1. GINA GREEN MARCH 2, 2015 FOR NARRATIVE DIAL 1-888-123-4567 PASSWORD 12345 Policy and Procedure Update

2. Overview Merger of multiple long term care organizations  Must adapt to new policy and procedures  Maintain strict adherence to regulatory agency requirements All departments will be affected  Requirement of the managers to educate their staff on the changes provided in the tutorial  Tutorial is available for viewing at any time on Central Website

3. Objectives Managers will have an understanding of the updates to the Genesis Policy and Procedure Manual with regard to restructuring Genesis Healthcare Managers will be able to return to their worksites, instruct their staff, and implement the changes

4. Past Present 1985-Established with 9 centers with focus of healthcare and rehabilitation vs. end of life care 1998-By 1998 Genesis Healthcare became a 2.4billion dollar public company with multiple rehab services 1999-Due to cutbacks in Medicare and Medicaid, Genesis was forced to file Bankruptcy 2003-Genesis HealthCare Corporation became a company that was generated from a fellow pharmacy company 2007- Private investors took over the company and it returned to being a private organization 2011- Health Care REIT obtained all real estate from the company and buildings are now leased to Genesis Healthcare. 2012- Genesis acquired Sun Healthcare Group 2015- Genesis merged with Skilled Healthcare Group, Inc. Provides services to 34 states in 500 centers. Rehab services operated in 47 states. History of Genesis Healthcare

5. Genesis Healthcare Locations http://www.genesishcc.com/findlocations

6. Regulatory Standards CMS Government Regulatory Standards  Guide the policy and procedures of our organization  Establish reimbursement standards and guidelines  Per the CMS Rules  “The provisions of this part contain the requirements that an institution must meet in order to qualify to participate as a SNF in the Medicare program, and as a nursing facility in the Medicaid program. They serve as the basis for survey activities for the purpose of determining whether a facility meets the requirements for participation in Medicare and Medicaid.” Weblink for Handbook  http://www.cms.gov/Regulations-and- Guidance/Legislation/CFCsAndCoPs/Downloads/som107ap_pp_guidelines_ ltcf.pdf

7. Federal (Ftag)Regulation Document http://www.hpm.umn.edu/nhregsplus/Resources%20and%20Publications/Federal_Resour ces/FedTagsLTC.pdf

8. Past Present NUR125-Nurses will obtain height upon admission via lying down. NUR334-Nurses will obtain weekly weights of new admissions x 4 weeks. NUR438-Nurses will report all medication changes to manager within 24 hours. NUR985-Nurses will confirm Gtube placement within 8 hours of new tube. NUR125c-Nurses will obtain height upon admission via wingspan. NUR334c-Nurses will obtain weekly weights of new admissions x 2 weeks. NUR438c-Nurses will report all medication changes prior to end of shift. NUR985c-Nurses will confirm Gtube placement within 12 hours of new tube. Nursing Policy & Procedure Changes

9. Past Present DTY132-The rinse cycle of dishwashing must be 165 degrees or greater. DTY432-There will be a gap no longer than 12 hours from dinner to breakfast meals. DTY598-Staff must have a hairnet on at all times while working in the kitchen. DTY132c-The rinse cycle of dishwashing must be 180 degrees or greater. DTY432c-There will be a gap no longer than 14 hours from dinner to breakfast meals. DTY598c-Staff must have a hairnet and beardnet if feasible on at all times while working in the kitchen. Dietary Policy & Procedure Changes

10. Past Present ENV879-Housekeeping will sanitize an isolation room q 8 hours when a compromised patient is present. ENV534-Housekeeping will provide cleaned laundry to residents within 72 hours of receipt. ENV879c-Housekeeping will sanitize an isolation room q 4 hours when a compromised patient is present. ENV534c-Housekeeping will provide cleaned laundry to residents within 48 hours of receipt. Environmental Policy & Procedure Changes

11. Implementation Tools http://www.genesishcc.com/ http://www.cms.gov/Regulations-and- Guidance/Legislation/CFCsAndCoPs/LTC.html http://www.cms.gov/Regulations-and- Guidance/Legislation/CFCsAndCoPs/LTC.html

12. Conclusion Merger has created an Nationwide Organization Unity and cohesion the goal for Genesis Healthcare Maintain regulatory standards for the safety of residents and staff Maintain a successful healthcare operation

13. References Centers for Medicare and Medicaid Services. (n.d.). Retrieved from http://www.cms.gov/Regulations-and- Guidance/Legislation/CFCsAndCoPs/LTC.html Federal Healthcare Regulation for Long Term Care Facilities. (2008). Retrieved from http://www.hpm.umn.edu/nhregsplus/Resources%20and%20Publications/Feder al_Resources/FedTagsLTC.pdf Genesis Healthcare. (2014). Retrieved from http://www.genesishcc.com/