1. OPPORTUNITIES IN THE HEALTHCARE INDUSTRY

2. Rolyn Companies provides healthcare, commercial, and residential fire, water and storm property damage recovery, cleanup and reconstruction services nationwide. A global decontamination and infectious disease control company, providing green energy-efficient environmental solutions for indoor surface decontamination through Hydrogen Peroxide aerosols. The oldest and largest non-profit, professional trade association dedicated to providing leadership and promoting best practices through advocacy, standards & professional qualifications for the restoration industry.

3. Discussion Points: We all have the same certificates, dehues, fans, air scrubbers, etc. How do we set ourselves apart? With climbing HAI and CAI numbers, there is a need! Being Proactive VS. Reactive. Remediators already have 80% of the required resources. Benefits of expanding into the Healthcare industry, including the currently light competition in the industry and the fact that your payment is not dependant on a 3 rd party.

8. Healthcare Associated Infections (HAIs) - The Facts Reducing HAI is good for the patient, staff, and bottom line! HAIs are currently the fourth leading cause of death in the United States, costing the healthcare system more than $40 billion a year. HAI causes more deaths a year than breast cancer, AIDS and automotive accidents combined. This equates to the crash of a commercial 747 airliner every day (271 a day).

9. Healthcare Associated Infections (HAIs) - The Facts 10% of inpatients contract infections from the hospital. 2 million(+) people suffer from HAI’s a year and over 103,000 of them die. 87% of the medical facilities do not take the recommended steps to prevent infections. Hospitals are leaving between 30 - 60% of surface microorganisms after their current cleaning procedures.

10. Community Acquired Infections (CAI) - The Facts The frequency of resistance to antibiotics among community acquired infections and the number of drugs to which they are resistant is increasing. The boundaries between community and hospital environments are becoming more blurred. Community-acquired pneumonia is responsible for an average of 4.5 million visits annually to physicians' offices, emergency departments, and outpatient clinics. Infections are lurking in schools, shopping malls, public transportation, hotels, etc.

11. Penalties for HAIs The US congress and healthcare lawmakers are focused on driving down the rate of nosocomial infections and have demonstrated this remains a high priority. The Patient Protection and Affordable Care Act (Public Law 111-148) provides ways to address healthcare- associated infections (HAIs).

12. Penalties for HAIs Beginning in 2015, the quartile of hospitals with the highest rates of HAIs will be penalized one percent of their Medicare payment. According to the US Department of Health & Human Services, this would result in an average penalty of $208,643 1. The new system essentially pits each hospital against all others in a race to the top. Hospitals are going to compete in lowering HAIs. Future reform by the U.S. Department of Health and Human Services may choose to expand the HAI pool to include additional facilities, home health agencies, ambulatory surgical centers and skilled nursing facilities.

13. Penalties for HAIs Medicaid will stop reimbursing facilities for preventable infections acquired in the course of treatment. The federal government will also increase reporting requirements that require HAI statistics be publically available on the internet, creating further incentive for hospitals to protect their good names and reputations in their community.

14. Proactive VS Reactive

15. Infection Control Risk Assessment Multi-disciplinary, documented process that assesses a construction project’s location and its adjacent patient populations. Should be completed during the planning stages of a project Should be followed for all renovation and construction work Acknowledge there is potential risk in all projects

16. ICRA Considerations Type of Construction Risk Groups Determining Class of Each Project Determining the Required ICRA Precautions Infection Control Permit

17. CONSTRUCTION ACTIVITY Risk Group Type AType BType CType D Group 1- Lowest (green)Class IClass II Class III/IV Group 2 - Medium (yellow)Class IClass IIClass IIIClass IV* Group 3 - Higher (orange)Class IClass III*Class III/IVClass IV* Group 4 - (red)Class I-III Contact IC to ensure approprate classification Class III/IV Class IV * Note: For Class III and IV activities, notify and obtain approval from Infection Control (IC) and/or Safety Department before construction or renovation activity begins.

18. Infection Control: Correct vs. Incorrect

20. Means and Methods Establishing Negative Air: Where will the HEPA filters vent? Recirculate Exhausted outside of the building. Window Existing duct work Exhausted outside of the project space but within the building. Not feasible to exhaust outside How will the filtration be monitored? How will this affect the HVAC system outside of the project?

21. Means and Methods Establishing Negative Pressure: Negative pressure should be achieved before the first swing of the hammer. In the event a portable tent is being used, at least a HEPA vacuum should be running before the ceiling grid is opened. There needs to be constant monitoring of negative air (digital reading and logging manometer). HEPA filters  CLEAN! How do you know that your HEPA filters are functioning correctly? HEPA filters change logs

22. Means and Methods Debris Removal: Plan a route ahead of time keeping away from highest risk patient areas. Covering and sealing of carts. Wiping down of carts, covers, and wheels. Dedicated hand off team that ferries full carts between the project and the dumpster. Double bagging trash going into cart.

23. Three Types of Cleaning Sanitiza tion Disinfec tion Decontami nation

24. 1,000,000 3 Log = Sanitation 5 Log = Disinfection 6 Log = Decontamination

25. Activated Hydrogen Peroxide

26. With the right control and application UV energy can be used for UV disinfection of water, purify air and surfaces, cure adhesives and coatings and sterilize tools.

28. QUESTIONS?

29. Thank you for your time. Samuel J Bergman, CR 800.808.1553 sjbergman@rolyncompanies.com www.rolyncompanies.com