Appendix M: Regulatory Component Benchmarks

Financial/Audits

· Provider has submitted all required audits in a timely fashion

· DMR audit indicates the provider is financially sound

· The provider's administrative and general expense ratio is 15 percent or less

· The provider's audit submissions offer complete disclosure that enable DMR to track where payments are being spent

Staffing

· Provider has no key positions (e.g., house manager, nurse) vacant for unacceptable period of time (e.g., no longer than 60 days)

· That overall turnover is in an acceptable range - (e.g., no more than 10 percent above the median turnover rate for the private providers in the region)

· No significant licensing citations in the area of staff training or background checks, as determined by DMR

· Staff records -- including scheduling and staff hours worked -- are kept and maintained so they may be produced upon advance request by licensing inspectors or for other DMR-related inquiries (e.g., mortality review, abuse or neglect investigations)

Licensing and Inspections

· No significant findings regarding physical plant or environmental concerns

· That the provider is not on a one-year inspection cycle

· That any plans of correction were submitted timely and approved by DMR as addressing the deficiencies

· There were no "urgent" health or safety deficiencies cited in the previous licensing inspection

Client Health and Safety

· Client deaths were expected or full inquiries into sudden and unexpected deaths were conducted

· All death reporting requirements to the appropriate persons/authorities were completed

· All accident reporting was done as required

· Participation in mortality review was forthcoming, and any recommendations resulting from mortality reviews were implemented

· Any DMR health/safety advisories or bulletins have been adopted into the provider procedure (based on most recent licensing inspection)

Client Issues/Satisfaction

· Provider vacancies respond to DMR client referrals in a timely manner

· Provider acts upon client/family survey suggestions and concerns

· Provider responsibilities with OPS are performed, and issues identified for provider follow-up or service are implemented in a timely manner

· Any submissions to program review or human rights committees are timely; client health and safety issues needing human rights committee or program review committee approval are addressed

Abuse and Neglect

· Provider reports all incidents required in the area of abuse and neglect and unusual incidents

· Investigations are conducted on a timely basis

· The number of incidents is within an acceptable range, as determined by DMR

· Providers who terminate employees notify DMR so names can be placed on registry