Medicine to make decisions on large,
important matters concerning the practice. The two Registered Nurses answer to the physician and Director of
Medicine. Since the Registered Nurses will be employed part-‐time, they will be responsible for working with
both physicians and answering to both during their scheduled work hours. If one physician is out on a house call,
the Registered Nurse on duty will answer first to the physician that is currently in-‐office.
Director of Medicine
Physician
Registered Nurse
Registered Nurse
Practice Manager
33
STAFFING
34
At Premiere Concierge Services having a staff that portrays great work ethic, respect, honestly, positive attitude
and integrity is significant. A top priority for our staff is for them to appreciate the way a concierge practice
functions. We want our staff to be dedicated to create a relationship with the members, while giving them the
top care needed. Premiere Concierge Services plans to have staff positions of a Director of Medicine, physician,
two Registered Nurses, and a Practice Manager. See Appendix B for the job descriptions in detail. The staff
positions are described below:
• Director of Medicine: a physician who will be responsible for the roles of the physician position, and will
serve as a leader to the medical aspects of Premiere Concierge Services
• Physician: responsible for spending time with the members to develop a relationship with them and
treat them with top care, while providing house calls to members and working at the office.
• Registered Nurse: responsible for escorting members to room, recording members’ history, taking vitals
and assisting medical staff members when needed
• Practice Manager: responsible for information management, project management, human resources
roles, marketing roles, answering phone calls and all operations of the organization
These positions will have various responsibilities explained in the job descriptions with different work schedules.
The Director of Medicine and physician will be working all operation hours on Monday through Friday, with
appointments on Saturday and Sunday and be available at all times to their members on a daily basis. The
Registered Nurses will work part-‐time during the weekdays, switching between Monday/Wednesday/Friday and
Tuesday/Thursday shifts. The weekends will be determined according to appointment times and availability. The
Practice Manager will only be working Monday through Friday. See the following table for staffing salaries.
35
Because we are operating under the assumption that it will take 60 days to begin bringing in patient revenue,
the Director of Medicine and physician will not be earning a salary during that 60-‐day period. Their salary will
begin in March 2016. The Practice Manager will be salaried starting in January 2016 as he or she will not be a
part owner and will be integral in the practices formative months. The Registered Nurses will begin working for
PCS in March 2016 and will begin receiving salary in that month.
RECRUITMENT AND RETAINING
At Premiere Concierge Service we will strive to recruit the most qualified staff members. To be able to recruit
the top staff members, we plan to market to professionals who desire to be apart of a concierge practice. The
concierge service has many benefits to the staff members, and we believe this is an advantage to us to recruit
the top staff members. For the medical staff members, the biggest asset is that he or she is able to practice
traditional medicine again, and is able to build relationships with their members. We plan to strictly use our
minimum requirements of each position to hire our staff, and seek candidates with experience in their position.
Our practice wants to recruit staff members who exhibit traits of a positive attitude, strong work ethic and
professionalism. Premiere Concierge Services will also select staff members who will represent and up hold our
Position #(Required Salary Total(Salaries Employment(Expense((30%) Total(ExpenseDirector(of(Medicine 1 180,000$((((((((((((( 118,000$(((((((((((((((( 35,400$(((((((((((((((((((((((((((((((((((( 153,400$((((((((((((((((Physician 1 170,000$((((((((((((( 108,000$(((((((((((((((( 32,400$(((((((((((((((((((((((((((((((((((( 140,400$((((((((((((((((Registered(Nurse 2 60,000$(((((((((((((((( 120,000$(((((((((((((((( 36,000$(((((((((((((((((((((((((((((((((((( 156,000$((((((((((((((((Practice(Manager 1 75,000$(((((((((((((((( 75,000$(((((((((((((((((( 22,500$(((((((((((((((((((((((((((((((((((( 97,500$((((((((((((((((((Totals( 5 485,000$((((((((((((( 421,000$(((((((((((((((( 126,300$((((((((((((((((((((((((((((((( ( 547,300$((((((((((((((((
Per(Month(Expense: 45,608.33$((((((((((( (Per(Week(Expense:( 10,525.00$((((((((((( (
Year(1(Salaries 472,333$((((((((((((((((Year(2(Salaries 547,300$((((((((((((((((
Salaries(Budget
36
mission. We plan to recruit our staff members through referrals and an application process done by the Director
of Medicine and Practice Manager.
At Premiere Concierge Services we plan on retaining our high quality staff members through bonuses when we
see a staff member needs to be rewarded for their work, and through our comprehensive benefits packages
which will be explained later. We want our staff to know they are appreciated at our practice and we want to
help them realize this by rewarding them frequently for their dedication to our practice. It is important to keep
our staff because of the relationships he or she has formed with their members. With having a small practice,
and not many staff members we hope the relationships will help retain the staff. We plan to promote monthly
contests that will help better our practice, motivate our staff, and reward our staff that achieves great results of
the contest. Premiere Concierge Services plans to make a significant investment in our staff members and we
hope our staff members don’t see their salary as their only compensation, but all of their benefits to work at a
concierge practice also.
CONTRACT WORK
Premiere Concierge Services plans to be a small organization, as we will only have five salaried staff members.
Rather than hiring additional staff members, we have decided to outsource cleaning services, grounds keeping,
lab services, shredding service and website developer.
CLEANING SERVICES
We will be contracting cleaning services out to Office Pride Mobile, who will come once every weekend to clean
the office. They will come after office hours to avoid distractions to staff members and members. Registered
Nurses will be in charge of keeping exam rooms sanitized and clean on daily basis, as Office Pride Mobile will
only come once per week.
37
Office Pride Mobile
9340 Sevenhills Curve
Mobile, AL 36695
(251) 473-‐9244
$350 per month
GROUNDS KEEPING
Although we are leasing our space, Premiere Concierge Services is responsible for grounds keeping issues.
Maximum Landscape, Inc. will come once per week to do maintenance to our small yard. In the winter months
(October – March) they will come every other week. The yard maintenance that Southern Pride Lawn Care will
provide is: mowing, clearing leaves, planting and maintaining flowers, and trimming bushes.
Maximum Landscape, INC.
P.O. Box 850754
Mobile, AL 36685
(251) 633-‐6657
$300 per month
LAB SERVICES
We plan to outsource all of our lab work. However, our EHR system we have chosen eMedicalFusion’s software
allows for bi-‐directional lab integration. The lab integration feature is compatible with Quest and Labcorp labs.
Premiere Concierge Services will use Solstas / Quest Diagnostics in Fairhope, Alabama for lab needs.
Solstas / Quest Diagnostics
811A Fairhope Ave.
Fairhope, Al 36532
(251) 990-‐2011
38
SHREDDING SERVICE
Our practice will be use a shredding service to comply with HIPAA and maintain patient confidentiality. Mobile
Shredding Service will come to our practice on a biweekly basis to collect documents that need to be shredded.
They will be taken to a shredding facility and our practice will be presented with a certificate of destruction for
compliance records. This outsourcing service will cost $120 per month.
Mobile Shredding Service
107 Saint Francis St.
Mobile, AL 36602
(251) 345-‐6250
$120 per month
WEBSITE DEVELOPER
Because we do not have designated Information Technology or social media staff members, we plan to contract
with a website developer. A-‐Factor Marketing will meet with the Practice Manager about our organization’s
vision for the website, strategize what will be best for our organization, create our website, and execute it. They
will be available to help maintain the website and make changes whenever needed. A-‐Factor Marketing will also
provide our Internet marketing, including maintaining our Facebook page with a combined fee. A-‐Factor
Marketing will charge $4,000 in January 2016 to start up the website, and $2,000 each subsequent year for
maintenance and Internet marketing fees.
A-‐Factor Marketing
4318 Downtowner Loop N. Building D.
Mobile, Al 36609
(251) 285-‐1576
39
STAFFING ISSUES
THEFT
Theft of any sort will not be tolerated and can lead to immediate termination of a staff member. Theft includes,
but is not limited to, office supplies, money, medicines, phone service, time, inappropriate use of the computer,
and stealing from co-‐workers. Theft will not be tolerated at Premiere Concierge Services. If this is problem at our
practice, the Practice Manager has the right to terminate the staff member immediately.
SHIFT TRADING
The only staff members who may trade shifts are the two Registered Nurse positions. All other positions may
not trade shifts, due to having only one staff member to fill their position. A shift trade request must be done
one week in advance and be approved and signed by both staff members and the Director of Medicine. The
Practice Manager will document all requests and approved requests for shift trading. If a staff member becomes
ill suddenly, the Practice Manager is in charge of finding a replacement or fulfilling the staff member’s duties
during his or her illness. Shift trading and time-‐off request procedures are explained in the staff member
handbook in Appendix B.
TARDINESS
Tardiness is not acceptable at Premiere Concierge Services and could be considered grounds for termination. In
order for our practice to run smoothly, it is essential that staff members are on time and maintain regular
attendance. Staff members are expected to be in the office and settled before the practice opens. If a staff
member must be late, they should inform the Practice Manager as soon as possible. At the end of each
workweek, all late arrivals and early departures will be totaled. For each accumulated six minutes that the staff
member is late, or leaves early, he or she loses one-‐tenth of an hour of pay.
40
USE OF OFFICE COMPUTERS
The use of office computers for personal use is prohibited. Office computers should be used for only medical or
office reasons. Each computer will be password protected and the password will only be known by the staff
member who uses the computer This password will be changed each month. Each staff member with an office
computer is expected to demonstrate caution and care to ensure confidentiality of information stored on the
computers. Staff should not install any software on computers unless the Practice Manager approves it. If a staff
member does not comply with these rules, the Practice Manager will inform them of the disciplinary procedure.
USE OF CELL PHONES
See Employee Handbook in Appendix B.
INSUBORDINATION
At Premiere Concierge Services all staff members are expected to treat their co-‐workers with top respect.
Disrespect and resisting authority will not be tolerated. The act of scheming to go above the Practice Manager
and Director of Medicine may result in the Practice Manager enforcing disciplinary procedures or immediate
termination.
PERFORMANCE EVALUATION
Premiere Concierge Services will evaluate our staff members every six months by the Practice Manager. After
the evaluation done the Practice Manager will have a meeting with the staff member about the evaluation. See
Appendix B for more details and the performance evaluation form.
41
MEMBER SATISFACTION
At Premiere Concierge Services, our first priority is our members. We want our members to feel that the extra
fees associated with concierge medicine are valuable. Our physicians will spend at the least thirty minutes with
each member during their appointments. This time should be used to make the member feel knowledgeable
about their health, treat them with quality care, and develop a patient-‐physician relationship. Time spent with
members should develop high member satisfaction. Members will receive a member satisfaction survey after
each visit to Premiere Concierge Services to help better our practice. The survey will be handed to the members
in a pre-‐stamped envelope so it will not be an inconvenience to fill out.
At Premiere Concierge Services we will rely on the surveys to measure member satisfaction. Feedback from our
members is important. Their appointment, our staff, communication with their provider, and overall satisfaction
will be topics included in our member satisfaction survey. The survey will only ask for the member’s age, gender,
provider’s name, not their name. The Practice Manager will review all completed and returned surveys and
analyze the results in an Excel worksheet. The survey results will be discussed in the first week of every month in
staff meetings. During these meetings it will be encouraged to discuss how to improve areas which are lower in
satisfaction. Incentives can be made by the Practice Manager to motivate staff members to improve survey
results.
The Practice Manager will be in charge of a monthly email newsletter to our members updating them about
Premiere Concierge Services to keep members feeling informed about our practice. This newsletter will include
a member satisfaction survey to make it convenient for members to submit one at any time. It will also be
available on our website to be filled out electronically. See Appendix B for the member satisfaction survey.
42
BENEFITS PACKAGE
See Employee Handbook in Appendix B.
DISCIPLINARY PROCEDURES
Staff members have the responsibility to execute their job, while following the practices policies and
procedures. Any staff member who does not follow them will receive notice by the disciplinary procedures, that
the Practice Manager will follow. See Employee Handbook in Appendix B for the disciplinary steps.
TERMINATION
All employment with Premiere Concierge Services is “at will” employment. A staff member can terminate his or
her employment at anytime or Premiere Concierge Services can terminate the staff member’s employment at
anytime. Staff members are not hired for a specific duration. See Employee Handbook in Appendix B for
explanation.
43
REGULATORY COMPLIANCE
44
HIPAA COMPLIANCE
The role of compliance officer will be assigned to the Practice Manager. The compliance officer will be
responsible for ensuring all business practices and procedures are HIPAA compliant. He or she will be required
to complete a HIPAA compliance training program developed by Thomas Reuters Risk Management Solutions.
Topics covered in this 45-‐minute course include:
What is HIPAA? Who is subject to HIPAA?
Protected Health Information (PHI) HIPAA Privacy
Notice of Privacy Practices Reasonable Safeguards Using PHI for Marketing
HIPAA Security Administrative Safeguards
Physical Safeguards Technical Safeguards
Handling PHI Security Breach
PHI Rights of Individuals Enforcement of HIPAA
Upon passing the course and receiving his or her HIPAA compliance certification, the compliance officer will be
responsible for ensuring all employees are trained in HIPAA compliance. The compliance officer may elect to
train employees by utilizing the Thomas Reuters training program, resources from the Department of Health and
Human Services, or a combination. All employees must receive training within five days of beginning work. If
they are not trained within the five-‐day time frame, they will not be permitted to return to work until they have
been trained.
All employees must read, understand, and acknowledge the Employee Confidentiality Agreement (Appendix C)
prior to their first day of work. All new patients will be distributed a copy of our Privacy Policy (Appendix C) prior
to the rendering of any services.
45
DRUG TESTING AND BACKGROUND CHECK POLICY
See Appendix C for Employee Drug Testing, Random Drug Testing, and Background Check policies.
Third-‐party provider for background checks and drug testing:
IntelliCorp
216-‐450-‐5300
$70 per employee per year; factored into employee expenses at 30% of the employee’s base salary
REGULATORY COMPLIANCE POLICIES
See Appendix C for our Equal Employment Opportunity and Harassment, Occupational Safety and Health, and
Americans with Disabilities Act policies.
NOTE: All policies are modeled after suggestions from the Society for Human Resource Management,
Department of Health and Human Services, and the Occupational Safety and Health Administration.
46
FINANCE AND ACCOUNTING
47
INITIAL FUNDING
Jan Feb TotalSources0of0CashLoan%Proceeds
BBVA 106,250%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 106,250000000000000000000Wells%Fargo 41,626%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 41,62600000000000000000000
Contributed%Capital 148,078%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 148,078000000000000000000
Total0Sources0of0Cash 295,954$%%%%%%%%%%%% 5$%%%%%%%%%%%%%%%%%%%% 295,954$00000000000000 0
Uses0of0CashLeasehold%Improvements 125,000%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 125,000000000000000000000Furniture%&%Fixtures 13,424%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 13,42400000000000000000000Technology%&%Equipment 35,549%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 35,54900000000000000000000
Operating0ExpensesAdvertising 2,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000Building%Lease 2,640%%%%%%%%%%%%%%%%%% 2,640%%%%%%%%%%%%%%%%%% 5,2800000000000000000000000Cable,%Phone,%Internet 1,028%%%%%%%%%%%%%%%%%% 428%%%%%%%%%%%%%%%%%%%%%% 1,4560000000000000000000000Cleaning%Service 350%%%%%%%%%%%%%%%%%%%%%% 350%%%%%%%%%%%%%%%%%%%%%% 7000000000000000000000000000Grounds%Keeping 300%%%%%%%%%%%%%%%%%%%%%% 300%%%%%%%%%%%%%%%%%%%%%% 6000000000000000000000000000Shredding 120%%%%%%%%%%%%%%%%%%%%% 120%%%%%%%%%%%%%%%%%%%%%% 2400000000000000000000000000Insurance%5%Facility%and%Umbrella 250%%%%%%%%%%%%%%%%%%%%%% 250%%%%%%%%%%%%%%%%%%%%%% 5000000000000000000000000000Insurance%5%Malpractice 1,500%%%%%%%%%%%%%%%%%% 1,500%%%%%%%%%%%%%%%%%% 3,0000000000000000000000000Interest 456%%%%%%%%%%%%%%%%%%%%% 456%%%%%%%%%%%%%%%%%%%%%% 9110000000000000000000000000Medical%Supplies 2,500%%%%%%%%%%%%%%%%%% 2,500%%%%%%%%%%%%%%%%%% 5,0000000000000000000000000Office%Supplies 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000Practice%Management%System 667%%%%%%%%%%%%%%%%%%%%%% 667%%%%%%%%%%%%%%%%%%%%%% 1,3330000000000000000000000Professional%Services 20,300%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 20,30000000000000000000000Salaries%and%Benefits 8,125%%%%%%%%%%%%%%%%%% 8,125%%%%%%%%%%%%%%%%%% 16,25000000000000000000000Security%System 240%%%%%%%%%%%%%%%%%%%%%% 40%%%%%%%%%%%%%%%%%%%%%%%% 2800000000000000000000000000Utilities%5%Water%and%Electronic% 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000Website%Development 4,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 4,0000000000000000000000000
Total0Uses0of0Cash 220,447$%%%%%%%%%%%% 19,375$%%%%%%%%%%%%%% 239,823$00000000000000 0
Net%Cash%Inflows%(Outflows) 75,507$%%%%%%%%%%%%%% 19,3755$%%%%%%%%%%%%%% 56,131$00000000000000000 0
Premiere0Concierge0ServicesSources0and0Uses0of0Cash0Projection
To0Start0of0Operations0
48
Under the assumption that PCS will not begin generating revenue for the first 60 days of operation, our
calculated start-‐up costs (uses of cash) are $239,823. We would like to generate enough sources of cash that will
allow for net cash to be 10% greater than break-‐even. To do so, our sources of cash must equal $295,954. We
will finance this amount through the following:
Because we will not be generating revenue in our first 60 days, principal payments on both the BBVA and Wells
Fargo loans will not begin until March 2016. Only interest will be charged in the first 60 days. BBVA charges
3.50% interest over the 5-‐year loan term. Wells Fargo charges 4.20% interest over the 7-‐year lease term.
Because the Director of Medicine will be earning approximately 10% more salary, he or she must buy-‐in for a
greater percentage than the physician. The remaining needed contributed capital after loan proceeds of
$148,078 will be financed 55% by the Director of Medicine ($81,443) and 45% by the physician ($66,635).
PCS does not submit claims to insurance companies. All of our revenue is generated through the $1,200, $1,500,
and $1,750 annual membership fees, billed monthly and due at the first of each month.
Leasehold)Improvements)(BBVA) 125,000.00$(
Loan(Proceeds 85% 106,250.00$((Contributed(Capital 15% 18,750.00$((((
Furniture,)Fixtures,)Tech.,)&)Equipment)(Wells)Fargo) 48,972.23$((((
Loan(Proceeds 85% 41,626.40$((((Contributed(Capital 15% 7,345.83$((((((
Operating)Costs 121,981.81$(Contributed(Capital 100% 121,981.81$((
Total)Initial)Funding 295,954.04$(
Initial)Funding
49
FINANCIAL STATEMENTS FOR FISCAL YEARS 1 AND 2
2016%Total 2017%TotalRevenue
Membership*Fee*Revenue 991,667$********** 1,487,500$*******
ExpensesAdvertising 15,500$************* 11,500$*************Building*Lease 31,680$************* 31,680$*************Cable,*Phone,*Internet 5,736$*************** 5,136$***************Cleaning*Service 4,200$*************** 4,200$***************Depreciation 30,945$************* 30,945$*************Grounds*Keeping 3,600$*************** 3,600$***************Shredding 1,440$*************** 1,440$***************Insurance*M*Facility*and*Umbrella 3,000$*************** 3,000$***************Insurance*M*Malpractice 18,000$************* 18,000$*************Interest 5,174$*************** 4,239$***************Medical*Supplies 30,000$************* 30,000$*************Office*Supplies 12,000$************* 12,000$*************Practice*Management*System 8,000$*************** 8,000$***************Professional*Services 20,300$************* M$*******************Salaries*and*Benefits 472,333$********** 547,300$**********Security*System 680$****************** 480$******************Utilities*M*Water*and*Electronic* 12,000$************* 12,000$*************Website*Development 4,000$*************** 2,000$***************
Total*Expenses 678,588$********** 725,520$**********
Net%Income%(Loss) 313,079$********** 761,980$**********
Premiere%Concierge%ServicesProjected%Income%Statement
For%Year%Ending%December%31,%2016%and%December%31,%2017
50
2016AssetsCurrent'Assets
Cash 444,481$**************Total-Current-Assets 444,481****************
Property,'Plant,'&'Equipment,'at'cost*********Leasehold*Improvements 125,000****************
Furniture*&*Fixtures 13,424*******************Technology*&*Equipment 35,549*******************
Total*Property,*Plant,*&*Equipment,*at*cost 173,972****************Less:*Accumulated*Depreciation 30,945*******************
Total-Property,-Plant,-&-Equipment,-net 143,028****************
Total-Assets 587,509$**************
Liabilities-&-Shareholder's-EquityCurrent'Liabilities
BBVA 21,142$****************Wells*Fargo 5,564$*******************
Total-Current-Liabilities 26,705******************
Long:Term'DebtBBVA 68,046******************Wells*Fargo 31,601*******************
Total-LongBTerm-Debt 99,647******************
Total-Liabilities 126,353****************
EquityContributed*Capital 148,078****************Retained*Earnings 313,079****************
Total-Equity 461,156****************
Total-Liabilities-&-Equity 587,509$**************
Premiere-Concierge-ServicesBalance-Sheet
December-31,-2016
51
FINANCIAL SPECIFICATIONS
All additional financial reports can be found in Appendix D. Below are explanations of various expenses and
start-‐up costs for clarification of the information in the reports.
• As explained in Staffing, the Director of Medicine and physician will not earn salary in the first 60 days of
operation. The Practice Manager will be salaried in that time period. The Registered Nurses will not
begin working for PCS and receiving salary until March 2016. For these reasons the 2016 salaries will be
lower than 2017.
• Leasehold improvements have been depreciated using the straight-‐line method over the 5-‐year life of
the lease.
• Technology and equipment have been depreciated using the straight-‐line method over an expected 7-‐
year life assuming a salvage value of 20% of purchase price. Items which have previously stored
protected health information and bio-‐hazardous materials will not be resold.
• Furniture and fixtures have been depreciated using the straight-‐line method over an expected 7-‐year life
assuming a salvage value of 15% of purchase price.
• We will be leasing a 2,200 square foot space at a rate of $14.40 per square foot for a total of $31,680.00
per year. The lease term is for five years and can be renewed at the finality of the lease.
• We have worked with Timothy J. Spafford of Architecture and Design, Inc. to draw up the office layout
plans (shown in Strategic Planning). His fee is $15,000 and is recorded as a professional service expense.
• Our contractor, Vance McCown of Vance McCown Construction company, estimates the renovations to
our space as per our desired layout will cost $125,000. This is recorded as a capital expenditure on the
Initial Facility and Operating Costs report.
52
• Our interior designer, Sarah Wallstedt, will handle all design-‐related tasks including selecting furniture
and décor. Her fee is $5,000 and is recorded as a professional service expense.
• PCS will use Verizon Wireless’s small business resources for our mobile device, landline, internet, and
cable needs. These needs are discussed in the subsequent Technology portion of the business plan.
These costs reported as “Cable, Phone, and Internet” expenses as well as in our technology budget.
• We have a contract with A-‐Factor Marketing, a web developer, to construct our website. A-‐Factor will
also manage our internet presence through managing the website in addition to a Facebook page. This
information is included in the Marketing section. There is a first year fee of $4,000 and $2,000 in each
subsequent year.
• We will carry malpractice insurance on each of our physicians. The premium is $9,000 per physician.
• Our facility will be covered by at Business Owner’s policy from Geico at $3,000 per year to protect PCS
against accidents, lawsuits, etc.
• ADT will provide us with a small business security system at a fee of $200 for the system and installation
in addition to $40 per month. Specifics about the system can be found in the Technology section.
53
TECHNOLOGY
54
DESIRED SYSTEM FUNCTIONALITY
Premiere Concierge Services is looking to acquire a practice management system and an electronic medical
record system. Ideally, we will invest in a system that is best-‐of-‐suite. A best-‐of-‐suite solution will ensure
simplicity and superior interoperability – two aspects that are pivotal to a small practice. Furthermore, our
needs as a concierge and membership payment model differ from those of a typical private practice. We desire
to invest in a software solution that will tailor to our unique needs as a concierge practice.
There are a number of functions that the solution Premiere Concierge Services acquires must contain. All of the
functions must have the personalized patient experience at their forefront. The system must include the
following: scheduling, membership account management, mobile device access, ePrescribing, personalized
patient communication, simple clinical note taking abilities, the ability to track patient metrics over time, and an
emphasis on security. The software solution that is chosen must tailor to the needs of our small staff size. It
needs to have a user friendly interface for our clinicians, support staff, and members. All of these features will
enable Premiere Concierge Services to place personalized patient care at the forefront of our practice.
ACCEPTABLE SYSTEMS
After vetting numerous systems Premiere Concierge Services has identified two systems that are considered to
be acceptable. The first, eMedicalFusion, is a practice management and EHR bundled software solution. The
second, McKesson’s Medisoft Clinical v20, is also a software solution that encompasses practice management
software with an EHR.
MEDISOFT
McKesson’s Medisoft Clinical v20 has several key features that would benefit Premiere Concierge Services.
McKesson’s solution is a best-‐of-‐suite solution which will aid in interoperability and simplicity. In addition, the
55
ePrescribing function and the ability for patients to communicate with our physicians via their mobile devices
would be assets to our practice. However, Medisoft Clinical v20 includes some features that our practice does
not stand to benefit from. Premiere Medical Services, as a private pay concierge practice, will not utilize or
benefit from the billing or coding functions that are included in McKesson’s solution. The inclusion of these
features in the system increases the price of the system without any benefit to our practice. The added cost of
the system coupled with lack of a tailored concierge approach has led Premiere Concierge Services to invest in
another system.
EMEDICALFUSION
Premiere Concierge Services has decided to invest in eMedicalFusion’s practice management and EHR software
solution. The software solution that eMedicalFusion offers is tailor made for a private-‐pay and membership-‐
model concierge medical practice. eMedicalFusion’s solution was created to specifically meet the challenges
faced by a small concierge practice.
This software solution will allow our practice the flexibility necessary to bill our members on a monthly basis
according to the tier that they belong to. This feature will streamline the workflow for our Practice Manager by
removing many of the daily tasks associated with prompting and collecting payments from members. The
software prompts members to make payments when they are due. In addition, the software includes a function
that allows a member to add a credit or debit card to his or her account so that monthly payments will
automatically be charged.
Appointment scheduling is another feature that has been made patient focused using eMedicalFusion’s
software. The software allows for patients to schedule appointments from his or her mobile device or computer.
The members will be able to see open appointment times for a particular day in real time. In addition, the
56
clinicians will be able to see who is scheduled for a certain time period and what his or her medical need
concerns.
In the 21st century mobile access to information is vital to provide a member with patient centered care. The
eMedicalFusion software is accessible from Apple, Android, and Surface tablets as well as Apple, Android, and
Microsoft smartphones. We have chosen to equip employees with Apple iPads and Apple iPhones so that they
may access the software when they are out of the office. In addition, the wide range of compatibility will allow
our members to access the patient portal aspect of the software on the go. The cornerstone of mobile access for
our members is the HIPAA compliant two-‐way communication between a physician and a member. Members
are able to send text and picture data to a physician via the patient portal. Physicians can, in turn, respond to a
member’s message using his or her mobile device or standard computer. This will allow members to get results
to questions and concerns in a timely manner.
The eMedicalFusion practice management and EHR software is completely cloud based. Premiere Medical
Services does not need to invest in any system specific hardware. The only equipment needed to access and use
the software are desktop computers and mobile devices. A MAGTEK Mini Magnetic Strip Reader will be included
in the software purchase so that credit and debit cards can be charged and put on file in the event that a
member does not wish to add the information using the patient portal. The cloud based software also includes
free updates and is billed on a monthly basis.
Electronic prescribing, commonly referred to as ePrescribing, is a feature that is included in this software
solution. A physician has the ability to select a pharmacy, select a medication from the selected pharmacies
formulary, select the dosage, and add instructions. All of these features can be done from a computer or a
mobile device. In addition, patients can schedule refills if the physician allows the medication to be refilled. The
57
software keeps track of the number of remaining refills a patient can schedule according to the physician’s care
plan.
Premiere Concierge Services will not include a lab in-‐house. However, eMedicalFusion’s software allows for bi-‐
directional lab integration. Lab report results for a member can be viewed over time because the data is
integrated into the member’s health record. The lab integration feature is compatible with Quest and Labcorp
labs. Premiere Concierge Services will use Solstas / Quest Diagnostics in Fairhope, Alabama for lab needs.
The software includes simple clinical note taking templates, however the software does allow for physicians to
customize the templates to according to his or her preferences. The physician will be able take notes on a
computer or using a mobile device. Furthermore, the note taking aspect of the EHR is so simple that the
physician can become proficient with using the software within an hour. The software will also allow a physician
to benchmark a member’s care plan for the future. This will allow the physician to manage a member’s progress
over time. In addition, the physician can choose to share the care plan and the benchmarked goals with the
patient via the patient portal. This allows the member to see in real time to see his or her progress.
STAFF TRAINING PLAN
eMedicalFusion has a simple yet effective training model that Premiere Concierge Services will use to train the
employees to use the software. eMedicalFusion will send an individual to our facility the week prior to the
practice’s door opening in order to train the employees to use the software. The trainer will walk physicians
through six training sessions that each last an hour. The topics discussed include: awareness training, scheduling
configuration, shopping cart configuration, patient management portal administration part one and part two,
and daily use of the patient management portal. The employees who are not physicians will also be trained to
use these specific features and thus the system as a whole. The training program is divided into two days. The
58
physicians and other employees each complete a three-‐hour session on the first and second day. Upon
completion of the training program all employees will be competent in using the system. Furthermore,
eMedicalFusion support staff is available Monday -‐ Friday from 9:00 AM – 8:00 PM EST via email, telephone, and
video chat communication. Finally, when updates to the software are released an online tutorial is published to
the website so that users can become familiar with the new features.
SECURITY AND DATA BACKUP PLAN
eMedicalFusion’s software is cloud based, which includes all of the data housed in the system. However, to
ensure that all programs, files, and information that the office uses that is not stored in the cloud will be secure
the office will receive an external hard drive from eMedicalFusion. The hard drive will back up all of the desktop
computers and mobile devices. The computers and mobile devices will be backed up every Friday. This ensures
that no hardware malfunction will disrupt the work flow of the practice. In addition, the external hard drive is a
solid state hard drive. This makes the external hard drive used to house the back up data significantly more
durable than traditional hard drives. The external hard drive will have the capabilities to store up to one
terabyte of data. Because of the large amount of storage multiple copies of backed up data can be stored at one
point. Each back up data file will be labeled according to the date of the back up, the device’s name, and the
user. The eMedicalFusion software has HIPAA compliant security measures built in. In addition, the HP
computers and the mobile devices will be updated on a weekly basis to ensure that the software used in each is
up to date with the latest manufacturer intended security measures.
59
TECHNOLOGY AND EQUIPMENT
MEDICAL EQUIPMENT
Our medical equipment requirements are as follows (see Appendix F for images of medical equipment):
• Body composition scanner from Seca, which achieves the following, to be located in a central location
for all comprehensive physicals and routine exams:
o Measures intra/extracellular water, body fat, skeletal muscle mass
o Clinically validated accuracy compares to scientific gold standards used in clinical studies
o Reproducible measurements ensure accuracy
o Hand-‐held electrodes mounted in standing aid for enhanced stability
Device Price Quantity Total1Expense1per1Device1Apple%iPad%Pro 1,079.00$%%%%%% 3 3,237.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Apple%Pencil 99.00$%%%%%%%%%%%% 3 297.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%iPad%Case 60.00$%%%%%%%%%%%% 3 180.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Computer%Tower 1,529.00$%%%%%% 6 9,174.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Computer%Monitor 139.99$%%%%%%%%% 10 1,399.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Personal%Printer 179.99$%%%%%%%%% 3 539.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Office%Printer 1,999.99$%%%%%% 1 1,999.99$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Apple%iPhone%16GB 199.99$%%%%%%%%% 3 599.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Body%Composition%Scanner 12,298.00$%%%% 1 12,298.00$%%%%%%%%%%%%%%%%%%%%%%%%%%Biohazard%Receptacles% 13.99$%%%%%%%%%%%% 4 55.96$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%InMOffice%Defibrillator 1,231.00$%%%%%% 1 1,231.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Travel%Defibrillator 959.99$%%%%%%%%% 2 1,919.98$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%WallMMounted%Height%Rod 96.00$%%%%%%%%%%%% 1 96.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Stethoscope 43.99$%%%%%%%%%%%% 5 219.95$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Diagnostic%Carry%Kit 60.00$%%%%%%%%%%%% 2 120.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%WallMMounted%Diagnostic%Set 1,089.95$%%%%%% 2 2,179.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Total1Expense 35,548.62$111111111111111111111111 1
Technology1&1Equipment1Budget
60
o Provides measurements in 20 seconds or less
o mBCA utilizes four comparative methods to achieve precise results
o 8.4 inch touch screen display for convenient use with wireless 360 software
o mBCA 514 is equipped with Seca wireless 360 for EMR transmission
o Touch screen display may be rotated 360 degrees for physician to patient sharing and discussion
o Weight capacity of 660 lbs. (300 kg)
o Large, easy access weighing platform constructed of safety glass for easy cleaning
o Automatic electrode detection
o Includes Seca Analytics 115 software for transmission of data from mBCA to PC
• Wall-‐mounted height rod to be located in a central location to measure patients' height during
comprehensive physicals and routine exams
• Sharps and biohazard disposal container to be located in:
o Exam rooms
o Laboratory
o Central location for any additional disposal needs
• Automated external defibrillators (AED):
o One AED located in a central office location for emergencies
o Two travel-‐compatible AEDs for each physician for house call emergencies
• Stethoscopes for each physician, nurse, and nurse practitioner in Caribbean blue to match our color
scheme
• Diagnostic kits:
o Wall-‐mounted diagnostic set to be located in each exam room. Contains:
§ Digital thermometer
61
§ Coaxial ophthalmoscope (eye, nasal, and throat examination tool)
§ Otoscope (ear examination tool)
§ Aneroid and sphygmomanometer (blood pressure measurement tools)
§ Specula dispenser (disposable covers for ophthalmoscope and otoscope)
§ Wall mounting board
o Diagnostic carry kit for each physician for house call visits. Contains:
§ Automatic sphygmomanometer
§ Thermometer
§ Blood glucose meter
NON-‐MEDICAL OFFICE TECHNOLOGY AND EQUIPMENT
Premiere Concierge Services’ office space will be equipped with adequate electronic equipment to better allow
our staff to perform their day-‐to-‐day tasks. See Appendix F for images of non-‐medical office technology and
equipment. The backbone of the office’s electronic technology will be the HP Z440 Workstation desktop tower
computer. The HP Z440 carries 8GB of RAM which will allow for faster processing and multitasking. It comes
equipped with Windows 8.1 Pro, which is compatible with the eMedicalFusion software. There will be a HP Z440
in the physician offices, Practice Manager office, reception area, and in each of the exam and consultation
rooms. The HP Pavilion 23-‐Inch IPS LED backlit monitor will be the monitor model in use in the office. The
Practice Manager, physicians, and reception desk will all be equipped with dual monitors to increase
productivity and multitasking. The exam and consultation rooms will be equipped with only a single monitor
because multitasking in those areas will be far less common. The physicians’ offices and the Practice Manager’s
office will each have a personal printer in them. The HP Officejet Pro will be the printer model in use. It provides
the ability to print, scan, and copy documents. Furthermore, the office will be equipped with an HP Officejet
62
Enterprise printer which is a high-‐end printer capable of handling the large printing jobs. It will also serve as the
printer used when printing from the receptionist desk.
Premiere Concierge Services will equip the physicians and Practice Manager with a mobile device bundle that
includes a Verizon Wireless iPhone 6s, Apple iPad Pro, and Apple Pencil. These items will allow the physicians
and Practice Manager to stay connected to the practice even when he or she is out of the office. The iPad Pro
combined with the Apple Pencil will allow physicians to provide personalized feedback to members from any
location. In addition, the physician and Practice Manager will be able to access the practice management and
EHR software from any location. The phones and tablets will have mobile data access via Verizon Wireless. The
internet service for the office will be provided by Verizon Wireless. Bundling the office’s wireless needs is the
most cost effective way to get all of the services.
63
WORKS CITED
ACIP Vaccine Recommendations. (2015, March 27). Retrieved November 11, 2015, from http://www.cdc.gov/vaccines/hcp/acip-‐recs/index.html
Annual Physical Exams: What to Expect. (n.d.). Retrieved November 12, 2015, from http://www.webmd.com/a-‐to-‐z-‐guides/annual-‐physical-‐examinations?page=2
Best Doctors. (2015, November 1). Privacy Policy. Retrieved November 6, 2015, from Best Doctors: www.bestdoctors.com/privacy-‐policy
Body Composition Analyzer | Professional Medical Scale | Seca mBCA 514. (n.d.). Retrieved November 4, 2015, from http://www.quickmedical.com/seca-‐medical-‐body-‐composition-‐analyzer-‐scale-‐mbca514.html
Body Composition Tests. (n.d.). Retrieved November 11, 2015, from http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Body-‐Composition-‐Tests_UCM_305883_Article.jsp#.VjkTAaI2k7A
Brochure Printing. (n.d.). Retrieved November 10, 2015, from http://www.fedex.com/us/office/brochure-‐printing.html
Cleaning Quote. (n.d.). Retrieved October 10, 2015, fromhttp://officepride.com/mobile/commercial-‐cleaning-‐quote/
Coding “Routine” Office Visits: 99213 or 99214? (n.d.). Retrieved November 10, 2015, from http://www.aafp.org/fpm/2005/0900/p52.html
Complete Blood Count (CBC). (n.d.). Retrieved November 10, 2015, from http://www.webmd.com/a-‐to-‐z-‐guides/complete-‐blood-‐count-‐cbc
Comprehensive Health Evaluation Program. (n.d.). Retrieved November 10, 2015, from http://www.hopkinsmedicine.org/usa/patient_information/appointments/comprehensive_health_evaluations.html
EMedicalFusion Concierge Medicine EHR Review. (n.d.). Retrieved November 11, 2015, from http://www.ctsguides.com/medical/emedicalfusion/
EMedicalFusion Practice Management Software Suite for Direct Pay Health Practitioners and Concierge Medicine Debuts Version 6.0 with Electronic Health Records Today in Las Vegas. (n.d.). Retrieved November 11, 2015, from http://www.prnewswire.com/news-‐releases/emedicalfusion-‐practice-‐management-‐software-‐suite-‐for-‐direct-‐pay-‐health-‐practitioners-‐and-‐concierge-‐medicine-‐debuts-‐version-‐60-‐with-‐electronic-‐health-‐records-‐today-‐in-‐las-‐vegas-‐235713471.html
Employe Handbook. (n.d.). Retrieved October 10, 2015, from http://familyhealthcareclinic.com/media/Personnel$20Policies$2CNovember$202009.pdf
64
Employee Performance Review. (n.d.). Retrieved November 10, 2015, from http://cf.ltkcdn.net/business/files/874-‐Employee-‐Performance-‐Review.pdf
Features & Functions -‐ eMedicalFusion eMedicalFusion. (n.d.). Retrieved November 11, 2015, from http://www.emedicalfusion.com/features-‐functions
Gavin, M. (2013, August 1). Sports Physicals. Retrieved November 11, 2015, from http://kidshealth.org/teen/food_fitness/exercise/sports_physicals.html
GC Medicine -‐ Home Page. (2014). Retrieved October 6, 2015, fromhttp://gcmedicine.com/Default.aspx
Heart-‐Health Screenings. (n.d.). Retrieved November 1, 2015, from http://www.heart.org/HEARTORG/Conditions/Heart-‐Health-‐Screenings_UCM_428687_Article.jsp#.VjkFiqI2k7A
High Deductible Health Plan (HDHP). (n.d.). Retrieved November 10, 2015, from https://www.healthcare.gov/glossary/high-‐deductible-‐health-‐plan/
How Will These Animals Help Your Buisness Build Better Marketing Solutions? (n.d.). Retrieved November 4, 2015, from http://www.afactormarketing.com
HP OfficeJet Business Printers. (n.d.). Retrieved November 4, 2015, from http://www8.hp.com/us/en/ads/officejet-‐pro-‐printers/officejet-‐pro-‐6800-‐series.html
HP Officejet Enterprise Color MFP X585dn | HP® Official Store. (n.d.). Retrieved November 4, 2015, from http://store.hp.com/us/en/pdp/printers/hp-‐officejet-‐enterprise-‐color-‐x585dn-‐multifunction-‐printer?jumpid=ps_gymaw6xezr&aoid=109887&003=51733796
HP Pavilion 23xw 23-‐inch IPS LED Backlit Monitor | HP® Official Store. (n.d.). Retrieved November 4, 2015, from http://store.hp.com/us/en/pdp/hp-‐pavilion-‐23xw-‐23-‐inch-‐ips-‐led-‐backlit
HP Z440 Workstation (ENERGY STAR) | HP® Official Store. (n.d.). Retrieved November 4, 2015, from http://store.hp.com/us/en/pdp/business-‐solutions/hp-‐z440-‐workstation-‐(energy-‐star)-‐p-‐f1m41ut-‐aba-‐-‐1
IPhone 6s -‐ Apple. (n.d.). Retrieved November 10, 2015, from http://www.apple.com/iphone-‐6s/
IPad Pro -‐ Apple Pencil -‐ Apple. (n.d.). Retrieved November 4, 2015, from http://www.apple.com/apple-‐pencil/?cid=wwa-‐us-‐kwm-‐ipad
IPad Pro -‐ Apple. (n.d.). Retrieved November 4, 2015, from http://www.apple.com/ipad-‐pro/
Leonard, D. (2012, November 29). Is Concierge Medicine the Future of Health Care? Retrieved September 13, 2015, from http://www.bloomberg.com/bw/articles/2012-‐11-‐29/is-‐concierge-‐medicine-‐the-‐future-‐of-‐health-‐care#p2
Mackey, C., Dwyer, J., & Truesdell, D. (2004). Nutritional Assessment. Retrieved November 10, 2015, from http://www.encyclopedia.com/topic/Nutritional_assessment.aspx
65
MAGTEK® Mini Magnetic Stripe Reader, USB 2.0 | Staples®. (n.d.). Retrieved November 11, 2015, from http://www.staples.com/MAGTEK-‐Mini-‐Magnetic-‐Stripe-‐Reader-‐USB-‐2-‐0/product_IM1E45877
Maximum Landscape, Inc., 'Maximum Service. Maximum Quality' – Mobile, AL – Home. (n.d.). Retrieved October 10, 2015, from http://maximumlandscapeinc.com
Mobile Shredding Service. (n.d.). Retrieved October 16, 2015, fromhttp://www.mobileshreddingservice.us
Occupational Safety and Health Administration. (n.d.). Sample Safety and Health Program for Small Business. Retrieved October 12, 2015, from OSHA: https://www.osha.gov/SLTC/etools/safetyhealth/mod2_sample_sh_program.html
Perman, C. (2011, January 19). These Doctors Make House Calls—And Love It. Retrieved September 12, 2015, from http://www.cnbc.com/id/41157342
Physical Activity Counseling. (n.d.). Retrieved November 10, 2015, from http://www.aafp.org/afp/2008/0415/p1129.html
Pulmonary Function Tests. (n.d.). Retrieved November 11, 2015, from http://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/pulmonary_function_tests_92,p07759/
Rabinowitz, E. (2015, February 12). Doctors Recapture Humanity through Concierge Medicine. Retrieved September 12, 2015, from http://www.hcplive.com/journals/md_magazine/2015/vol7-‐issue1/doctors-‐recapture-‐humanity-‐through-‐concierge-‐medicine
Samsung -‐ T1 1TB External Serial ATA Portable Solid State Drive -‐ Black. (n.d.). Retrieved November 11, 2015, from http://www.bestbuy.com/site/samsung-‐t1-‐1tb-‐external-‐serial-‐ata-‐portable-‐solid-‐state-‐drive-‐black/4225008.p?id=1219621585087&skuId=4225008 Society for Human Resource Management. (2014, July 3). ADA/ADAA Policy. Retrieved November 6, 2015, from SHRM: http://www.shrm.org/templatestools/samples/policies/pages/adaadaaapolicy.aspx
Shilton, A. (2015, May 4). Concierge Medicine Means Only the Ridiculously Rich Can Find a Doctor. Retrieved September 13, 2015, fromhttp://www.slate.com/articles/health_and_science/medical_examiner/2015/05/
Society for Human Resource Management. (2014, March 20). Background and Reference Check Policy. Retrieved November 15, 2015, from SHRM: http://www.shrm.org/templatestools/samples/policies/pages/cms_005370.aspx
Society for Human Resource Management. (2014, June 17). Drug and Alcohol Policy. Retrieved November 15, 2015, from SHRM: http://www.shrm.org/templatestools/samples/policies/pages/cms_019908.aspx
Society for Human Resource Management. (2014, March 20). Equal Employment Opportunity and Harassment Policy. Retrieved October 12, 2015, from SHRM: http://www.shrm.org/templatestools/samples/policies/pages/cms_007618.aspx
66
Society for Human Resource Management. (2014, June 17). Random Drug Testing Policy. Retrieved November 15, 2015, from SHRM: http://www.shrm.org/templatestools/samples/policies/pages/cms_021943.aspx
Staff Member-‐ Handbook. (n.d.). Retrieved October 20, 2015, from https://www.classicconcierge.com/classicteam/wp-‐content/uploads/2014/07/Staff member-‐Handbook.pdf
Stroke: Screening and Tests. (n.d.). Retrieved November 10, 2015, from https://www.floridahospital.com/stroke/screening-‐and-‐tests
Support eMedicalFusion. (n.d.). Retrieved November 11, 2015, from http://www.emedicalfusion.com/technical-‐support#/SupportServicesandHours
Three Must-‐Have EHR Features for Membership Medicine. (2015, March 4). Retrieved November 11, 2015, from http://conciergemedicinetoday.org/2015/03/04/three-‐must-‐have-‐ehr-‐features-‐for-‐membership-‐medicine/
Urine Test. (n.d.). Retrieved November 11, 2015, from http://www.webmd.com/a-‐to-‐z-‐guides/urine-‐test
Wieczner, J. (2013, November 10). Pros and Cons of Concierge Medicine. Retrieved September 13, 2015, from http://www.wsj.com/articles/SB10001424052702303471004579165470633112630?alg=y
67
APPENDIX A: MARKETING
68
EXPLANATION OF SERVICES
MEDICAL HISTORY
During the medical history potion of the comprehensive physical this will be the time for members to discuss
any present complaints or concerns. Additionally, the member’s physician will discuss their lifestyle behaviors
like smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor will also check on the member’s
vaccination status and update their personal and family medical history.
VITAL SIGNS
Vital signs that the physician will check to make sure are normal include, blood pressure, heart rate, respiration
rate, and temperature.
HEART EXAM
By listening to the heart with a stethoscope, a physician might detect an irregular heartbeat, a heart murmur, or
other clues to heart disease which can be monitored further and/or require a referral to a specialist.
LUNG EXAM
By using a stethoscope, our physicians will listen for crackles, wheezes, or decreased breath sounds. These and
other sounds are clues to the presence of heart or lung disease. Our physicians will refer the member to a
specialist if necessary.
HEAD AND NECK EXAM
The physician will exam the throat and tonsils. As well, the ears, nose, sinuses, eyes, lymph nodes, thyroid, and
carotid arteries will be examined.
69
ABDOMINAL EXAM
The physician may use a range of examination techniques including tapping your abdomen to detect liver size
and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.
NEUROLOGICAL EXAM
The physician will assess nerves, muscle strength, reflexes, balance, and mental state.
COMPLETE BLOOD COUNT
A complete blood count (CBC) gives the physician information about the kinds and numbers of cells in the blood,
especially red blood cells, white blood cells, and platelets. A CBC helps the member’s physician check any
symptoms, such as weakness, fatigue, or bruising, the member may have. A CBC also helps the physician
diagnose conditions, such as anemia, infection, and many other disorders.
URINE ANALYSIS
A urine test checks different components of urine, a waste product made by the kidneys. The test can give
information about the member’s health and problems they may have. The kidneys take out waste material,
minerals, fluids, and other substances from the blood to be passed in the urine. Urine has hundreds of different
body wastes. What a member eats and drinks, how much the member exercises, and how well their kidneys
work can affect what is in their urine. More than 100 different tests can be done on urine.
BODY COMPOSITION ANALYSIS
Body composition is used to describe the percentages of fat, bone, water and muscle in human bodies. Because
muscular tissue takes up less space in our body than fat tissue, our body composition, as well as our weight,
determines leanness. If a member has too much fat, especially if a lot of it is at member’s waist, they're at higher
70
risk for such health problems as high blood pressure, high blood cholesterol and diabetes. Which, increases
member’s risk for heart disease and stroke.
NUTRITIONAL ASSESSMENT
A nutritional assessment is an in-‐depth evaluation data related to a member’s food and nutrient intake,
lifestyle, and medical history. Once the data on the member is collected and organized, our physicians can
assess and evaluate the nutritional status of that member. The nutritional assessment can aid in the
development of the member’s wellness plan.
EXERCISE COUNSELING
Exercise counseling consists of assessing the member’s current physical activity (type, frequency, intensity, and
duration) and providing them with an individually tailored recommendation. The physician’s recommendation
concerning physical activity should be supported by a discussion with the member about, what steps to action
they will take, their plan, and their intended start date. Additionally, the physician should consistently follow up
in order to hold member’s accountable.
HEART SCREENING
The key to preventing cardiovascular disease, also called coronary artery disease (CAD), is managing the risk
factors, such as high blood pressure, high total cholesterol or high blood glucose. The best way to know which
risk factors our members have is through screening tests during their comprehensive physical. The following
are the key screening tests recommended for optimal cardiovascular health:
Blood Pressure
Blood pressure is one of the most important screenings because high blood pressure usually has no symptoms
71
so it can’t be detected without being measured. High blood pressure greatly increases the risk of heart disease
and stroke. If blood pressure is below 120/80 mm Hg, be sure to get it checked at least once every two years,
starting at age 20. If blood pressure is higher, our physicians may want to check it more often.
Fasting Lipoprotein Profile (cholesterol and triglycerides)
Members should have a fasting lipoprotein profile taken every four to six years, starting at age 20. This is a blood
test that measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. A member
may need to be tested more frequently if the member’s physician determines that they’re at an increased risk
for heart disease or stroke.
Body Weight
Starting around 20 years old, a member’s physician may ask for their waist circumference or use the member’s
body weight to calculate their body mass index (BMI) during the comprehensive physical. These measurements
allow the member’s physician to know whether that member is at a healthy body weight and composition.
Blood Glucose
Starting at age 45, members should have their blood glucose level checked at least every three years. High blood
glucose levels put a member at greater risk of developing insulin resistance, prediabetes and type 2 diabetes.
Untreated diabetes can lead to many serious medical problems including heart disease and stroke. If a member
is overweight and has at least one additional cardiovascular risk factor, that member’s physician may
recommend a blood glucose test even if the member is not yet 45, or more frequently than every 3 years.
Discuss smoking, physical activity, diet
Smoking is the most important preventable cause of premature death in the United States. If a member smokes,
72
their physician can suggest approaches to help quit. Additionally, a discussion of each member’s diet and
physical activity habits is crucial, this will also help the physician develop the member’s wellness plan.
STROKE SCREENING
Screening for stroke will begin with a physical exam and the physician asking the member about risk factors for
stroke, including smoking, heart disease and family history, along with information about when the symptoms
began (if relevant). During the physical exam, the physician will check the member’s mental alertness,
coordination and balance, and look for numbness in the face, arms or legs, confusion, and trouble with vision or
speaking. In addition, the physician will look for signs of carotid artery disease, which is a common cause of
ischemic stroke, by listening to the patient’s carotid arteries with a stethoscope.
73
ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION PHYSICAL EVALUATION FORM
ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION
Name__________________________________________________ Sex ________ Age______ Date of birth _______________ Address ______________________________________________________________________ Phone______________________ School ________________________________________________________Grade __________ Sport ______________________
Preparticipation Physical Evaluation Form
History Date_______________________
Explain “Yes” answers below: Yes No 1. Has a doctor ever restricted/denied your participation in sports? 2. Have you ever been hospitalized or spent a night in a hospital?
Have ever had surgery? 3. Do you have any ongoing medical conditions (like Diabetes or Asthma)? 4. Are you presently taking any medications or pills (prescription or over‐the‐counter? 5. Do you have any allergies (medicine, pollens, foods, bees or other stinging insects)? 6. Have you ever passed out during or after exercise? Have you ever been dizzy during or after exercise? Have you ever had chest pain or discomfort in your chest during or after exercise? Do you tire more quickly than your friends during exercise? Have you ever had high blood pressure? Have you ever been told that you have a heart murmur, high cholesterol, or heart infection? Have you ever had racing of your heart or skipped heartbeats? Has anyone in your family died of heart problems or a sudden death before age 50? Does anyone in your family have a heart condition? Has a doctor ever ordered a test on your heart (EKG, echocardiogram)? 7. Do you have any skin problems (itching, rashes, staph, MRSA, acne)? 8. Have you ever had a head injury or concussion? Have you ever been knocked out or unconscious? Have you ever had a seizure? Have you ever had a stinger, burner, pinched nerve, or loss of feeling or weakness in your arms or legs? 9. Have you ever had heat or muscle cramps? Have you ever been dizzy or passed out in the heat? 10. Do you have trouble breathing or do you cough during or after activity? Do you take any medications for asthma (for instance, inhalers)? 11. Do you use any special equipment (pads, braces, neck rolls, mouth guard, eye guards, etc.)? 12. Have you had any problems with your eyes or vision? Do you wear glasses or contacts or protective eye wear? 13. Have you had any other medical problems (infectious mononucleosis, diabetes, infectious diseases, etc.)? 14. Have you had a medical problem or injury since your last evaluation? 15. Have you ever been told you have sickle cell trait? Has anyone in your family had sickle cell disease or sickle cell trait? 16. Have you ever sprained/strained, dislocated, fractured, broken or had repeated swelling or other injuries of any bones or joints? Head Back Shoulder Forearm Hand Hip Knee Ankle Neck Chest Elbow Wrist Finger Thigh Shin Foot
17. When was your first menstrual period?__________________________________________________________________ When was your last menstrual period?___________________________________________________________________ What was the longest time between your periods last year?________________________________________________
Explain “Yes” answers: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I hereby state that, to the best of my knowledge, my answers to the above questions are correct. Signature of athlete ___________________________________________________________ Date ___________________
Signature of parent/guardian __________________________________________________ DUPLICATE AS NEEDED Rev. 2010 FORM 5 Page 1 of 2
74
75
APPENDIX B: STAFFING
76
Premiere Concierge Services: Job Description
Job title Director of Medicine
Job purpose
The Director of Medicine will be part of an integrated healthcare organization that provides health plans and comprehensive services to members in a concierge environment. Treat members and provide preventive care to members, while being the director of medical services.
Duties and responsibilities
• Provide medical services and treatment to members and families • Responsible for examining members to ensure proper care, diagnosis, treatment and recovery • Request necessary tests, follow-‐up appointments and home-‐visits, coordinate services including
laboratory, x-‐rays and refers members to specialists, as necessary. • Lead all medical services • Serve as director for the medical areas of the practice • Assist Practice Manager in management decisions • Provide proper education to members in regards to development, health maintenance, medical
treatments, etc.
Qualifications
• Degree in medicine from an accredited school and license to practice medicine is required. • Licensure for prescribing and registration for DEA based on state requirement. • 10+ years of experience • Strong command of English language; outstanding communication skills. • Experience with all age groups • Polished, poised and professional in both mindset and manner; use of utmost discretion at all times.
77
Premiere Concierge Services: Job Description
Job title Physician
Reports to Director of Medicine
Job purpose
The physician will be part of an integrated healthcare organization that provides health plans and comprehensive services to members in a concierge environment. Treat members and provide preventive care to members, while being able to make house calls and in office appointments.
Duties and responsibilities
• Provide medical services and treatment to members and families • Responsible for examining members to ensure proper care, diagnosis, treatment and recovery • Request necessary tests, follow-‐up appointments and home-‐visits, coordinate services including
laboratory, x-‐rays and refers members to specialists, as necessary. • Keep and maintain appropriate records relating to all professional services rendered. • Provide proper education to members in regards to development, health maintenance, medical
treatments, etc.
Qualifications
• Degree in medicine from an accredited school and license to practice medicine is required. • Licensure for prescribing and registration for DEA based on state requirement. • 10+ years of experience • Strong command of English language; outstanding communication skills. • Experience with all age groups • Polished, poised and professional in both mindset and manner; use of utmost discretion at all times.
78
Premiere Concierge Services: Job Description
Job title Registered Nurse
Reports to Director of Medicine
Job purpose
The Registered Nurse will be part of an integrated healthcare organization that provides health plans and comprehensive services to members in a concierge environment. Should be apart of care before, during and after when any healthcare is delivered.
Duties and responsibilities
• Provide medical services and treatment to members and families • Implement and document all patient care • Assist physicians during evaluations and procedures • Administer medications • Take members vitals and be familiar • Prepare and maintain member rooms • Willingness to step in and help where needed
Qualifications
• Bachelor's degree in Nursing BSN • 3+ years experience in a clinical setting • Strong command of English language; outstanding communication skills. • Experience with all age groups • Polished, poised and professional in both mindset and manner; use of utmost discretion at all times.
79
Premiere Concierge Services: Job Description
Job title Practice Manager
Reports to Director of Medicine
Job purpose
The Practice Manager will be responsible for overseeing the practice, demonstrate the ability to manage office personnel, and demonstrate effective communication throughout the organization, while also serving as the practices receptionist.
Duties and responsibilities
• Implement and monitor office policies, processes and procedures • Enhance patient satisfaction and retention. • Maintain appropriate staffing levels and morale • Conduct monthly staff meetings. • Conduct performance evaluation with staff members • Answer telephones and direct calls to appropriate staff. • Perform various clerical or administrative functions, such as ordering and maintaining an inventory of
supplies • Appointment scheduling for members • Check in members
Qualifications
• 5+ years of experience in medical office management • Degree of Business Administration or Health Administration • Proficient with Microsoft Office and Excel • Outstanding communication skills • Problem solving skills • Administrative skills
80
STAFF MEMBER PERFORMANCE EVALUATION FORM
Staff Member Name and Position ____________________ Date of Evaluation ___________________
Part 1: Circle the number that best represents Staff member’s performance for each item.
1. Quality/accuracy of work
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
2. Quantity of work
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
3. Dependability
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
4. Attendance/Punctuality
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
5. Professional communication skills with co-‐workers/supervisors
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
6. Customer-‐focused communication skills
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
7. Ability to work as a member of a team; teamwork
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
8. Ability to work independently
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
81
9. Open to feedback
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
10. Willingness to take on additional responsibilities
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
11. Complies with company policies and procedures
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
12. Exhibits effective problem solving skills
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
13. Eagerness to learn new job-‐related skills
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
14. Asks questions and seeks guidance as needed
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
15. Makes progress toward professional development goals
1 2 3 4 5 Deficient Below Standard Meets Expectations Above Standard Outstanding
Part 2: Explanation/description of concerns regarding any items with scores of 1 or 2, along with plans for making necessary improvements. Enter N/A for any items with scores of 3 or higher.
Item #: Concerns:
82
Part 3: Developmental Goals: Agree on and list 3 -‐ 5 developmental goals for next review period.
1. _____________________________________
2. _____________________________________
3. _____________________________________
4. _____________________________________
5. _____________________________________
Part 4: Training Needs: List any specific training needed to improve job performance or make progress toward achieving agreed-‐upon developmental goals.
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Part 5: Staff member comments ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Completed by:
________________________________ Staff member Name (Please Print)
________________________________ Signature
________________________________ Supervisor Name (Please Print)
________________________________ Signature
________________ Date Evaluated
________________ Date Reviewed
83
PREMIERE CONCIERGE SERVICES: MEMBER SATISFACTION
Dear Member,
Thank you for choosing Premiere Concierge Services. Please tell us your opinion about the service you received. Your responses will be kept strictly confidential. Thank you for your help.
Gender: _______ Age: _______ Provider: ____________________________
PLEASE RATE THE FOLLOWING:
A. YOUR APPOINTMENT:
Topic: 1 2 3 4 5 N/A Ease of making appointment Appointment available within a reasonable amount of time Getting care for illness as soon as you wanted it Getting after-‐hours care when you needed it Waiting time for all of appointment Ease of getting referred to other services
B. OUR STAFF:
Topic: 1 2 3 4 5 N/A The courtesy of the Registered Nurse The courtesy of the physician The caring concern of our medical staff members The relationship with your provider
C. OUR COMMUNICATION WITH YOU:
Topic: 1 2 3 4 5 N/A Your phone calls answered promptly Explanation of your health Your test results reported Our ability to return your calls in a timely manner Your ability to obtain prescriptions by phone Your ability to contact us after hours
84
D. YOUR VISIT WITH YOUR PROVIDER:
Topic: 1 2 3 4 5 N/A Willingness to listen carefully to you Taking time to answer your questions Amount of time spent with you Explaining things in a way you could understand Instructions regarding medication/follow up care Advice given to you on ways to stay healthy
E. YOUR OVERALL SATISFACTION WITH:
Topic: 1 2 3 4 5 N/A Our practice The quality of your medical care Overall rating of care from your provider
Would you recommend Premiere Concierge Services to others? If no, please explain why:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
If there is any way we can improve our services to you, please tell us how:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Thank you very much for your help!
85
STAFF MEMBER HANDBOOK
The Staff Member Handbook is designed to provide you with valuable information about the practices, policies, responsibilities and benefits you have as a staff member at Premiere Concierge Services. Please take time to read this handbook. The policies and procedures summarized in the handbook are presented as information only and are not conditions of employment.
Premiere Concierge Services reserves the right to modify, suspend, revoke, terminate or change in whole or in part, any of its policies, procedures or practices at any time with or without notice. The information in this handbook is subject to change.
I understand that changes in Premiere Concierge Services’ policies may supersede, modify, or render obsolete the information summarized in this booklet. As Premiere Concierge Services provides updated policy information, I accept responsibility for reading and abiding by the changes.
I understand that this handbook intends no modifications to contractual relationships or alterations of at-‐will employment relationships.
I understand that I have an obligation to inform the Practice Manager of any changes in personal information, such as phone number, address, etc. I also accept responsibility for contacting the Practice Manager if I have questions or concerns or need further explanation.
I agree to read the handbook and abide by the standards, policies, and procedures defined or referenced in this document.
Signed: ______________________________
Print Name:___________________________
Date: _________
86
RECRUITMENT AND SELECTION
Recruitment: The Practice Manager is responsible for recruiting qualified candidates for employment. All qualified and interested applicants are urged to apply. Furthermore, we encourage staff members to refer qualified candidates to the Practice Manager when positions become available. Those candidates possessing the minimum qualifications for the position will be carefully considered for those open positions listed on the candidate’s application for employment.
Standards of Selection: Premiere Concierge Services will select the most qualified candidate for the position regardless of the applicant’s race, sex, religion, national origin, age, disability or veteran’s status. Every effort will be made to hire the most capable and responsible candidate who has a good character and work record. To be eligible for consideration, the candidate must, at the very least, possess the minimum qualifications for the position. The minimum qualifications are listed in the job description.
EMPLOYMENT PROCEDURES
General: All applications for employment must be sent to the Practice Manager for processing. Applications for employment will be accepted only when positions become available. No qualified applicant will be offered employment until all of the pre-‐employment procedures have been completed.
Pre-‐employment interview: When positions become available, applicants will be asked to undergo a pre-‐employment or screening interview to determine whether they possess the minimum qualifications for the position. The Practice Manager will make a recommendation on whether the applicant should be given an offer of employment.
Pre-‐employment Physical: All applicants who have been given a conditional offer of employment will be required to take a pre-‐employment physical. The applicant must pass the physical examination as a condition of employment. Applicants will be given a physical examination administered by Premiere Concierge Services free of charge. However, if the applicant prefers to be examined by a physician of his/her choice, he/she will be required to pay the cost of the examination. Furthermore, if the applicant has been examined during the last 180 days, certified copies of the examination results can be forwarded to Premiere Concierge Services and used to satisfy the pre-‐employment physical examination requirement.
Pre-‐Employment Drug Testing and Background Check: See Appendix C
Work Schedule: Upon being hired, each staff member is assigned a stipulated budgeted amount or amount stipulated on the salary scale for hours that he or she is expected to work each week. If the staff member is available for work, and reports to work, Premiere Concierge Services will compensate the Staff member his or her weekly hours worked. The staff member may be asked to work more than the number of regular working hours, in which case, the staff member will be compensated for these additional hours by compensatory time or overtime pay.
87
ORIENTATION
In order to make your adjustment to our practice smooth and uninterrupted, we have developed an orientation program. You will receive orientation in two phases.
The first phase will be conducted by the Practice Manager and will include information about the history and purpose of Premiere Concierge Services, its organization, policies, procedures, ands staff members. The staff member, if eligible will be offered a schedule of benefits for which they may participate. The Staff member will also be counsel on vacation, sick, and other types of leave that they may be eligible for during orientation. Staff members will also be counseled on the Performance Evaluation that will be conducted every six months.
The Director of Medicine will conduct the second phase. The staff member will be oriented to the new work environment and the particular duties and responsibilities of the position for which the staff member was hired.
WORKING HOURS
Work Hours: Premiere Concierge Services operates from 8:00 a.m. to 5:00 p.m. Monday through Friday with walk-‐ins and appointments; and from 10:00 a.m. to 3:00 on Saturday and Sunday with appointments only, except on holidays. The Practice Manager must approve special Requests for work hours different from this normal work schedule.
Lunch Hours: The lunch period for our practice has been set from 11:00 a.m. to 2:00 p.m. Staff members are permitted to take one unpaid hour for lunch sometime during this lunch period. Staff members are encouraged to take their lunch during times that will not interrupt service to our members.
For example, a position with two staff members should stagger their lunch period so that only one person is absent from the department at a time.
Staff members will be expected to take a lunch hour every day, unless he receives prior approval from the Practice Manager.
Absentees and Tardiness
Absences: We recognize that from time to time it may be necessary to be absent from a scheduled work shift because of a personal illness or injury.
When this occurs, it is your responsibility to:
1. Notify the Practice Manager by 8:15 a.m. on each day that you plan to be absent and provide your expected length of your absence.
2. If the Practice Manager is not available, you should notify the Director of Medicine 3. Failure to report to work and to call in for three consecutive business days will be considered voluntary
resignation.
88
Excessive Unscheduled Absences: We expect every staff member to maintain good attendance. Whenever a staff member is late or absent, someone else will have to perform his duties, which causes an undue hardship on those staff members who are present. Attendance records will be maintained on every staff member, and disciplinary action, up to and including termination will be taken against those staff members who are excessively absent or late for work.
Tardiness: All staff members are expected to report to work on time, and may not leave work early or take a break unless authorized by his supervisor. The Practice Manager will be responsible for monitoring the staff member’s late arrivals and early departures. At the end of each work week, all late arrivals and early departures will be totaled. For each accumulated six minutes that the staff member is late, or leaves early, he or she loses one-‐tenth of an hour of pay.
GENERAL CONDUCT
Staff Member Conduct: As a staff member of Premiere Concierge Services you are expected to be kind, courteous, and considerate with members, the visiting public, and your fellow co-‐workers at all times. You will find that professional behavior will accomplish more and you will get more satisfaction out of your work.
When people are ill, they are often irritable and/or possibly frightened. Accordingly, our members must be treated with the utmost courtesy and understanding. Further, thoughtfulness and cheerfulness are important at all times. Staff members should not be caring on personal conversations in the presents of members. Personal conversations should not precede conducting your job. Your personal conduct often determines the reputation of the health center.
SMOKING
Because Premiere Concierge Services is dedicated to providing a healthy work environment for its staff members, tobacco use (smoking, chewing or dipping tobacco) is not allowed in the workplace or on business property.
Staff members must also refrain from tobacco use when working outside the office or during business travel. Staff members receiving visitors or vendors must ensure that their visitors or vendors understand and adhere to the tobacco-‐free workplace policy. Staff members who disregard the tobacco-‐free policy will be subject to the disciplinary procedures.
TELEPHONE MESSAGES
Staff members who are given company cell phones may use their device within the confines of their job descriptions. The device should not be a distraction to other staff members or members of the practice. Cell phone conversations should be related to patient care or other business matters. Company cell phones may not be used for personal use. Use of personal cell phones will not be tolerated. However, personal cell phones may be used outside of the building or during designated break times. Inappropriate company or personal cell phone usage will be handled by the Practice Manager in accordance with disciplinary procedures.
89
PERSONAL AND PROFESSIONAL APPEARANCE
Cleanliness, good grooming, and professional attire are an absolute necessity at all times in the practice. Each staff member is expected to dress professionally, in good taste and in accordance with the requirements of his or her position, and to maintain an appearance becoming of a health care professional.
All medical staff is required to dress in practice uniforms at all times. The Practice Manager is required to dress in business professional.
At no time are the following to be worn to work:
• Jeans of any color or any kind (pants, skirts or jackets) • Shorts (regular or walking) • Short pants • Mini skirts (above top of knee) • Sleeveless blouses or shirts without jackets, • T-‐shirts • Sandals (where toes are exposed)
Jewelry which is out of line with the uniform or dress, or with the safe and efficient care of our patients (dangling jewelry, multiple earrings, nose-‐rings, face-‐rings), rolled up or tied up scrub pant legs, colored shoe strings or colored socks.
SAFETY
Preventing accidents in and around the practice is extremely important. To reduce the possibility of injury to our members, guests and staff members, the practice makes every effort to provide safe working conditions and safe operating procedures for our equipment, and to encourage safe working practices. Each staff member should be alert to unsafe conditions, equipment or methods of operations. If you see an unsafe working condition or an operational hazard, report it to the Practice Manager immediately so it can be eliminated.
If a staff member, member, or visitor is injured while on practice property; this injury must be promptly attended to and immediately reported to the Practice Manager. Regardless of how minor the injury, it should be reported so that measures can be taken to prevent more serious injuries in the future.
In addition to injuries or accidents, staff members should immediately report the following to the Practice Manager:
1. Damage to any practice equipment or supplies. 2. Loss or theft of personal property or practice supplies and equipment. 3. Uncooperative behavior of visitors. 4. Telephone threats. 5. Any other occurrence, which would have a bearing upon the efficient operation of the practice that may
have legal implications, or that, jeopardizes the reputation of the practice. 6. Any unsanitary or unclean condition on or near the practice premises
90
WORK RULES/DISCIPLINARY PROCEDURES:
Work rules are necessary in every organization and they must be followed. When these rules are not followed, Premiere Concierge Service’s applies a progressive disciplinary procedure in order to give staff members an opportunity to improve their performance where appropriate. Typically, performance or behavior problems or policy violations are addressed through the disciplinary procedures. There are circumstances, however, where the severity of the problem may require that the disciplinary procedures be accelerated to suspension or termination. While termination is the last resort, there are circumstances in which immediate termination without progressive counseling may be appropriate.
The following are examples of work rule violations that will result in termination:
1. Theft from fellow staff members, the practice, or the members, or any other form of dishonesty. 2. Neglect or abuse of members. 3. Refusal to perform assigned duties, and refusal to obey a legitimate order of the Practice Manager or
Director of Medicine. 4. Reporting to work or working in an intoxicated or drugged condition, possession, transfer, sale or
consumption of alcoholic beverages, intoxicants or any kind of illegal drug or stimulant. 5. Unexcused absence from work. 6. Falsifying time cards, personnel records, or any other practice records. Supplying false or misleading
information when applying for employment or at any time during employment. Misuse of time cards, punching in or out for another person on his or her time card or allowing another staff member to punch your time card in or out for you in your absence.
7. Possession of firearms, weapons, or explosives on practice property. 8. Illegal, immoral or indecent conduct, soliciting persons for immoral purposes or the assisting and/or
abetting of any of the above. 9. Soliciting or accepting tips or personal gratuities from members or visitors. 10. Fighting on practice premises, coercion, intimidation or threats of any kind. 11. Disrespectful conduct, using vulgarity or failing to give quality service in a courteous manner. 12. Deliberate violations of safety or security protections. 13. Unauthorized entry into or exit from practice premises at any location, at any time. 14. Unauthorized removal of practice records or property from the premises. 15. Any act which could have a detrimental effect on the operation or profitability of the practice, including
but not limited to lying, misrepresenting or concealing pertinent facts from management.
The following disciplinary procedure should be followed by the Practice Manager, and verified and signed documentation by the Director of Medicine:
1. Verbal warning 2. Written warning with suspension until further notice 3. Written notice of termination of employment
All disciplinary procedures must be given by the Practice Manager and approved with documentation by the Director of Medicine.
91
RATING OF EMPLOYEES PERFORMANCE
Premiere Concierge Services believes evaluating our staff members is needed to offer the best services. Performance evaluations will be completed in order to make sure staff members are fulfilling their responsibilities and to help improve staff members’ productivity. The Practice Manager will perform these evaluations every six months. After the evaluation is completed, the Practice Manager will meet with the staff member evaluated to discuss the evaluation, what could be done to improve future performance, and any concerns of the staff member. The Practice Manager must document all evaluations, results, and meeting notes. See Appendix B for the performance evaluation form.
CONFLICT RESOLUTION PROGRAM
Problems arising in the practice can often times be easily resolved through effective communication. If you have a complaint or suggestion for improvement, we invite you to come to us immediately. We cannot resolve your problems or hear your suggestions until you come talk to us. Our door is always open. In an effort to streamline the resolution of problems and complaints, the practice has established a Conflict Resolution Program. To be effective, the programs procedures must be closely followed:
Step 1: Any staff member who believes that he has a problem or conflict to resolve must first discuss it with the Director of Medicine within three working days of the action, which is the basis of his complaint. The staff member is required to provide a full and frank explanation of the problem. The Director of Medicine will give a written reply to the employee within three working days after the meeting.
Step 2: If a mutually satisfactory solution to the problem is not reached in Step 1 of the program, the staff member must contact the Practice Manager within three working days of receiving the Director of Medicine’s reply. The next higher supervisor will consider the staff member problem and give a written reply within three working days after the meeting.
Step 3: Request for Review: Staff members who have unresolved grievances can meet with both the Practice Manager and Director of Medicine. The request for a meeting must be made within seven working days after the staff member receives notification of the employment decision. The Practice Manager and Director of Medicine will issue a decision as soon as is reasonably possible. The decision will be binding.
SALARIES/WAGES
Wages and salaries: It is our goal to attract, retain, and reward competent staff members at all levels. To attain this goal, we will pay our staff members competitively within the job market for similar skills, training, qualifications, and abilities, taking into consideration the relative value of the job to the practice, as well as how the staff members performs in their job. Salary ranges, including a minimum and a maximum, are set for each position in the practice.
PAYROLL PROCEDURES
Pay Period: All staff members will be paid on a bi-‐weekly basis (every two weeks). The staff members will receive their paycheck on Friday of the week following the end of the payroll period.
92
Distribution of Pay Checks: Usually, payroll checks are distributed between the hours of 12:01 p.m. to 5:00 p.m. If the staff member is not scheduled to work on the payday, they are allowed to pick up their paycheck from the Practice Manager on the next workday.
Payroll Adjustments: While the practice takes great pride in making certain that the staff member receives the correct pay every pay period, occasionally adjustments have to be made. Every effort will be made to issue a supplemental check as soon as possible.
Payroll Advances: The practice is unable to provide payroll advances.
EMPLOYEE BENEFITS
Workers Compensation: Workers Compensation Insurance covers all staff member on the first day of his or her employment. Eligible staff members may receive partial payment of wages lost due to injury or illness incurred in the workforce, or death benefits in the event of loss of life.
Sick Leave: Staff members are granted sick leave. Sick leave may be used after 30 days of employment. You can use sick leave when you miss work due to the following:
• A medical, dental, or vision appointment for you or a family member • Your own illness or injury • Temporary care of a family member with an illness or injury • Death of a family member
In order to reduce the staff member’s loss of pay when this occurs, the staff member is awarded a certain amount of paid sick leave each year. Each full-‐time staff member will have six paid sick days per year and part-‐time staff member will have three paid sick days. When a staff member knows they will not be able to attend work, they must notify the Practice Manager immediately. The Practice Manager has the right to grant more sick days to a member who has worked for the practice for over two years.
Vacations: All staff members are entitled to paid vacations. All requests for vacation should be made to the Practice Manager 30 days in advance and only one staff member may be on vacation at a time due to a small staff. Vacation time requests will be granted on a first come first serve basis. Full time staff members who have worked at Premiere Concierge Services for one to five years will be allowed two weeks of vacation time. Full time staff member who have worked at Premiere Concierge Services for more than five years will be allowed three weeks. Part time staff members will receive one week of vacation time. If the Director of Medicine or physician is on vacation, it is to their discretion to decide if they answer phone calls from members. When one physician is on vacation, the other is responsible for that physician’s walk-‐in appointments.
Retirement: Premiere Concierge Services offers all eligible staff member pre-‐tax dollars contributed to a 401k program. To encourage staff member savings, Premiere Concierge Services will match up to 6% of the staff member’s contributions to the savings plan. The practice will contribute 4% in the first year of a staff member’s employment, 5% in the second year of employment, 6% in the third and all subsequent years.
93
Health Insurance: Premiere Concierge Services offers a comprehensive medical health insurance plan to eligible staff members and dependents. All full-‐time and permanent part-‐time staff members who work at least twenty hours per week are eligible to participate in the group health insurance plan, after having completed the ninety-‐day probationary period. Premiere Concierge Services will pay 67% of the monthly insurance premium. The remaining 33% will be deducted from the participating staff member’s pay check.
Medical Leave and Maternity Leave: A medical leave of absence will be granted to staff members who cannot work due to pregnancy, illness, injury, or serious health condition. The practice requires satisfactory documentation supporting the request for leave. The staff member must notify the Practice Manager of a planned medical or maternity leave thirty days in advance. A request for medical or maternity leave must be accompanied by a written statement from the staff member’s physician certifying the staff member is pregnant or is suffering from an illness or injury and he or she is unable to work.
Enrollment/Disenrollment Period: The enrollment and disenrollment period for all benefits will be during the month of January. New staff members are eligible to enroll within 30 days of employment. If they opt not to participate in all or any of the benefits within 30 days of hire, they will become eligible again in January of the next year.
Holidays: All full-‐time employees will be eligible for eight (8) straight time hours of holiday pay at his regular rate of pay even if they are not scheduled to work on the holiday (sick, vacation or other scheduled leave). Staff members whose regularly scheduled work hours do not fall on the holiday will not be paid for the holiday. We recognize the following holidays:
1. New Year’s Day 2. Memorial Day 3. Independence Day 4. Labor Day 5. Thanksgiving Day 6. Christmas Day
TERMINATION
Possible classifications of termination are voluntary, involuntary, and death termination. The Practice Manager will be responsible for informing staff members of termination. Each staff member will be paid through their final day of employment, including all un-‐used paid time off. All termination documents and supporting evidence must be document by the Practice Manager.
Voluntary: Voluntary termination occurs when a staff member informs the office manger of resignation. The staff member is expected to provide the Practice Manager with a written notice of their voluntary termination with two weeks’ notice. Upon notification of resignation, the Practice Manager is responsible coordinating remaining staff members to fulfill the resigned member’s duties until a replacement can be hired. The Practice Manager will handle the staff member’s termination. This process includes return of all company property, review of benefit status, and completion of an exit interview.
94
Involuntary: The Practice Manager should first exhaust all disciplinary procedures prior to the termination of a staff member. As Alabama is an employment-‐at-‐will state, termination may occur for any reason (i.e., misconduct, tardiness, absenteeism, unsatisfactory performance, etc.) The Practice Manager may call for immediate termination with approval from the Director of Medicine. The Practice Manager should follow the same procedures as for voluntary termination.
Deceased Staff Members: In the event of the death of a staff member, termination will be effective on the date of death. The Practice Manager is responsible for scheduling a meeting immediately to inform other staff members of the situation. The Practice Manager will handle all beneficiary payments with surviving family members.
95
APPENDIX C: REGULATORY COMPLIANCE
96
HIPAA COMPLIANCE AND CONFIDENTIALITY STATEMENT
All patient Protected Health Information (PHI—which includes patient medical and financial information), employee records, financial and operating data of the practice, and any other information of a private or sensitive nature are considered confidential. Confidential information should not be read or discussed by any employee unless pertaining to his or her specific job requirements. Examples of inappropriate disclosures include:
§ Employees discussing or revealing PHI or other confidential information to friends or family members.
§ Employees discussing or revealing PHI or other confidential information to other employees without a legitimate need to know.
§ The disclosure of a patient’s presence in the office, hospital, or other medical facility, without the patient’s consent, to an unauthorized party without a legitimate need to know, and that may indicate the nature of the illness and jeopardize confidentiality.
The unauthorized disclosure of PHI or other confidential information by employees can subject each individual employee and the practice to civil and criminal liability. Disclosure of PHI or other confidential information to unauthorized persons, or unauthorized access to, or misuse, theft, destruction, alteration, or sabotage of such information, is grounds for immediate disciplinary action up to and including termination.
Employee Confidentiality Agreement
I hereby acknowledge, by my signature below, that I understand that the PHI, other confidential records, and data to which I have knowledge and access in the course of my employment with [insert name of practice/health care facility] is to be kept confidential, and this confidentiality is a condition of my employment. This information shall not be disclosed to anyone under any circumstances, except to the extent necessary to fulfill my job requirements. I understand that my duty to maintain confidentiality continues even after I am no longer employed.
I am familiar with the guidelines in place at [insert name of practice/health care facility] pertaining to the use and disclosure of patient PHI or other confidential information. Approval should first be obtained before any disclosure of PHI or other confidential information not addressed in the guidelines and policies and procedures of [insert name of practice/health care facility] is made. I also understand that the unauthorized disclosure of patient PHI and other confidential or proprietary information of [insert name of practice/health care facility] is grounds for disciplinary action, up to and including immediate dismissal.
Date Signature of Employee Print Name Supervisor
97
PRIVACY POLICY
Our Privacy Obligations
We maintain the privacy of medical and health information of any individual for whom we provide services (“Protected Health Information” or “PHI”) and endeavor to comply with all relevant state, national, and international laws and regulations including the U.S. Health Insurance Portability and Accountability Act (HIPAA) of 1996. We abide by the terms of this Notice, as amended from time to time.
Uses and Disclosures Requiring Your Written Authorization
Use or Disclosure of PHI with Your Authorization
We require your authorization, given upon an executed release form, to use or disclose PHI. After we receive your authorization, we will use and disclose PHI to provide our services to you. This authorization will allow us to collect information from hospitals and doctors’ offices you identify in order to provide you our services. We may also disclose PHI to other medical institutions or medical professionals who are involved in the delivery of our services to you.
We will not disclose PHI to a family member, relative, friend, or any other person unless they are specifically identified by you on your authorization as appropriate to receive PHI. If you object to such uses or disclosures, please notify the Practice Manager.
We may disclose PHI to the physician(s) or medical institutions you identify on your authorization when such PHI is appropriate for them to continue your treatment or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or for health care fraud and abuse detection or compliance.
HIV-‐related Information Limitation. We require a separate, specific and independent release to use or disclose Confidential HIV-‐related information, except, in certain limited circumstances, to public health or other government officials or persons you have had sexual contact or have shared needles or syringes (in each case as required by law), or to persons specified in a special court order, or to certain persons with whom you have had sexual contact or have shared needles or syringes.
Payment
Unless you have specifically agreed in advance, we will never use or disclose your PHI to obtain payment from the entity from whom we are paid. We may share with such payers de-‐identified information (information which does not include your name, address, social security number or other way to identify who you are).
Marketing Communications
We will never use your PHI for any marketing materials without first receiving a written authorization, a testimonial release. We will never require your execution of a testimonial release before you may receive our service. We will also never use your PHI for mass marketing purposes.
Permissible Uses and Disclosures Without Your Written Authorization
98
We are not required to receive an authorization from you for the following uses and disclosures:
Operations
We may use and disclose PHI for our service operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the services that we deliver to you. For example, we may use PHI to evaluate the quality and competence of our personnel and consulting medical institutions and medical professionals. We may disclose PHI to our management in order to resolve any complaints you may have and ensure that you receive the highest quality services.
Public Health Activities
We may disclose PHI for the following public health activities to report:
• information to public health authorities for the purpose of preventing or controlling disease, injury or disability;
• information to a health oversight agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government programs
• child abuse, neglect or domestic violence, to a governmental authority, including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic violence;
• information about products and services under the jurisdiction of the U.S. Food and Drug Administration;
• to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition;
• to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety • to organizations that facilitate organ, eye or tissue procurement, banking or transplantation; • for research purposes if an Institutional Review Board/Privacy Board approves a waiver of authorization
for disclosure; and • information to your employer as required under laws addressing work-‐related illnesses and injuries or
workplace medical surveillance.
Governmental Proceedings
We may disclose PHI for the following governmental proceedings to report:
• in the course of a judicial or administrative proceeding in response to a legal order or other lawful process;
• to the police or other law enforcement officials as required or permitted or permitted by law or in compliance with a court order or a grand jury or administrative subpoena;
• to a coroner or medical examiner as authorized by law; • to units of the government with special functions, such as the U.S. military or the U.S. Department of
State under certain circumstances required by law; as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs; and
99
• when required to do so by any other law not already referred to in the preceding categories.
Your Individual Rights
For Further Information; Complaints
If you desire further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we made about access to PHI, you may contact our Privacy Officer. You may reach our Privacy Officer at the contact information provided below. You may also file written complaints with the relevant local, state, national, or international privacy agency. We will not retaliate against you if you file a complaint with us or any governmental agency.
Right to Request Additional Restrictions
You may request restrictions on our use and disclosure of PHI
• for treatment, payment and health care operations, • to individuals involved with our delivery of services to you, or • to notify or assist in the notification of such individuals regarding your location and general condition.
All requests for such restrictions must be made in writing. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction.
Right to Receive Confidential Communications
You may request, and we will accommodate, any reasonable written request for you to receive PHI by alternative means of communication or at alternative locations.
Right to Inspect and Copy Your Health Information
Upon written request, you may access your electronic PHI file in our possession in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to your records. If you desire access to your records, please request access from the Privacy Officer identified below, a written authorization may be required. If you request copies, we may charge a nominal fee per pay or per file, which we will identify to you in advance of starting the request. We may also charge you for our postage costs, if you request that we mail the copies to you.
100
EMPLOYEE DRUG TESTING POLICY
Purpose
In compliance with the Drug-‐Free Workplace Act of 1988, Premiere Concierge Services has a longstanding commitment to provide a safe, quality-‐oriented and productive work environment consistent with the standards of the community in which the company operates. Alcohol and drug abuse poses a threat to the health and safety of Premiere Concierge Services employees and to the security of the company’s equipment and facilities. For these reasons, Premiere Concierge Services is committed to the elimination of drug and alcohol use and abuse in the workplace.
Scope
This policy outlines the practice and procedure designed to correct instances of identified alcohol and drug use in the workplace.
This policy applies to all employees and all applicants for employment of Premiere Concierge Services. The human resource (HR) department is responsible for policy administration.
Substance Abuse Awareness
Illegal drug use and alcohol misuse have many serious adverse health and safety consequences. Information about those consequences and sources of help for drug or alcohol problems is available from the HR department, which has been trained to make referrals and to assist employees with drug or alcohol problems.
Employee Assistance
Premiere Concierge Services will assist and support employees who voluntarily seek help for such problems before becoming subject to discipline or termination under this or other Premiere Concierge Services policies. Such employees will be allowed to use accrued paid time off, placed on leaves of absence, referred to treatment providers and otherwise accommodated as required by law. Such employees may be required to document that they are successfully following prescribed treatment and to take and pass follow-‐up tests if they hold jobs that are safety-‐sensitive or require driving, or if they have violated this policy previously. Once a drug test has been scheduled, unless otherwise required by the Family and Medical Leave Act or the Americans with Disabilities Act, the employee will have forfeited the opportunity to be granted a leave of absence for treatment, and possible discipline, up to and including discharge, will be unavoidable.
Employees should report to work fit for duty and free of any adverse effects of illegal drugs or alcohol. This policy does not prohibit employees from the lawful use and possession of prescribed medications. Employees must, however, consult with their doctors about the medications’ effect on their fitness for duty and ability to work safely, and they must promptly disclose any work restrictions to their supervisor. Employees should not, however, disclose to Premiere Concierge Services underlying medical conditions unless directed to do so.
101
Work Rules
1. Whenever employees are working, are operating any Premiere Concierge Services vehicle, are present on Premiere Concierge Services premises or are conducting company-‐related work offsite, they are prohibited from:
a. Using, possessing, buying, selling, manufacturing or dispensing an illegal drug (to include possession of drug paraphernalia).
b. Being under the influence of alcohol or an illegal drug as defined in this policy.
c. Possessing or consuming alcohol.
2. The presence of any detectable amount of any illegal drug or illegal controlled substance in an employee’s body system, while performing company business or while in a company facility, is prohibited.
3. Premiere Concierge Services will also not allow employees to perform their duties while taking prescribed drugs that are adversely affecting their ability to safely and effectively perform their job duties. Employees taking a prescribed medication must carry it in the container labeled by a licensed pharmacist or be prepared to produce it if asked.
4. Any illegal drugs or drug paraphernalia will be turned over to an appropriate law enforcement agency and may result in criminal prosecution.
Required Testing
Pre-‐employment
All applicants must pass a drug test before beginning work or receiving an offer of employment. Refusal to submit to testing will result in disqualification of further employment consideration.
Reasonable suspicion
Employees are subject to testing based on (but not limited to) observations by the supervision of apparent workplace use, possession or impairment. HR, the plant manager or the director of operations should be consulted before sending an employee for testing. All levels of supervision making this decision must use the Observation Checklist to document specific observations and behaviors that create a reasonable suspicion that the person is under the influence of illegal drugs or alcohol. If the results of the Observation Checklist indicate further action is justified, the manager or supervisor should confront the employee with the documentation and with a union representative present (for all unionized employees) or with another member of management (for all nonunionized employees). Under no circumstances will the employee be allowed to drive himself or herself to the testing facility. A member of supervision/management and a union rep (if appropriate) must escort the employee; the supervisor/manager will make arrangements for the employee to be transported home.
102
Post-‐accident
Employees are subject to testing when they cause or contribute to accidents that seriously damage a Premiere Concierge Services vehicle, machinery, equipment or property or result in an injury to themselves or another employee requiring offsite medical attention. In any of these instances, the investigation and subsequent testing must take place within two hours following the accident, if not sooner. Under no circumstances will the employee be allowed to drive himself or herself to the testing facility.
Follow-‐up
Employees who have tested positive, or otherwise violated this policy, are subject to discipline, up to and including discharge. Depending on the circumstances and the employee’s work history/record, Premiere Concierge Services may offer an employee who violates this policy or tests positive the opportunity to return to work on a last-‐chance basis pursuant to mutually agreeable terms, which could include follow-‐up drug testing at times and frequencies determined by Premiere Concierge Services for a minimum of one year but not more than two years as well as a waiver of the right to contest any termination resulting from a subsequent positive test. If the employee either does not complete the rehabilitation program or tests positive after completing the rehabilitation program, the employee will be subject to immediate discharge from employment.
Collection and Testing Procedures
Employees subject to alcohol testing should be driven to a Premiere Concierge Services-‐designated facility and directed to provide breath specimens. Breath specimens should be tested by trained technicians using federally approved breath alcohol testing devices capable of producing printed results that identify the employee. If an employee’s breath alcohol concentration is .04 or more, a second breath specimen should be tested approximately 20 minutes later. The results of the second test should be determinative. Alcohol tests may, however, be a breath, blood or saliva test, at the company’s discretion. For purposes of this policy, test results generated by law enforcement or medical providers may be considered by the company as work rule violations.
Applicants and employees subject to drug testing should be driven to a Premiere Concierge Services-‐designated medical facility and directed to provide urine specimens. Applicants and employees may provide specimens in private unless they appear to be submitting altered, adulterated or substitute specimens. Collected specimens should be sent to a federally certified laboratory and tested for evidence of marijuana, cocaine, opiates, amphetamines, PCP, benzodiazepines, methadone, methaqualone and propoxphane use. (Where indicated, specimens may be tested for other illegal drugs.) The laboratory should screen all specimens and confirm all positive screens. There must be a chain of custody from the time specimens are collected through testing and storage.
The laboratory should transmit all positive drug test results to a medical review officer (MRO) retained by Premiere Concierge Services, who should offer persons with positive results a reasonable opportunity to rebut or explain the results. Individuals with positive test results may also ask the MRO to have their split specimen sent to another federally certified laboratory to be tested at the applicant’s or employee’s own expense. Such requests must be made within 72 hours of notice of test results. If the second facility fails to find any evidence of drug use in the split specimen, the employee or applicant will be treated as passing the test. In no event should
103
a positive test result be communicated to Premiere Concierge Services until such time that the MRO has confirmed the test to be positive.
Consequences
Applicants who refuse to cooperate in a drug test or who test positive will not be hired and will not be allowed to reapply/retest in the future.
Employees who refuse to cooperate in required tests or who use, possess, buy, sell, manufacture or dispense an illegal drug in violation of this policy will be terminated. If the employee refuses to be tested, yet the company believes he or she is impaired, under no circumstances will the employee be allowed to drive himself or herself home.
The first time an employee tests positive for alcohol or illegal drug use under this policy, the result will be discipline up to and including discharge.
Employees will be paid for time spent in alcohol or drug testing and then suspended pending the results of the drug or alcohol test. After the results of the test are received, a date and time will be scheduled to discuss the results of the test; this meeting will include a member of management/supervision, a union representative (if requested), and HR. Should the results prove to be negative, the employee will receive back pay for the times/days of suspension.
Confidentiality
Information and records relating to positive test results, drug and alcohol dependencies, and legitimate medical explanations provided to the MRO should be kept confidential to the extent required by law and maintained in secure files separate from normal personnel files. Such records and information may be disclosed among managers and supervisors on a need-‐to-‐know basis and may also be disclosed when relevant to a grievance, charge, claim or other legal proceeding initiated by or on behalf of an employee or applicant.
Inspections
Premiere Concierge Services reserves the right to inspect all portions of its premises for drugs, alcohol or other contraband; affected employees may have union representation involved in this process. All employees, contract employees and visitors may be asked to cooperate in inspections of their persons, work areas and property that might conceal a drug, alcohol or other contraband. Employees who possess such contraband or refuse to cooperate in such inspections are subject to appropriate discipline, up to and including discharge.
Crimes Involving Drugs
Premiere Concierge Services prohibits all employees, including employees performing work under government contracts, from manufacturing, distributing, dispensing, possessing or using an illegal drug in or on company premises or while conducting company business. Premiere Concierge Services employees are also prohibited from misusing legally prescribed or over-‐the-‐counter (OTC) drugs. Law enforcement personnel should be notified, as appropriate, when criminal activity is suspected.
104
Premiere Concierge Services does not desire to intrude into the private lives of its employees, but recognizes that employees’ off-‐the-‐job involvement with drugs and alcohol may have an impact on the workplace. Therefore, Premiere Concierge Services reserves the right to take appropriate disciplinary action for drug use, sale or distribution while off company premises. All employees who are convicted of, plead guilty to or are sentenced for a crime involving an illegal drug are required to report the conviction, plea or sentence to HR within five days. Failure to comply will result in automatic discharge. Cooperation in complying may result in suspension without pay to allow management to review the nature of the charges and the employee’s past record with Premiere Concierge Services.
Definitions
“Company premises” includes all buildings, offices, facilities, grounds, parking lots, lockers, places and vehicles owned, leased or managed by Premiere Concierge Services or on any site on which the company is conducting business.
“Illegal drug” means a substance whose use or possession is controlled by federal law but that is not being used or possessed under the supervision of a licensed health care professional. (Controlled substances are listed in Schedules I-‐V of 21 C.F.R. Part 1308.)
“Refuse to cooperate” means to obstruct the collection or testing process; to submit an altered, adulterated or substitute sample; to fail to show up for a scheduled test; to refuse to complete the requested drug testing forms; or to fail to promptly provide specimen(s) for testing when directed to do so, without a valid medical basis for the failure. Employees who leave the scene of an accident without justifiable explanation prior to submission to drug and alcohol testing will also be considered to have refused to cooperate and will automatically be subject to discharge.
“Under the influence of alcohol” means an alcohol concentration equal to or greater than .04, or actions, appearance, speech or bodily odors that reasonably cause a supervisor to conclude that an employee is impaired because of alcohol use.
“Under the influence of drugs” means a confirmed positive test result for illegal drug use per this policy. In addition, it means the misuse of legal drugs (prescription and possibly OTC) when there is not a valid prescription from a physician for the lawful use of a drug in the course of medical treatment (containers must include the patient’s name, the name of the substance, quantity/amount to be taken and the period of authorization).
Reasonable Suspicion and Post-‐Accident Testing Protocol
1. The employee will be advised that Premiere Concierge Services believes that there is reasonable suspicion to believe that he or she is affected by illegal drugs or alcohol (or due to the nature of the accident the policy mandates this) and that this test is being offered to confirm or deny this suspicion.
2. The employee will be transported to any one of the company’s contracted testing facilities (e.g., health services, prompt care or the emergency department). One member of management or a designated attendant will accompany the employee along with a union representative, if requested by the
105
employee. Under no circumstances will the employee be allowed to drive himself or herself to the testing facility.
3. Prior to leaving for the testing facility, supervision/management will contact the testing facility to inform it that a staff member from Premiere Concierge Services will be arriving and will need a drug or alcohol test completed.
4. The employee should be provided water to drink prior to leaving the company premises.
5. The employee should be given reasonable time—not to exceed 15 minutes—to secure photo ID in the company of a Premiere Concierge Services representative.
6. The employee to be tested must present a photo ID (i.e., a driver’s license or state ID card) to the testing facility staff before the specimen can be obtained. Ensure that the employee brings the photo ID with him or her when leaving Premiere Concierge Services premises.
7. The employee to be tested must sign a consent form provided by the testing facility. Refusal to sign is addressed under the “Consequences” section of this document.
8. A Premiere Concierge Services representative must sign as a witness to the collection procedure, along with the tested employee.
9. After returning to the company or when leaving the testing facility, the supervisor/manager must make arrangements to transport the person home (unless testing results are immediate). Under no circumstances will the tested employee be allowed to drive himself or herself home.
106
EMPLOYEE RANDOM DRUG TESTING POLICY
Purpose
This policy describes Premiere Concierge Services’ policy and procedures for conducting random drug tests of employees.
Random Testing
Premiere Concierge Services will randomly test employees for compliance with its drug-‐free workplace policy. As used in this policy, “random testing” means a method of selection of employees for testing, performed by an outside third party. The selection will result in an equal probability that any employee from a group of employees will be tested. Furthermore, Premiere Concierge Services has no discretion to waive the selection of an employee selected by this random selection method.
Scheduled Periodic Testing
Premiere Concierge Services reserves the right to conduct periodic testing on a regularly scheduled basis for employees in designated departments, classifications or workgroups.
Post-‐Rehabilitation Testing
When an employee has had a confirmed positive test result, or has been sent to a drug dependency program at the request of the company, Premiere Concierge Services, as a condition of continued employment, will require the taking and passing by the employee of follow-‐up drug tests during a probationary period within the two-‐year period after the employee’s return to work.
Substances Covered by Drug and Alcohol Testing
Employees will be tested for their use of commonly abused controlled substances, which include amphetamines, barbiturates, benzodiazepines, opiates, cannabinoids, cocaine, methadone, methaqualone, phencyclidine (PCP), propoxyphene and chemical derivatives of these substances.
Employees must advise testing lab employees of all prescription drugs taken in the past month before the test and be prepared to show proof of such prescriptions to testing lab personnel.
Testing Methods and Procedure
All testing will be conducted by a licensed independent medical laboratory, which will follow testing standards established by the state or federal government. Testing will be conducted on a urine sample provided by the employee to the testing laboratory under procedures established by the laboratory to ensure privacy of the employee, while protecting against tampering/alteration of the test results.
Employees will be considered to be engaged at work for the time spent in taking any tests and will be compensated for such time at their regular rate.
107
Premiere Concierge Services will pay for the cost of the testing, including the confirmation of any positive test result by gas chromatography. The testing lab will retain samples in accordance with state law, so that an employee may request a retest of the sample at his or her own expense if the employee disagrees with the test result.
Refusal to Undergo Testing
Employees who refuse to submit to a test are subject to immediate discharge.
Positive Test
If an employee tests positive on an initial screening test, the employee will be temporarily suspended while the confirmation test is being conducted. On receipt of the confirmation test, the employee will be subject to disciplinary action, up to and including discharge. Discipline selected by Premiere Concierge Services will depend on a variety of factors, including the prior work record of the employee, the length of prior employment, the prior accident and attendance record of the employee, the circumstances that led to the testing, and the proposals by the employee to address the problem.
Right to Explain Test Results
All employees and applicants have the right to meet with the testing laboratory personnel, and with Premiere Concierge Services, to explain their test results. These discussions should be considered confidential except that information disclosed in such tests will be communicated to personnel within Premiere Concierge Services or within the lab who need to know such information to make proper decisions regarding the test results or regarding the employment of the individual.
Right to Review Records
Employees have a right to obtain copies of all test results from the testing laboratory, or from Premiere Concierge Services. When an employee disagrees with the test results, the individual may request that the testing laboratory repeat the test. Such repeat testing will be at the expense of the individual, unless the repeat test overturns the original report of the lab, in which case Premiere Concierge Services will reimburse the employee for the costs incurred for the retest.
Confidentiality Requirements
All records concerning test results will be kept in medical files that are maintained separately from the personnel file of the employee.
Testing laboratories may conduct testing only for substances included on the disclosure list provided to the individual, and may not conduct general testing related to the medical conditions of the individual that are unrelated to drug use.
108
Retesting
Employees may request a retest of their positive test results within five working days after notification by Premiere Concierge Services of such positive test result. This retest is at the expense of the individual, unless the original test result is called into question by the retest.
Where the employee or applicant believes that the positive test result was affected by taking lawful or prescribed substances, the individual may be suspended without pay pending receipt of confirming information to substantiate the claims of the individual. Normally, the individual will be provided no more than five business days in which to provide this additional information.
Once Premiere Concierge Services has determined whether there is evidence to indicate that the test results are incorrect, Premiere Concierge Services will advise the individual of its decision.
Treatment, Termination and Rehire
Employees who test positive for any drug(s) listed on the disclosure list have two choices. The employee may agree to enter an authorized treatment program approved by Premiere Concierge Services, and agree to subsequent retesting for a period of two years after returning from treatment, or the employee will be terminated immediately and will not be considered for rehire until he or she can show that he or she has remained drug-‐free for a period of two years or more.
109
EMPLOYEE BACKGROUND CHECK POLICY
Purpose Premiere Concierge Services believes that hiring qualified individuals contributes to our overall strategic success. Background checks serve as an important part of the selection process. The information we collect helps Premiere Concierge Services promote a safe work environment for our current and future employees. Background checks also help us obtain information necessary to determine an applicant’s overall employability and to ensure the protection of Premiere Concierge Services’ physical property, proprietary information and other assets. Premiere Concierge Services complies with all applicable federal, state and local laws, including fair employment practices and equal employment opportunity, when conducting background checks.
Procedure At Premiere Concierge Services background checks will be conducted on all job applicants applying for sensitive positions. These include positions involving security and financial responsibilities, as well as other positions determined by Premiere Concierge Services to be sensitive. Premiere Concierge Services will use a third-‐party agency to conduct the background checks to verify the accuracy of the information provided by the applicant during the selection process. Information collected by the agency includes past employment, education, character, finances and reputation.
Premiere Concierge Services will ensure that all background checks are conducted in compliance with all applicable federal and state statutes, such as the Fair Credit Reporting Act and the Americans with Disabilities Act. The information that can be collected from previous employers and other sources will be limited to that which is job-‐related and pertains to the quality and quantity of work performed by the applicant and to the applicant’s attendance record, education and other lawful, work-‐related inquiries. The human resource department along with appropriate management personnel will be primarily responsible for the background check process.
Arrest and conviction records Premiere Concierge Services may check criminal arrest and conviction records as part of the applicant selection process. In accord with the Equal Employment Opportunity Commission’s current interpretation of Title VII of the Civil Rights Act of 1964, this information cannot be used as a basis for denying employment, unless it is determined to be job-‐related and consistent with business necessity.
Credit reports Premiere Concierge Services may collect credit information on applicants consistent with the guidelines set forth by the federal Fair Credit Reporting Act (FCRA). The FCRA requires organizations to obtain a candidate’s written authorization before obtaining a credit report. When doing this, the employer must:
• Certify to the consumer-‐reporting agency that the employer is in compliance with the FCRA and will not misuse the information it receives.
• Disclose to the applicant or employee, on a separate form, its plans to obtain a consumer or investigative consumer report and that the information received will be used solely for employment purposes.
110
• Inform the individual of his or her right to request additional information on the nature of the report and the means through which such information may be obtained.
• Inform the applicant that the report will include information about the individual’s character, general reputation and personal characteristics.
• Provide the individual with a summary of his or her rights under the FCRA.
If the results of the credit check are negative, Premiere Concierge Services will inform the applicant before taking adverse action based on the results, provide the applicant with a Statement of Consumer Rights from the Federal Trade Commission, offer the applicant the opportunity to review a copy of the credit report, and advise the applicant of his or her rights to dispute inaccurate information. Applicants should be granted reasonable time to dispute the information (approximately three to five days).
Record-‐Keeping Premiere Concierge Services assures applicants that all information obtained from the background check process will only be used as part of the employment process and will be kept strictly confidential. Premiere Concierge Services human resources will maintain a log that will include the position you are applying for, your name and the date of the background check. Only appropriate human resource personnel at Premiere Concierge Services will have access to this information. Premiere Concierge Services complies with all federal and state laws regarding the collection, storing and disposal of applicant information, such as the Fair and Accurate Credit Transactions Act (FACTA).
111
EQUAL EMPLOYMENT OPPORTUNITY AND HARASSMENT POLICY
Objective
Premiere Concierge Services is an equal opportunity employer. In accordance with anti-‐discrimination law, it is the purpose of this policy to effectuate these principles and mandates. Premiere Concierge Services prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or genetic information. Premiere Concierge Services conforms to the spirit as well as to the letter of all applicable laws and regulations. Additionally, Premiere Concierge Services will take action to employ, advance in employment, and treat qualified Vietnam-‐era veterans and disabled veterans without discrimination in all employment practices.
Scope
The policy of equal employment opportunity (EEO) and anti-‐discrimination applies to all aspects of the relationship between Premiere Concierge Services and its employees, including:
• Recruitment • Employment • Promotion • Transfer • Training • Working conditions • Wages and salary administration • Employee benefits and application of policies
The policies and principles of EEO also apply to the selection and treatment of independent contractors, personnel working on our premises who are employed by temporary agencies and any other persons or firms doing business for or with Premiere Concierge Services.
Dissemination and Implementation of Policy
The officers of Premiere Concierge Services will be responsible for the dissemination of this policy. Directors, managers and supervisors are responsible for implementing equal employment practices within each department. The HR department is responsible for overall compliance and will maintain personnel records in compliance with applicable laws and regulations.
Procedures
Premiere Concierge Services administers our EEO policy fairly and consistently by:
• Posting all required notices regarding employee rights under EEO laws in areas highly visible to employees.
• Advertising for job openings with the statement “An Equal Opportunity Employer—M/F/D/V.” • Posting all required job openings with the appropriate state agencies.
112
• Forbidding retaliation against any individual who files a charge of discrimination, opposes a practice believed to be unlawful discrimination, reports harassment, or assists, testifies or participates in an EEO agency proceeding.
• Requires employees to report to a member of management, an HR representative or the general counsel any apparent discrimination or harassment. The report should be made within 48 hours of the incident.
• Promptly notifies the general counsel of all incidents or reports of discrimination or harassment and takes other appropriate measures to resolve the situation.
Harassment
Harassment is a form of unlawful discrimination and violates Premiere Concierge Services policy. Prohibited sexual harassment, for example, is defined as unwelcome sexual advances, request for sexual favors and other verbal or physical conduct of a sexual nature when:
• Submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment.
• Submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individuals.
• Such conduct has the purpose or effect of substantially interfering with an individual’s work performance or creating an intimidating, hostile or offensive working environment.
Premiere Concierge Services encourages employees to report all incidents of harassment to a member of management or the HR department. Premiere Concierge Services conducts harassment prevention training for all employees, and maintains and enforces a separate policy on harassment prevention, complaint procedures and penalties for violations. Premiere Concierge Services investigates all complaints of harassment promptly and fairly, and, when appropriate, takes immediate corrective action to stop the harassment and prevent it from recurring.
Remedies
Violations of this policy, regardless of whether an actual law has been violated, will not be tolerated. Premiere Concierge Services will promptly, thoroughly and fairly investigate every issue that is brought to its attention in this area and will take disciplinary action, when appropriate, up to and including termination of employment.
113
OCCUPATIONAL SAFETY AND HEALTH PROGRAM
Management Leadership and Employee Involvement Management commits the necessary resources of staff, money, and time to ensure that all persons on the worksite are protected from injury and illness hazards. In addition, management visibly leads in the design, implementation, and continuous improvement of the site’s safety and health activities. Specifically, the highest level management establishes and reviews annually the site’s safety and health policy and ensures that all employees know, understand, and support that policy. All management levels, with input from hourly employees, develop an annual safety and health goal with objectives and action plans to reach that goal. At the end of each year all management levels, with input from hourly employees, evaluate progress in accomplishing the action plans, achieving all objectives, and meeting the annual goal. This evaluation, which also includes an evaluation of the overall safety and health program, results in a written report that includes the next year’s goal, objectives, and action plans, including any remaining action needed to accomplish the current year’s goal. Management ensures that all employees, including themselves, have clearly written safety and health responsibilities included within their job description, with appropriate authority to carry out those responsibilities. Also, management ensures that all employees, including all levels of management, receive performance evaluations that include a written evaluation of the accomplishment of assigned safety and health responsibilities. Management ensures that all visitors to the site, including contract and temporary labor, co-‐op students, interns, vendors, and sales people, have knowledge of site hazards applicable to them and how to protect themselves against those hazards, including emergency alarms and procedures. Management also ensures that these visitors do not introduce to the site hazards that can be prevented or that are not properly controlled. Management ensures that at least several avenues exist for employee involvement in safety and health decision making and problem solving. These avenues may include serving on committees and ad hoc problem solving groups, acting as safety observers, assisting in training other employees, analyzing hazards inherent in site jobs and how to protect against those hazards (writing JHAs), and planning activities to heighten safety and health awareness. Management encourages employees’ involvement and devises appropriate recognition for outstanding employee participation.
Worksite Analysis Management hires outside consultants as necessary to conduct baseline surveys that identify all safety and health hazards at the site at the time of the survey. All hazards found during these surveys are eliminated whenever possible or controlled. All employees who may encounter the controlled hazards are trained in appropriate job procedures to follow to protect themselves from these hazards. Management establishes change procedures to follow whenever the site experiences changes in equipment, material, or processes. To ensure employee protection, these change procedures include consideration of safety and health in the selection of the change, equipment and process shut down procedures, start up procedures,
114
and phase hazard analysis. Appropriate employees are trained to follow these procedures. Management and employees work together to analyze safety and health hazards inherent in each job site and to find means to eliminate those hazards whenever possible, and otherwise to protect persons against those hazards. These job hazard analyses (JHAs) are revised as appropriate, for example, following a change in the job, the reappearance of a hazard, or an accident at this job. All employees at this site are trained to recognize hazards and to report any hazard they find to the appropriate person so that the hazard can be corrected as soon as possible. In addition to taking immediate action to report a hazard orally and to provide interim protection, if necessary, including stopping the work causing the hazard, employees may submit a safety work order to the maintenance department, or they may submit a safety suggestion form. Safety work orders take priority over any other work order. Safety suggestions will be considered each week during the site inspection by the site inspection team. All employee reports of hazards must be eventually written, with the correction date recorded. These reports are posted in the lunch room until the hazard is corrected and then are kept on file in the owner’s office for three years. During that time they are available for employee review.
Site management, with input from an hourly employee chosen by lot, organizes the monthly site inspection team. Membership on these teams rotates each month with the goal that all site employees serve one month each year. Teams consist of four people, two managers or supervisors and two hourly employees. Each week, at the beginning of work on Wednesday morning, the team inspects the entire worksite, in writing describing all hazards found, including their location. The team assigns appropriate persons responsible for seeing that the hazard is corrected and documenting the date of the correction. These inspection reports are posted in the lunch room, in the maintenance shop, and in the owner’s office. A hazard remains on the monthly report until it is corrected.
Any near miss, first aid incident, or accident is investigated by the trained team selected each year by the owner and an hourly employee. The team consists of two managers or supervisors and two hourly employees, each of whom has received training in accident investigation. All investigations have as a goal the identification of the root cause of the accident, rather than assigning blame. All accident reports are posted in the lunch room and are open to comment by any employee. The accident investigation team assigns responsibility to appropriate employees for correcting any hazards found and for assigning a date by which the correction must be completed. As part of the annual safety and health program evaluation, the site owner, a manager, and an hourly employee review all near misses, first aid incidents, and entries on the OSHA 300 Log, as well as employee reports of hazards, to determine if any pattern exists that can be addressed. The results of this analysis are considered in setting the goal, objectives, and action plans for the next year.
Hazard Prevention and Control Management ensures that the this priority is followed to protect persons at this site: (1) Hazards will be eliminated when economically feasible, such as replacing a more hazardous chemical with a less hazardous one;
115
(2) Barriers will protect persons from the hazard, such as machine guards and personal protective equipment (PPE); (3) Exposure to hazards will be controlled through administrative procedures, such as more frequent breaks and job rotation. Management ensures that the worksite and all machinery is cared for properly so that the environment remains safe and healthy. If maintenance needs exceed the capability of the worksite employees, contract employees are hired to do the work and are screened and supervised to ensure they work according to the site’s safety and health procedures.
All employees, including all levels of management, are held accountable for obeying site safety and health rules. The following four step disciplinary policy will be applied to everyone by the appropriate level of supervisor:
§ oral warning;
§ written reprimand;
§ three days away from work;
§ dismissal.
Visitors, including contractors who violate safety and health rules and procedures, will be escorted from the site. Should the disciplined person request a review of the disciplinary action, an ad hoc committee of six people, three managers and three hourly workers, chosen by their respective colleagues, will review the situation and make a recommendation to the owner, who reserves the right for final decision. If his decision differs from the committee, he may, within confidentially strictures, make public his reasons. The site works with appropriate outside agencies, such as the fire department, the police department, and the hospital to write emergency plans for all potential emergencies, including fire, explosion, accident, sever weather, loss of power and/or water, and violence from an outside source. Desk top drills are conducted monthly so that all employees experience a drill on each type of emergency once a year. A total site evacuation drill focusing on one emergency type, with all work shut down, and coordinated with the appropriate agency, is conducted once a year. Each drill, whether table top or actual evacuation, is evaluated by the drill planning committee, constituted each year with two managers or supervisors and two hourly employees who volunteer. This committee’s written report is posted in the lunch room, and supervisors ensure that all employees know the results. When necessary, the emergency procedures are revised as a result of the evaluation report.
Persons needing emergency care are transported by company van or community ambulance to the hospital, located five miles from the site. Usually that trip can be made in less than ten minutes. Onsite during all shifts designated persons fully trained in cardiac pulmonary resuscitation (CPR), first aid, and the requirements of OSHA’s Bloodborne Pathogen Standard, are the first responders to any emergency. These persons are trained by qualified Red Cross instructors. One of these designated persons’ safety and health responsibilities is to ensure that first aid kits are stocked and readily accessible in the marked locations throughout the plant. Appropriate personal protective equipment (PPE) is provided for the different types of accidents possible at the site. All emergency responders have been offered the Hepatitis B vaccine.
116
Management maintains a proactive occupational health program that provides for occupational health professionals from the local hospital to participate in worksite analyses to find and protect employees against all health hazards. This plan provides initial health screening for each employee, appropriate to the hazards with which each employee will be working, and for tracking of any health changes in each employee through periodic physical examinations, post-‐exposure exams, and exit exam. Certified industrial hygienists conduct periodic air and noise monitoring. The doctor and occupational health nurse, working on contract for the site, examine health surveillance data to discern changes in overall employee health screening results to discern any trends that need to be addressed. Health professionals, appropriately trained and knowledgeable about site hazards, immediately treat employees for occupational health problems and follow each case until the individual can return full-‐time to all aspects of his assigned job. These professionals ensure that employee medical records are kept confidentially so that diagnosis and treatment are not divulged, but management does have information about the employee under treatment as to:
§ ability to perform job tasks;
§ job limitations or accommodations needed;
§ length of time the limitations must be implemented.
Management ensures that supervisors honor these restrictions. This health care is provided free of charge for all employees. The total plan is reviewed annually to assess its effectiveness. Through consultants, management has assessed all work at this site and determined that the following OSHA standards apply to the site’s work. Individual safety and health programs for each of these standards have been written and implemented. Employees affected by these standards have been trained to understand them and to follow the programs’ directions. These standards are:
Hazard Communication Confined Space Program
Hearing Conservation Lockout/Tagout
Bloodborne Pathogens Program Emergency Evacuation Program
Required PPE, Including Respiratory Protection
Training Management believes that employee involvement in the site’s safety and health program can only be successful when everyone on the site receives sufficient training to understand what their safety and health responsibilities and opportunities are and how to fulfill them. Therefore, training is a high priority to ensure a safe and healthy workplace. Finding time and knowledgeable personnel to do effective training is vital. Each year management pays special attention to the evaluation of the year’s training efforts to look for methods of improvement.
117
Currently, all new employees receive two hours of safety and health orientation before they begin work. When they have learned this material, they begin their assigned job with a trained buddy. For the first day the employee only observes the buddy doing the job and reads the appropriate JHAs. The second day the new employee does the job, while the buddy observes him/her. For the first six months on the job a new employee is considered a probationer and may not work beyond the line of vision of another employee. Supervisors are strictly charged to ensure that this training process is followed for all new employees and for any employee beginning a new job at the worksite. All employees are paid for one full day’s work (eight hours) beyond their production schedule each pay period. This time is usually split into several sections to attend training classes. A list of training topics, by week, is published each year. Each topic is offered at least twice. Each employee is responsible for ensuring that he/she masters the year’s training topics. Completing the year’s training is a significant portion of each employee’s performance evaluation, including all levels of management. training records are kept by the personnel manager and are available for employee review, upon request.
All employees are encouraged to suggest qualified trainers, including themselves. Management is responsible for ensuring that all training offered at the site is conducted by qualified persons.
118
ADA/ADAA POLICY
Purpose
The Americans with Disabilities Act (ADA) and the Americans with Disabilities Amendments Act (ADAAA) are federal laws that require employers with 15 or more employees to not discriminate against applicants and individuals with disabilities and, when needed, to provide reasonable accommodations to applicants and employees who are qualified for a job, with or without reasonable accommodations, so that they may perform the essential job duties of the position.
It is the policy of Premiere Concierge Services to comply with all federal and state laws concerning the employment of persons with disabilities and to act in accordance with regulations and guidance issued by the Equal Employment Opportunity Commission (EEOC). Furthermore, it is the company policy not to discriminate against qualified individuals with disabilities in regard to application procedures, hiring, advancement, discharge, compensation, training or other terms, conditions and privileges of employment.
Procedures
When an individual with a disability requests accommodation and can be reasonably accommodated without creating an undue hardship or causing a direct threat to workplace safety, he or she will be given the same consideration for employment as any other applicant. Applicants who pose a direct threat to the health, safety and well-‐being of themselves or others in the workplace when the threat cannot be eliminated by reasonable accommodation will not be hired.
Premiere Concierge Services will reasonably accommodate qualified individuals with a disability so that they can perform the essential functions of a job unless doing so causes a direct threat to these individuals or others in the workplace and the threat cannot be eliminated by reasonable accommodation or if the accommodation creates an undue hardship to Premiere Concierge Services. Contact human resources (HR) with any questions or requests for accommodation.
All employees are required to comply with the company’s safety standards. Current employees who pose a direct threat to the health or safety of themselves or other individuals in the workplace will be placed on leave until an organizational decision has been made in regard to the employee’s immediate employment situation.
Individuals who are currently using illegal drugs are excluded from coverage under the company ADA policy.
The HR department is responsible for implementing this policy, including the resolution of reasonable accommodation, safety/direct threat and undue hardship issues.
Terms Used in This Policy
As used in this ADA policy, the following terms have the indicated meaning:
• Disability: A physical or mental impairment that substantially limits one or more major life activities of the individual, a record of such an impairment, or being regarded as having such an impairment.
119
• Major life activities: Term includes caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating and working.
• Major bodily functions: Term includes physical or mental impairment such as any physiological disorder or condition, cosmetic disfigurement or anatomical loss affecting one or more body systems, such as neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, immune, circulatory, hemic, lymphatic, skin and endocrine. Also covered are any mental or psychological disorders, such as intellectual disability (formerly termed “mental retardation”), organic brain syndrome, emotional or mental illness and specific learning disabilities.
• Substantially limiting: In accordance with the ADAAA final regulations, the determination of whether an impairment substantially limits a major life activity requires an individualized assessment, and an impairment that is episodic or in remission may also meet the definition of disability if it would substantially limit a major life activity when active. Some examples of these types of impairments may include epilepsy, hypertension, asthma, diabetes, major depressive disorder, bipolar disorder and schizophrenia. An impairment, such as cancer that is in remission but that may possibly return in a substantially limiting form, is also considered a disability under EEOC final ADAAA regulations.
• Direct threat: A significant risk to the health, safety or well-‐being of individuals with disabilities or others when this risk cannot be eliminated by reasonable accommodation.
• Qualified individual: An individual who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires.
• Reasonable accommodation: Includes any changes to the work environment and may include making existing facilities readily accessible to and usable by individuals with disabilities, job restructuring, part-‐time or modified work schedules, telecommuting, reassignment to a vacant position, acquisition or modification of equipment or devices, appropriate adjustment or modifications of examinations, training materials or policies, the provision of qualified readers or interpreters, and other similar accommodations for individuals with disabilities.
• Undue hardship: An action requiring significant difficulty or expense by the employer. In determining whether an accommodation would impose an undue hardship on a covered entity, factors to be considered include:
o The nature and cost of the accommodation.
o The overall financial resources of the facility or facilities involved in the provision of the reasonable accommodation, the number of persons employed at such facility, the effect on expenses and resources, or the impact of such accommodation on the operation of the facility.
o The overall financial resources of the employer; the size, number, type and location of facilities.
120
o The type of operations of the company, including the composition, structure and functions of the workforce; administrative or fiscal relationship of the particular facility involved in making the accommodation to the employer.
• Essential functions of the job: Term refers to those job activities that are determined by the employer to be essential or core to performing the job; these functions cannot be modified.
The examples provided in the above terms are not meant to be all-‐inclusive and should not be construed as such. They are not the only conditions that are considered to be disabilities, impairments or reasonable accommodations covered by the ADA/ADAAA policy.
121
APPENDIX D: FINANCE AND ACCOUNTING
122
Revenu
eJan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016<To
tal
Mem
bership*Fee*Re
venu
e0
$*******************
0$**************
99,167
$*********
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$*******
99,167
$********
991,667
$***********
Expe
nses Advertisin
g2000
00
2000
00
2000
7500
02000
00
15500
Building*L
ease
2640
2640
2640
2640
02640
2640
2640
2640
2640
2640
2640
31680
Cable,*Pho
ne,*Interne
t1028
428
428
428
428
428
428
428
428
428
428
428
5736
Cleaning*Se
rvice
350
350
350
350
350
350
350
350
350
350
350
350
4200
Depreciat
ion
00
00
00
00
00
030945
30945
Grou
nds*K
eeping
300
300
300
300
300
300
300
300
300
300
300
300
3600
Shredd
ing
120
120
120
120
120
120
120
120
120
120
120
120
1440
Insurance*0*Facilit
y*and
*Umbrella
250
250
250
250
250
250
250
250
250
250
250
250
3000
Insurance*0*M
alpractice
1500
1500
1500
1500
1500
1500
1500
1500
1500
1500
1500
1500
18000
Interest
456
456
456
449
443
436
430
423
417
410
403
397
5174
Med
ical*Sup
plies
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
30000
Office*Supp
lies
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
12000
Practice*Managem
ent*S
ystem
667
667
667
667
667
667
667
667
667
667
667
667
8000
Professio
nal*Servic
es20300
00
00
00
00
00
020300
Salar
ies*a
nd*Ben
efits
8125
8125
45608
45608
45608
45608
45608
45608
45608
45608
45608
45608
472333
Security*S
ystem
240
4040
4040
4040
4040
4040
40680
Utilit
ies*0*W
ater*an
d*Ele
ctronic*
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
1000
12000
Web
site*De
velopm
ent
4000
00
00
00
00
00
04000
Total<Expen
ses<
46,475
$*************
19,375
$********
56,859
$*********
58,852
$*******
54,206
$*******
56,839
$*******
58,833
$*******
64,326
$*******
56,820
$*******
58,813
$*******
56,806
$*******
87,744
$********
678,588
$***********
Net<Incom
e<(Loss)
46,475
0$*************
19,375
0$********
42,308
$*********
40,315
$*******
44,961
$*******
42,327
$*******
40,334
$*******
34,841
$*******
42,347
$*******
40,354
$*******
42,360
$*******
11,422
$********
313,079
$***********
Prem
iere<C
oncie
rge<S
ervic
esMon
thly<Income<S
tatemen
tFor<Y
ear<E
nding<D
ecem
ber<3
1,<20
16
123
Leasehold)Improvements 125,000.00$((%)Financed 85%Loan)Amount 106,250.00$((Rate 3.50%Term 60Payment 1,993.87$(((((((
Period Beg.)Balance Payment Principal Interest End)BalanceJan216 106,250.00$(( 2$(((((((((((((( 2$(((((((((((((( 309.90$((((((( 106,250.00$((Feb216 106,250.00$(( 2$(((((((((((((( 2$(((((((((((((( 309.90$((((((( 106,250.00$((Mar216 106,250.00$(( 1,993.87$(((( 1,683.97$(((( 309.90$((((((( 104,566.03$((Apr216 104,566.03$(( 1,993.87$(((( 1,688.89$(((( 304.98$((((((( 102,877.14$((May216 102,877.14$(( 1,993.87$(((( 1,693.81$(((( 300.06$((((((( 101,183.33$((Jun216 101,183.33$(( 1,993.87$(((( 1,698.75$(((( 295.12$((((((( 99,484.58$(((((Jul216 99,484.58$((((( 1,993.87$(((( 1,703.71$(((( 290.16$((((((( 97,780.87$(((((Aug216 97,780.87$((((( 1,993.87$(((( 1,708.68$(((( 285.19$((((((( 96,072.19$(((((Sep216 96,072.19$((((( 1,993.87$(((( 1,713.66$(((( 280.21$((((((( 94,358.53$(((((Oct216 94,358.53$((((( 1,993.87$(((( 1,718.66$(((( 275.21$((((((( 92,639.87$(((((Nov216 92,639.87$((((( 1,993.87$(((( 1,723.67$(((( 270.20$((((((( 90,916.20$(((((Dec216 90,916.20$((((( 1,993.87$(((( 1,728.70$(((( 265.17$((((((( 89,187.50$(((((
Jan217 89,187.50$((((( 1,993.87$(((( 1,733.74$(((( 260.13$((((((( 87,453.76$(((((Feb217 87,453.76$((((( 1,993.87$(((( 1,738.80$(((( 255.07$((((((( 85,714.96$(((((Mar217 85,714.96$((((( 1,993.87$(((( 1,743.87$(((( 250.00$((((((( 83,971.09$(((((Apr217 83,971.09$((((( 1,993.87$(((( 1,748.95$(((( 244.92$((((((( 82,222.14$(((((May217 82,222.14$((((( 1,993.87$(((( 1,754.06$(((( 239.81$((((((( 80,468.08$(((((Jun217 80,468.08$((((( 1,993.87$(((( 1,759.17$(((( 234.70$((((((( 78,708.91$(((((Jul217 78,708.91$((((( 1,993.87$(((( 1,764.30$(((( 229.57$((((((( 76,944.61$(((((Aug217 76,944.61$((((( 1,993.87$(((( 1,769.45$(((( 224.42$((((((( 75,175.16$(((((Sep217 75,175.16$((((( 1,993.87$(((( 1,774.61$(((( 219.26$((((((( 73,400.55$(((((Oct217 73,400.55$((((( 1,993.87$(((( 1,779.79$(((( 214.08$((((((( 71,620.76$(((((Nov217 71,620.76$((((( 1,993.87$(((( 1,784.98$(((( 208.89$((((((( 69,835.78$(((((Dec217 69,835.78$((((( 1,993.87$(((( 1,790.18$(((( 203.69$((((((( 68,045.60$(((((
$17,062.50$21,141.90
Year)1)Principal)PaymentCurrent)Liability)December)31,)2016
124
Furniture(&(Fixtures 13,423.61$))))Technology(&(Equipment 35,548.62$))))Total(Loan(Request 48,972.23$))))%(Financed 85%Loan(Amount 41,626.40$))))Rate 4.20%Term 84Payment 584.85$)))))))))
Period Beg.(Balance Payment Principal Interest End(BalanceJan316 41,626.40$)))) 3$))))))))))) 3$))))))))))) 145.69$)) 41,626.40$))))Feb316 41,626.40$)))) 3$))))))))))) 3$))))))))))) 145.69$)) 41,626.40$))))Mar316 41,626.40$)))) 584.85$))))) 439.16$))))) 145.69$)) 41,187.24$))))Apr316 41,187.24$)))) 584.85$))))) 440.69$))))) 144.16$)) 40,746.55$))))May316 40,746.55$)))) 584.85$))))) 442.24$))))) 142.61$)) 40,304.31$))))Jun316 40,304.31$)))) 584.85$))))) 443.78$))))) 141.07$)) 39,860.53$))))Jul316 39,860.53$)))) 584.85$))))) 445.34$))))) 139.51$)) 39,415.19$))))Aug316 39,415.19$)))) 584.85$))))) 446.90$))))) 137.95$)) 38,968.29$))))Sep316 38,968.29$)))) 584.85$))))) 448.46$))))) 136.39$)) 38,519.83$))))Oct316 38,519.83$)))) 584.85$))))) 450.03$))))) 134.82$)) 38,069.80$))))Nov316 38,069.80$)))) 584.85$))))) 451.61$))))) 133.24$)) 37,618.19$))))Dec316 37,618.19$)))) 584.85$))))) 453.19$))))) 131.66$)) 37,165.00$))))
Jan317 37,165.00$)))) 584.85$))))) 454.77$))))) 130.08$)) 36,710.23$))))Feb317 36,710.23$)))) 584.85$))))) 456.36$))))) 128.49$)) 36,253.87$))))Mar317 36,253.87$)))) 584.85$))))) 457.96$))))) 126.89$)) 35,795.91$))))Apr317 35,795.91$)))) 584.85$))))) 459.56$))))) 125.29$)) 35,336.35$))))May317 35,336.35$)))) 584.85$))))) 461.17$))))) 123.68$)) 34,875.18$))))Jun317 34,875.18$)))) 584.85$))))) 462.79$))))) 122.06$)) 34,412.39$))))Jul317 34,412.39$)))) 584.85$))))) 464.41$))))) 120.44$)) 33,947.98$))))Aug317 33,947.98$)))) 584.85$))))) 466.03$))))) 118.82$)) 33,481.95$))))Sep317 33,481.95$)))) 584.85$))))) 467.66$))))) 117.19$)) 33,014.29$))))Oct317 33,014.29$)))) 584.85$))))) 469.30$))))) 115.55$)) 32,544.99$))))Nov317 32,544.99$)))) 584.85$))))) 470.94$))))) 113.91$)) 32,074.05$))))Dec317 32,074.05$)))) 584.85$))))) 472.59$))))) 112.26$)) 31,601.46$))))
Year(1(Principal(Payment $4,461.40Current(Liability(December(31,(2016 $5,563.54
125
Position #(Required Salary Total(Salaries Employment(Expense((30%) Total(ExpenseDirector(of(Medicine 1 180,000$((((((((((((( 118,000$(((((((((((((((( 35,400$(((((((((((((((((((((((((((((((((((( 153,400$((((((((((((((((Physician 1 170,000$((((((((((((( 108,000$(((((((((((((((( 32,400$(((((((((((((((((((((((((((((((((((( 140,400$((((((((((((((((Registered(Nurse 2 60,000$(((((((((((((((( 120,000$(((((((((((((((( 36,000$(((((((((((((((((((((((((((((((((((( 156,000$((((((((((((((((Practice(Manager 1 75,000$(((((((((((((((( 75,000$(((((((((((((((((( 22,500$(((((((((((((((((((((((((((((((((((( 97,500$((((((((((((((((((Totals( 5 485,000$((((((((((((( 421,000$(((((((((((((((( 126,300$((((((((((((((((((((((((((((((( ( 547,300$((((((((((((((((
Per(Month(Expense: 45,608.33$((((((((((( (Per(Week(Expense:( 10,525.00$((((((((((( (
Year(1(Salaries 472,333$((((((((((((((((Year(2(Salaries 547,300$((((((((((((((((
Salaries(Budget
126
Item Cost/Unit Quantity Total2Expense2per2ItemOffice&Chair 99.99$&&&&&&&& 4 399.96$&&&&&&&&&&&&&&&&&&&&&&&&&&
Office&Desk 219.99$&&&&&& 3 659.97$&&&&&&&&&&&&&&&&&&&&&&&&&&
Office&Bookcase 139.99$&&&&&& 3 419.97$&&&&&&&&&&&&&&&&&&&&&&&&&&
Office&File&Cabinet 114.99$&&&&&& 3 344.97$&&&&&&&&&&&&&&&&&&&&&&&&&&
Office&Drapery 39.00$&&&&&&&& 4 156.00$&&&&&&&&&&&&&&&&&&&&&&&&&&
Consultation&Room&Desk 179.99$&&&&&& 2 359.98$&&&&&&&&&&&&&&&&&&&&&&&&&&
Consultation&Room&Chair 99.00$&&&&&&&& 2 198.00$&&&&&&&&&&&&&&&&&&&&&&&&&&
Consultation&Room&Couch 479.00$&&&&&& 2 958.00$&&&&&&&&&&&&&&&&&&&&&&&&&&
Consultation&Room&Rug 49.99$&&&&&&&& 2 99.98$&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Consultation&Room&Drapery 39.00$&&&&&&&& 2 78.00$&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Exam&Room&Set 2,499.00$&&& 2 4,998.00$&&&&&&&&&&&&&&&&&&&&&&&
Exam&Room&Blinds 14.99$&&&&&&&& 2 29.98$&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Break&Room&Table&Set 239.00$&&&&&& 2 478.00$&&&&&&&&&&&&&&&&&&&&&&&&&&
Break&Room&Refrigerator 999.99$&&&&&& 1 999.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Break&Room&Microwave 149.99$&&&&&& 1 149.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Break&Room&and&Lobby&Keurigs 112.95$&&&&&& 2 225.90$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Sofa 496.99$&&&&&& 1 496.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Loveseat 577.99$&&&&&& 1 577.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Coffee&Table 254.99$&&&&&& 1 254.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&End&Table 169.99$&&&&&& 2 339.98$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Console&Table 339.99$&&&&&& 1 339.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Media&Stand 399.99$&&&&&& 1 399.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Rug 99.00$&&&&&&&& 1 99.00$&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Drapery 69.00$&&&&&&&& 2 138.00$&&&&&&&&&&&&&&&&&&&&&&&&&&
Lobby&Television 219.99$&&&&&& 1 219.99$&&&&&&&&&&&&&&&&&&&&&&&&&&
Total2Expense 13,423.61$22222222222222222222
Furniture2&2Fixtures2Budget
127
Device Price Quantity Total1Expense1per1Device1Apple%iPad%Pro 1,079.00$%%%%%% 3 3,237.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Apple%Pencil 99.00$%%%%%%%%%%%% 3 297.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%iPad%Case 60.00$%%%%%%%%%%%% 3 180.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Computer%Tower 1,529.00$%%%%%% 6 9,174.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Computer%Monitor 139.99$%%%%%%%%% 10 1,399.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Personal%Printer 179.99$%%%%%%%%% 3 539.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Office%Printer 1,999.99$%%%%%% 1 1,999.99$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Apple%iPhone%16GB 199.99$%%%%%%%%% 3 599.97$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Body%Composition%Scanner 12,298.00$%%%% 1 12,298.00$%%%%%%%%%%%%%%%%%%%%%%%%%%Biohazard%Receptacles% 13.99$%%%%%%%%%%%% 4 55.96$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%InMOffice%Defibrillator 1,231.00$%%%%%% 1 1,231.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Travel%Defibrillator 959.99$%%%%%%%%% 2 1,919.98$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%WallMMounted%Height%Rod 96.00$%%%%%%%%%%%% 1 96.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Stethoscope 43.99$%%%%%%%%%%%% 5 219.95$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Diagnostic%Carry%Kit 60.00$%%%%%%%%%%%% 2 120.00$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%WallMMounted%Diagnostic%Set 1,089.95$%%%%%% 2 2,179.90$%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Total1Expense 35,548.62$111111111111111111111111 1
Technology1&1Equipment1Budget
128
Depreciate FY+1 FY+2Furniture(&(Fixtures 1,508.58$(((( 1,508.58$((((Technology(&(Equipment 4,436.04$(((( 4,436.04$((((Leasehold(Improvements 25,000.00$(( 25,000.00$((
DepreciationFY+1+and+2
129
APPENDIX E: FURNITURE AND FIXTURES
130
Personal Office Furniture: Office Depot
• Realspace Shore Mini Solutions Computer Desk with Hutch, Antique White – $219.99 • Realspace Shore Mini Solutions 4-‐Shelf Bookcase, Antique White – $139.99 • Realspace Shore Mini Solutions Rolling Pedestal File, Antique White – $114.99 • Realspace Eaton Mid-‐Back Bonded Leather Chair, Tan/Black – $99.99
Personal Office Drapery: Pottery Barn, Cameron Cotton, Ivory, 50 x 84” – $39.00
131
Consultation Room Furniture: Ikea
• Loveseat: Norsborg, Dark blue – $479.00 • Desk: Bekant, Birch veneer and white – $179.99 • Chair: Gregor, Vittyard white and beige – $99.00 • Rug: Marslev, turquoise and beige – $49.99
Consultation Room Drapery: Pottery Barn, Cameron Cotton, Ivory, 50 x 84” – $39.00
132
Exam Room Furniture: MedSupplier, Clinton Industries Ready Room – $2,499.00, Includes:
• Exam table, Wedgewood • Wall cabinets, Fossil • Base cabinets, Fossil, with stainless steel sink and chrome faucet • Exam chair, Wedgewood • Glove box holder, Stainless steel • Waste receptacle, Stainless steel • Padded side chair, Wedgewood
Exam Room Blinds: Ikea, gray – $14.99
133
Break Room Furniture: Ikea
• Table set: Lehrhamn, Vittaryd beige – $239.00 (two sets to accommodate all employees for meetings)
Break Room Appliances:
• Refrigerator: Samsung, Stainless steel, 24.5 Cu. Ft. – $999.99 • Break Room Microwave: Samsung, Stainless steel, 1.6 Cu. Ft. – $149.99 • Break Room and Lobby Keurigs: K145 OfficePRO Brewing System – $112.95
134
Lobby Furniture: Ashley Furniture
• Sofa: Seafoam, 88'' w x 40'' d x 38'' h – $496.99 • Loveseat: Seafoam, 65'' w x 40'' d x 38'' h – $577.99 • End Tables: Bisque, 22'' w x 22'' d x 24'' h – $169.99 • Console Table: Light brown, 72'' w x 18'' d x 30.25'' h – $339.99
135
Lobby Television: Samsung, Black, 32” Class LED 1080p HDTV – $219.99
Lobby Furniture: Ashley Furniture
• Coffee Table: Bisque, 48'' w x 24'' d x 18.25'' h – $254.99
• Media Stand: Green, 44.75'' w x 21.5'' d x 36'' h – $399.99
• Rug: Steel, 60'' w x 84'' d – $99.00
Lobby Drapery: Pottery Barn, Belgian linen sheer drapes, Flax, 50 x 84” – $69.00
136
APPENDIX F: TECHNOLOGY AND EQUIPMENT
137
Apple iPhone 6s: Verizon 16 GB – $200.00 (new contract price)
Available in white, gold, space grey, and rose gold depending on individual preference
Apple iPad Pro: Wi-‐Fi + Cellular 128GB – $1,079.00
Available in Gold or Silver depending on individual physician’s preference
138
Apple Pencil: Designed for iPad Pro – $99.00
Enhances the capabilities and ease of use for user especially if he or she is not accustomed to using a tablet. Further enhances the ability of a physician to provide feedback to members.
Computers: HP Z440 Workstation (Energy Star) – $1,529.00
8GB RAM
Intel Xeon E5 Processor
Windows 7 Professional and 8.1 Pro
139
Monitors: HP Pavilion 23xw 23-‐Inch IPS LED Backlit Monitor – $139.99
1920 x 1080
Main Office Printer: HP Officejet Enterprise Color MFP X585dn – $1,999.99
Will serve as the office’s main printer for tasks that cannot be handled by a standard printer.
140
Desk Printers: HP Officejet Pro 6830 e-‐All-‐in-‐One Printer – $179.99
All individuals will have a personal printer in their respective offices.
Body Composition Scanner: Seca mBCA 514 Professional Medical Body Composition Scanner – $12,298.00
141
Wall Mounted Height Rod: Health o Meter – $96.00
Sharps and Biohazard Disposal Container: OakRidge 5 Quart Container – $13.99
142
In-‐Office Automated External Defibrillator: Phillips Value Package (Includes alarmed cabinet) – $1,231.00
Travel Automated External Defibrillator: Phillips HeartStart Home Defibrillator – $959.99
143
Stethoscopes: 3M Littman in Caribbean Blue – $43.99
Mounted Diagnostic System: Welch Allyn Gs 777 Integrated Diagnostic Wall System – $1,089.95
144
Diagnostic Carry Kit: Hi-‐Tech Combo (Blood pressure, blood glucose, thermometer, and carry bag) – $60.00
Stripe Reader: MAGTEK, Mini Magnetic Stripe Reader, USB 2.0 – included in PM System
External Hard Drive: Samsung, T1 1TB External Serial ATA Portable Solid State Drive – included in PM System