Primary Services

DENTAL
Services

CSM is able to offer dental services to all of our clients through the use of two different types of leaders in on site dental care:

Mobile Dental Services
Offers on-site comprehensive mobile dental services through the use of licensed mobile dental clinics that have treated tens of thousands of residents safely since 2008. Our providers are some of the only ones in the industry to treat patients onsite in a fully licensed mobile dental clinic, which can truly provide comprehensive care.  CSM is able to offer dental services to all of our clients through the use of two different types of leaders in on site dental care:

 

Portable Dental Services
Portable Dental is similar in structure to Mobile Dental with one important exception: Portable Dental has the ability to see and treat residents that are unable, or do not want, to be brought out to the mobile dental clinic.

TeleMedicine Advantage
Both Mobile Dental and Portable Dental will be utilizing telemedicine for:

• Post – Operative consults and follow ups
• Immediate Responses to emergency visits
• Speech Therapy for residents receiving new dentures

Mobile Dental Services offers the following comprehensive services:

• On-site routine dental exams, cleanings and x-rays
• On-site surgical, restorative and periodontal treatment
• On-site denture and partial fabrication and repair
• Handles all state DHS income offsets, item D or Pt. pay deductions
• Treats residents without the ability to pay for services
• Treats residents in a true and safe dental environment licensed by the state board of Dentistry and inspected by the state board of health
• Utilizes only the use of licensed Dentists, so every resident is seen by the Dentist on every visit.
• Uses only the newest and best equipment to treat residents.
• Nomad handheld X-Ray
• Ultra Sonic Scalers
• Ultra Violet oral cancer screening technology
• Intra-oral imaging
• Pentamix vinyl impression system, and much more…..
• Dental billing is set by the state DHS, DSCS or DHR. Mobile Dental is not an insurance system but a true fee for service. Residents will only receive the treatment that they need specific to their care plan

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OPTOMETRY
Services

CSM is able to offer optometry services to all of our clients.

Staff
Includes the eye physician and an assistant

Schedule

• Scheduled as needed (minimum 90 days)
• Treat 30-35 residents per day

On Site Treatment

• Eye health exams
• Visual Acuities
• Binocular Vision Testing
• Refraction
• Slit Lamp Examinations
• Anterior Eye Structure
• Ophthalmoscopic evaluation of Retina
• Retinal Photos
• Eye Glasses
• CSM Handles offset or Item D
• Delivery within 30 days
• Multiple Selections

Telemedicine Advantage

• Eye Glasses, etc…
• Emergency facility staff consultations

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PODIATRY
Services

CSM is able to offer podiatry services to all of our clients.

Staff
Podiatrist and CSM will provide an assistant if needed

Schedule

• Scheduled at facility every 60-90 days
• Treat 30-40 residents per day

On Site Treatment

• Mycotic Nails
• Corns
• Calluses
• Diabetics
• Foot Ulcers
• Heel Pain
• Neuropathy
• PAD
• Gout
• Bunions
• Diabetic Shoes
• Any Income offset or Item D will be done by CSM

Telemedicine Advantage

• Post-operative healing consultations
• Patient Prosthetics consults
• Specialty Shoes, etc…
• Emergency facility staff consultations

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MEDICATION THERAPY MANAGEMENT & DNA TESTING

that a patient takes to confirm that he or she is complying with a medication regimen, while also ensuring the patient is avoiding potentially dangerous drug interactions and other complications. This is especially important for those taking large numbers of medications to address chronic illnesses and multiple diseases. Taking multiple medications is known as polypharmacy, and it is particularly common among older adults, as they are more likely to need medications to manage an array of chronic conditions.
There are a number of aspects to medication management, all of which are focused on making sure that medications are used appropriately. Keeping track of all of the medications currently

in use by a patient is an important part. This can include creating printed lists describing medications, their dosages, and how they are being used. These lists can be kept in patient charts and provided to patients to help them track the drugs they use and understand why various medications are being prescribed.
Monitoring medication administration is also key. Medications usually need to be taken in specific doses at set intervals. Missing doses or timing doses incorrectly can cause complications. To manage this, everything from devices that issue reminders to patients to take their medications to filling pill cases for patients and marking the lid of each compartment to indicate when the contents need to be taken may be used.

Steps for Service

1. Test requisition form is signed by the physician for each resident.
2. Resident is swabbed for DNA sample.
3. Swab and resident information is sent to the lab.
4. A full color medication management and DNA report is returned to the ordering physician.

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VESTIBULAR
AUTO-ROTATION TESTING

Treatment and Schedule:

Vestibular Auto Rotation Testing is a fall prevention solution for residents who suffer from dizziness, vertigo, and/or disequilibrium.

• A physician’s order is obtained
• Date of Service is scheduled according to facility’s convenience
• On-site tests are performed
• Test read by physician and referral’s may be made to physical therapy department, meanwhile increasing the Medicare/Medicaid cap
• Provider offers training to all physical therapy departments when needed
• Test will be repeated to monitor progress
• Covered by Medicare, Medicaid, and most private insurance
• Increases star rating

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BEHAVIORAL HEALTH

Treatment and Schedule:
New Consultations are typically done fact to face but may also be done remotely via a telemedicine e-encounter, based upon a Resident’s needs.

Monthly Visits:
Routine Follow ups are typically performed via a telemedicine encounter, but if residents cannot cooperate then provider will schedule an in-house visit.

Change in Behavior:
Patients that need an immediate visit for a behavioral issue may be immediately scheduled for a telemedicine e-encounter.

Documentation:
Physician’s will complete documentation and will send directly to facility.

The Need for Behavioral Health
Studies indicate that from 20 to 60 percent of the jail population, on any given day, have mental health problems. Access to care givers for these needs is very difficult. With our network of providers and technology, we can help bridge the gap between patient needs and care giving.
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WOUND CARE

Treatment:

• Telemedicine encounters for rural areas
• On site wound care for non-rural areas
• On site debridement consults and instruction

Scheduling:

• Monthly
• Weekly
• Biweekly

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AUDIOLOGY

Treatment and Schedule:
When a resident presents with a hearing issue, a physician’s order will be obtained for an audiology exam. A tele-med visit will be scheduled with an Audiologist or an associate. If the result of that exam is determined to be a hearing issue, an impression will be taken on site for a hearing aid.

• Hearing aid will be delivered within 30 days if the resident is state eligible
• Item-D or income offsets will be done by CSM
• Hearing aid adjustments will be done via the tele-med station
• 900 MHz frequency

Procedures performed while on sight:

• Comprehensive diagnostic audio-logical evaluations and hearing tests
• Rehabilitation services for hearing loss
• Counseling for hearing loss and Tinnitus (Ringing in the ears)
• Computerized hearing aid analysis (Real Ear Measurement)
• Hearing aid repair services
• Custom ear molds for hearing aids, iPods and MP3s
• Cerumen management (earwax removal)

TeleMedicine Advantage:
Our audiologist will be using telemedicine for:

• An initial hearing test
• Adjustments to the hearing aide

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LAB

• Results provided within first 24 hours for routine testing
• Results delivered via fax, internet, electronic medical record, or courier
• Daily courier stops
• Early morning phlebotomy
• Maintenance of recurring orders
• Stat laboratory testing*
• Laboratory chart audits*
• Infection control reports*

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TELEMETRY

Portable Telemetry

• On-Site Portable Telemetry Harness
• Continuous Feed to Provider monitored by Cardiologists
• Immediate notification of change in condition
• Results sent to the facility from Provider

Advantages

• Residents stay at the facility
• No transportation cost
• No lost CMS reimbursement

Heartrak TCAT
Wireless External Cardiac Ambulatory Telemetry

• Real-time ECG analysis on-board device
• Patient, Auto, Trended and Full-Disclosure data sent wirelessly via cellular telephony network without patient interaction
• Powered by 1AA alkaline battery (w/ 5 day battery life)
• Two-way communication allows clinicians to adjust trigger settings, request additional data and adjust study durations remotely
• LED status indicators for Monitoring, Battery and Wireless Communication conditions assist in patient compliance

Provider ensures 24 hour monitoring by experienced critical care trained R.N.’s who maintain expertise in adult and pediatric electrophysiology; in addition, two board-certified cardiologists are on staff at all times. Nurses are able to assess symptoms and patient complaints such as chest pains and shortness of breath and provide appropriate notification to physicians 24 hours a day 365 days a year. National recognition gained and a distinctive reputation for providing the highest standard of cardiac diagnostic service.

1. Simply send the telemetry physicians order to the CSM office.
2. Provider will send the telemetry unit with instructions to begin monitoring.
3. Monitoring will be done remotely by professionals without the resident having to leave the facility.
4. Results of the session will be given to the facility upon completion.
5. The appropriate insurance will be billed.

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MOBILE X-RAY

Digital X-Ray

• Pace Maker Checks
• X-Ray to determine Picc Line Placement

24 Hour Holter Monitor Study

• Monitor is placed on patient for 24 hours to monitor heart activity
• EKG’s
• 10 lead process

Bone Density Scans

• Total test time takes only 2 minutes. The test scans the patient’s hand to determine bone density.

Ultrasound
Ultrasound tests are done bedside, and the following tests can be performed:

• Vascular Studies
• Carotid
• Abdominal Vascular
• (IVC, Aorta, Renal Arteries, Mesenteric Arteries)
• Venous (Upper and Lower Extremities)
• Arterial (Upper and Lower Extremities)
• Thyroid
• Venous Studies
• Abdomen/Retro Peritoneum Studies
• Echocardiogram
• ABI
• Same day DVT studies when called in before 2PM.

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