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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!
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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!
info@intellicorp.net!
$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.!
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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
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2.)Quantity)of)work))
1 2 3 4 5
Deficient Below Standard Meets Expectations Above Standard Outstanding
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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](https://image.slidesharecdn.com/a5a4e21e-666a-411f-86f4-8a03bc7c3b8a-151203195128-lva1-app6892/85/PCS-Business-Plan-80-320.jpg)
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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:](https://image.slidesharecdn.com/a5a4e21e-666a-411f-86f4-8a03bc7c3b8a-151203195128-lva1-app6892/85/PCS-Business-Plan-81-320.jpg)
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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.!!
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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.!
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Date!
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Signature!of!Employee!
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Print!Name!
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Supervisor!](https://image.slidesharecdn.com/a5a4e21e-666a-411f-86f4-8a03bc7c3b8a-151203195128-lva1-app6892/85/PCS-Business-Plan-96-320.jpg)
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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!](https://image.slidesharecdn.com/a5a4e21e-666a-411f-86f4-8a03bc7c3b8a-151203195128-lva1-app6892/85/PCS-Business-Plan-104-320.jpg)
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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.!](https://image.slidesharecdn.com/a5a4e21e-666a-411f-86f4-8a03bc7c3b8a-151203195128-lva1-app6892/85/PCS-Business-Plan-106-320.jpg)
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•! 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).!
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PCS Business Plan
- 1.
- 2. & & 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. & & 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! & & &
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- 7. & & 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. & & 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 DaphneFairhope 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 37 44 40 36 0 10 20 30 40 50 Daphne Fairhope Spanish!Fort Mobile Average!Age
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- 10. & & 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! & & &
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- 20. & & 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. & & 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.!!! & & ServicePer(day Per(week Per(month Per(year Comprehensive,Physicals 1 7 28 400 Wellness,Plans 1 7 28 400 House,Calls 2 14 56 672 Office,Visits 5 27 108 1,296 Vaccinations 5 35 140 1,680 School,Physicals 5 20 20,,,,,,,,,,,,,,,, Distribution(of(Services(per(Physician
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- 23. & & 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!$250.!For!our!donations!these!teams!will!wear!the!Premiere!Concierge! Services’!logo!on!their!jerseys.!! ! Type CostFrequency/per/Year Total/Expense Brochures 2,000.00$.. 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/Budget For/Year/Ending/December/31,/2016 Type Cost Frequency/per/Year Total/Expense Brochures 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/Budget For/Year/Ending/December/31,/2017
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- 27. & & 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.!!
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- 30. & & 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!
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- 34. & & 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. & & 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 #(RequiredSalary Total(Salaries Employment(Expense((30%) Total(Expense Director(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$(((((((((((((((( Salaries(Budget
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- 47. & & 47& INITIAL&FUNDING& ! Jan FebTotal Sources0of0Cash Loan%Proceeds BBVA 106,250%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 106,250000000000000000000 Wells%Fargo 41,626%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 41,62600000000000000000000 Contributed%Capital 148,078%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 148,078000000000000000000 Total0Sources0of0Cash 295,954$%%%%%%%%%%%% 5$%%%%%%%%%%%%%%%%%%%% 295,954$000000000000000 Uses0of0Cash Leasehold%Improvements 125,000%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 125,000000000000000000000 Furniture%&%Fixtures 13,424%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 13,42400000000000000000000 Technology%&%Equipment 35,549%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 35,54900000000000000000000 Operating0Expenses Advertising 2,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000 Building%Lease 2,640%%%%%%%%%%%%%%%%%% 2,640%%%%%%%%%%%%%%%%%% 5,2800000000000000000000000 Cable,%Phone,%Internet 1,028%%%%%%%%%%%%%%%%%% 428%%%%%%%%%%%%%%%%%%%%%% 1,4560000000000000000000000 Cleaning%Service 350%%%%%%%%%%%%%%%%%%%%%% 350%%%%%%%%%%%%%%%%%%%%%% 7000000000000000000000000000 Grounds%Keeping 300%%%%%%%%%%%%%%%%%%%%%% 300%%%%%%%%%%%%%%%%%%%%%% 6000000000000000000000000000 Shredding 120%%%%%%%%%%%%%%%%%%%%% 120%%%%%%%%%%%%%%%%%%%%%% 2400000000000000000000000000 Insurance%5%Facility%and%Umbrella 250%%%%%%%%%%%%%%%%%%%%%% 250%%%%%%%%%%%%%%%%%%%%%% 5000000000000000000000000000 Insurance%5%Malpractice 1,500%%%%%%%%%%%%%%%%%% 1,500%%%%%%%%%%%%%%%%%% 3,0000000000000000000000000 Interest 456%%%%%%%%%%%%%%%%%%%%% 456%%%%%%%%%%%%%%%%%%%%%% 9110000000000000000000000000 Medical%Supplies 2,500%%%%%%%%%%%%%%%%%% 2,500%%%%%%%%%%%%%%%%%% 5,0000000000000000000000000 Office%Supplies 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000 Practice%Management%System 667%%%%%%%%%%%%%%%%%%%%%% 667%%%%%%%%%%%%%%%%%%%%%% 1,3330000000000000000000000 Professional%Services 20,300%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 20,30000000000000000000000 Salaries%and%Benefits 8,125%%%%%%%%%%%%%%%%%% 8,125%%%%%%%%%%%%%%%%%% 16,25000000000000000000000 Security%System 240%%%%%%%%%%%%%%%%%%%%%% 40%%%%%%%%%%%%%%%%%%%%%%%% 2800000000000000000000000000 Utilities%5%Water%and%Electronic% 1,000%%%%%%%%%%%%%%%%%% 1,000%%%%%%%%%%%%%%%%%% 2,0000000000000000000000000 Website%Development 4,000%%%%%%%%%%%%%%%%%% 5%%%%%%%%%%%%%%%%%%%%%%% 4,0000000000000000000000000 Total0Uses0of0Cash 220,447$%%%%%%%%%%%% 19,375$%%%%%%%%%%%%%% 239,823$000000000000000 Net%Cash%Inflows%(Outflows) 75,507$%%%%%%%%%%%%%% 19,3755$%%%%%%%%%%%%%% 56,131$000000000000000000 Premiere0Concierge0Services Sources0and0Uses0of0Cash0Projection To0Start0of0Operations0
- 48. & & 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. & & 49& FINANCIAL&STATEMENTS&FOR&FISCAL&YEARS&1&AND&2& & & & 2016%Total2017%Total Revenue Membership*Fee*Revenue 991,667$********** 1,487,500$******* Expenses Advertising 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%Services Projected%Income%Statement For%Year%Ending%December%31,%2016%and%December%31,%2017
- 50. & & 50& & & 2016 Assets Current'Assets Cash444,481$************** Total-Current-Assets 444,481**************** Property,'Plant,'&'Equipment,'at'cost *********Leasehold*Improvements 125,000**************** Furniture*&*Fixtures 13,424******************* Technology*&*Equipment 35,549******************* Total*Property,*Plant,*&*Equipment,*at*cost 173,972**************** Less:*Accumulated*Depreciation 30,945******************* Total-Property,-Plant,-&-Equipment,-net 143,028**************** Total-Assets 587,509$************** Liabilities-&-Shareholder's-Equity Current'Liabilities BBVA 21,142$**************** Wells*Fargo 5,564$******************* Total-Current-Liabilities 26,705****************** Long:Term'Debt BBVA 68,046****************** Wells*Fargo 31,601******************* Total-LongBTerm-Debt 99,647****************** Total-Liabilities 126,353**************** Equity Contributed*Capital 148,078**************** Retained*Earnings 313,079**************** Total-Equity 461,156**************** Total-Liabilities-&-Equity 587,509$************** Premiere-Concierge-Services Balance-Sheet December-31,-2016
- 51. & & 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. & & 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!$40!per!month.!Specifics!about!the!system!can!be!found!in!the!Technology!section.! & & & & & &
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- 59. & & 59& TECHNOLOGY&AND&EQUIPMENT& & MEDICAL&EQUIPMENT& Our!medical!equipment!requirements!are!as!follows!(see!Appendix!F!for!images!of!medical!equipment):! •! Body!composition!scanner!from!Seca,!which!achieves!the!following,!to!be!located!in!a!central!location! for!all!comprehensive!physicals!and!routine!exams:! o!Measures!intra/extracellular!water,!body!fat,!skeletal!muscle!mass! o! Clinically!validated!accuracy!compares!to!scientific!gold!standards!used!in!clinical!studies! o! Reproducible!measurements!ensure!accuracy! o! Hand:held!electrodes!mounted!in!standing!aid!for!enhanced!stability! Device Price Quantity Total1Expense1per1Device1 Apple%iPad%Pro 1,079.00$%%%%%% 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$1111111111111111111111111 Technology1&1Equipment1Budget
- 60. & & 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. & & 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! NONZMEDICAL&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!
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- 73. & & 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
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- 76. & & 76& Premiere ConciergeServices: 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. & & 77& Premiere ConciergeServices: 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. & & 78& Premiere ConciergeServices: 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. & & 79& Premiere ConciergeServices: 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. & & 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 23 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. & & 81& 9.)Open)to)feedback)) 1 23 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:
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- 83. & & 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. & & 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!/!
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- 89. & & 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. & & 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.!!
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- 92. & & 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. & & 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.!)
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- 96. & & 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!
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- 98. & & 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. & & 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.! & & & &
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- 101. & & 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! Pre8employment! 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.
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- 104.
- 105. & & 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.
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- 109.
- 110. & & 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. & & 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. & & 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.
- 114.
- 115. & & 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. & & 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.
- 118.
- 119. & & 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. & & 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.
- 122.
- 123. & & 123& & & Leasehold) Improvements 125,000.00$(( %)Financed85% Loan)Amount 106,250.00$(( Rate 3.50% Term 60 Payment 1,993.87$((((((( Period Beg.)Balance Payment Principal Interest End)Balance Jan216 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 $21,141.90 Year)1)Principal)Payment Current)Liability)December)31,)2016
- 124. & & 124& & Furniture(&(Fixtures 13,423.61$)))) Technology(&(Equipment35,548.62$)))) Total(Loan(Request 48,972.23$)))) %(Financed 85% Loan(Amount 41,626.40$)))) Rate 4.20% Term 84 Payment 584.85$))))))))) Period Beg.(Balance Payment Principal Interest End(Balance Jan316 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 $4,461.40 Current(Liability(December(31,(2016 $5,563.54
- 125. & & 125& & & Position #(RequiredSalary Total(Salaries Employment(Expense((30%) Total(Expense Director(of(Medicine 1 180,000$((((((((((((( 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$(((((((((((((((( Salaries(Budget
- 126. & & 126& & Item Cost/UnitQuantity Total2Expense2per2Item Office&Chair 99.99$&&&&&&&& 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$22222222222222222222 Furniture2&2Fixtures2Budget
- 127. & & 127& & & & DevicePrice Quantity Total1Expense1per1Device1 Apple%iPad%Pro 1,079.00$%%%%%% 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$1111111111111111111111111 Technology1&1Equipment1Budget
- 128. & & 128& & & DepreciateFY+1 FY+2 Furniture(&(Fixtures 1,508.58$(((( 1,508.58$(((( Technology(&(Equipment 4,436.04$(((( 4,436.04$(((( Leasehold(Improvements 25,000.00$(( 25,000.00$(( Depreciation FY+1+and+2
- 129.
- 130. & & 130& Personal&Office&Furniture:&Office&Depot& •! Realspace&Shore&Mini&Solutions&Computer&Desk&with&Hutch,&Antique&White&–&$219.99& •!Realspace&Shore&Mini&Solutions&4ZShelf&Bookcase,&Antique&White&–&$139.99& •! Realspace&Shore&Mini&Solutions&Rolling&Pedestal&File,&Antique&White&–&$114.99& •! Realspace&Eaton&MidZBack&Bonded&Leather&Chair,&Tan/Black&–&$99.99& Personal&Office&Drapery:&Pottery&Barn,&Cameron&Cotton,&Ivory,&50&x&84”&–&$39.00& & & & &
- 131. & & 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. & & 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. & & 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. & & 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. & & 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&
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