TABLE OF CONTENTS

		PAGE
OVERVIEW		3


DISCHARGING YOUR OBLIGATIONS		4

	The Compliance Committee and Compliance Officer
	The Process


ELEMENTS OF THE ACCENTCARE, INC. CODE OF CONDUCT		5

Key Areas

1	Billing
2	Client Rights	6
3	Confidentiality
4	Conflicts of Interest
5	Discrimination and Employment
6	Fraud and Abuse	6
7	Gifts and Gratuities
8	Immigration
9	Information Systems Issues
10	Occupational Safety and Health Administration (“OSHA”)	8
11	Professional Licensure, Certification and Credentialing
12	Quality Assessment and Performance Improvement
13	Record Retention, Completion and Maintenance
14	Reporting Requirements	9
15	Reviews and Inspections


CONCLUSION


COMPLIANCE COMMITTEE MEMBERS		10
COMPLIANCE OFFICER

OVERVIEW

Since 1982, AccentCare, Inc. agencies have taken pride in offering high‑quality home health care services to individuals and families in Arizona (1992), California (1992), New York (1982), Washington (2005), and Ohio (1984). As with any vital and vibrant organization, however, AccentCare, Inc. cannot be content with the status quo, but rather must focus on the future. To preserve and enhance our well-deserved reputation, everyone associated with AccentCare, Inc. must share a commitment not only to our clients and our work but also to compliance with the numerous laws, regulations, and policies that govern our conduct.

To assist us in our compliance goals, we have developed the AccentCare, Inc. Compliance Plan which includes a Code of Conduct. In that Code, we have briefly summarized the provisions that govern various legal and ethical requirements we must meet. The Code is expected to serve as a useful guide to assist us and you in identifying and addressing those instances where there may not be compliance with the law or with AccentCare, Inc. policy.

The failure to follow existing law can damage our reputation and threaten our ability to carry out our mission. Unlawful behavior also may result in criminal liability and civil fines and penalties. Individuals who knowingly violate or recklessly disregard this Compliance Plan, the Code of Conduct, or the laws, regulations and policies which govern AccentCare, Inc. will face severe consequences including termination.

We recognize that our ability to achieve compliance with the law depends upon our ability to recognize, avoid, and remedy existing problems. Our compliance, therefore, depends not only upon a choice to “follow the rules” but also our obligation to our mission, our agency, each other, and all those who serve AccentCare, Inc. in any capacity, to comply with the laws and to bring all issues of potential concern to the attention of a supervisor or to an AccentCare, Inc. Compliance Committee member (see “Discharging Your Obligations”, below). In return, you have our commitment that the issues you raise will be promptly and properly reviewed and that appropriate corrective action will be taken where necessary. Most important, you will not in any way be subject to any adverse consequences for making good faith reports; to the contrary, we view the failure to bring appropriate concerns to our attention to be a serious breach of your obligations that could lead to disciplinary action.

In short, we commend and will support strongly those who make the proper choices at AccentCare, Inc., and will hold accountable those persons who make inappropriate choices or those who turn a blind eye toward improper conduct. Through our collective efforts we are confident that we can and will enhance our existing reputation for excellence.

DISCHARGING YOUR OBLIGATIONS

We recognize that there may be instances where you learn of practices at AccentCare, Inc. that may be of concern to you. While there are many different ways for you to address those concerns, we recognize that your choice will likely depend upon your relationship with the particular employee, independent contractor or vendor involved in the conduct at issue; upon your relationship with your supervisor; or upon your knowledge of the laws, regulations and policies governing the practice that is of concern to you. We wish to assure you that this Compliance Plan as well as the Compliance Committee (see “Compliance Committee and Compliance Officer”, below) exist to help you when you are unable, for any reason, to assure yourself that the conduct in question is in fact appropriate, or if you believe that the problem has not been effectively remedied. In those instances, we fully expect that you will promptly inform the Compliance Committee of the issue. That Committee is composed of senior members of AccentCare, Inc.’s administration who are committed to ensuring full compliance with all existing laws, rules, regulations, protocols and policies that govern us.

The Compliance Committee and Compliance Officer

The AccentCare, Inc. Compliance Committee has been formed to aid in identifying any potential areas of non-compliance through audits, to assist in investigating areas of concern raised by our employees or by others, and to remedy any deficiencies. The Compliance Committee will meet quarterly or more frequently as necessary. The Compliance Committee is responsible for overseeing the development and implementation of policies and procedures for the Compliance Committee, informing employees, independent contractors and vendors of this Compliance Plan, providing training regarding specific job responsibilities and requirements, and for conducting audits and monitoring employees and others responsible for documenting the services we provide, coding and submitting claims for reimbursement. These policies and procedures will be reviewed at least annually and revised if necessary. The Committee’s work is intended to be and will be confidential and privileged to the extent permitted by law. If requested, the Committee also will make all reasonable efforts to protect the identity of the reporting employee or individual. When the Committee completes any necessary investigation, or implements any necessary steps to address the problems detected, the Committee will, whenever appropriate, inform the reporting employee or independent contractor of the result of the investigation and of any action taken concerning the issue presented. The Committee will review and, if necessary, modify this Compliance Plan and Code of Conduct annually.

The Compliance Officer reports directly to the owners of AccentCare, Inc. The Compliance Officer will chair the AccentCare, Inc. Compliance Committee. The Compliance Committee members including the Compliance Officer are listed, along with their telephone numbers, in Attachment A to this Compliance Plan document.

The Process

All AccentCare, Inc. employees, independent contractors and vendors are strongly encouraged to bring concerns to the attention of the Compliance Officer or any member of the Compliance Committee. Reports may be made in person, in writing, or over the telephone to the individuals listed in Attachment A. Written communications should be marked “CONFIDENTIAL.” Although reports may be made anonymously, in order for the Compliance Committee to obtain more information from or respond to the reporting individual, he or she should provide his or her name and work location when the report is made.

All reports and communications received will be confidential and privileged to the extent permitted by law. Counsel for AccentCare, Inc. and the Compliance Committee will review reports and assist in deciding upon an appropriate investigation. The cooperation of the reporting employee or individual may be sought during any investigation, and such cooperation will be positively noted in the employee’s or individual’s file. Upon conclusion of the investigation, with the advice of legal counsel, the Committee will determine the necessary follow-up action to be taken. Any concerns about the Compliance Officer, the Committee members, or the Committee’s actions or determinations may be brought directly to the owners of AccentCare, Inc.

ELEMENTS OF ACCENTCARE INC.’S CODE OF CONDUCT

The following Code of Conduct summarizes the conduct we expect from all our employees, independent contractors and vendors, and highlights certain key areas where the potential for concerns may be significant. This Code will not serve as a substitute for a thorough understanding of your job function, your obligations, and the laws and institutional policies that apply to your job. It will not constitute an excuse to avoid training or in-service presentations in your area. However, it can and should provide useful guidance, make you sensitive to potential problems you may face, and help you to avoid particular pitfalls.

Key Areas

Our agency is subject to many federal, state and local laws, together with various internal policies and protocols. We have attempted to summarize below the general obligations arising in key areas of our operations. The key areas are:

1. Billing

2. Client Rights

3. Confidentiality

4. Conflicts of Interest

5. Discrimination and Employment

6. Fraud and Abuse

7. Gifts and Gratuities

8. Immigration

9. Information Systems Issues

10. Occupational Safety and Health Administration (“OSHA”)

11. Professional Licensure, Certification and Credentialing

12. Quality Assessment and Performance Improvement

13 Record Retention, Completion and Maintenance

14. Reporting Requirements

15. Reviews and Inspections

16. Wage and Hour Issues

1. Billing

Home health care services are paid for by Medicare, Medicaid and other federal and state government agencies, private insurance and personal funds. While there are established particular billing formats, protocols, and practices with which all employees involved in the billing process must become familiar, there are certain common issues that are important to mention.

AccentCare, Inc. is prohibited from submitting false claims to obtain payment for the services we provide. False claims include claims for payment which the home health care services provider knows are unwarranted and claims the home health care provider submits with reckless disregard for their accuracy or “deliberate ignorance” of the applicable guidelines. False claims can result in significant penalties and costs to AccentCare, Inc. Obviously, therefore, AccentCare, Inc. is committed to ensuring that all claims for payment are proper, that they accurately reflect the services necessarily delivered, and that they comply with existing billing and coding regulations, bulletins, advisories and guidelines. If you are uncertain as to a particular charge or billing practice, or if you believe the documentation supporting a claim for payment may be inadequate, you should contact your supervisor for guidance. If you seek guidance and you remain concerned about any aspect of our billing, you should immediately bring that concern directly to a Compliance Committee member.

It is our intention to comply with all payor requirements. Where the requirements are unclear, as they occasionally are, you or your supervisor may ask the Compliance Officer to seek guidance from the payor directly. The advice given should be carefully recorded, including the name and title of the payor representative, and the time, date, telephone number and place of the communication. A letter should be sent to the payor representative via receipted mail confirming the advice. Copies of that letter, together with any relevant correspondence, will be maintained by the Compliance Officer.

Given the number of client encounters within our agencies, and the occasional ambiguous, complex, or conflicting rules, there may be times when you discover an error in a previously submitted claim. You should immediately report that error to your supervisor so that it may be rectified. If you feel you are unable to make such a report to your supervisor for any reason, or if appropriate corrective action is in your judgment not taken, you should contact a Compliance Committee member immediately.

2. Client Rights

AccentCare, Inc. recognizes that each client and their family are entitled to receive ethical treatment in accordance with accepted standards of care. It should be the express goal of all AccentCare, Inc. personnel and independent contractors to treat all clients and their families with courtesy, compassion and dignity, while recognizing and honoring the client’s and family’s right to privacy and confidentiality. All agency personnel and independent contractors shall fully familiarize themselves with the rights of our clients, and conduct themselves at all times in a manner consistent with these rights. In addition, all agency staff and independent contractors involved in the delivery of client services shall attend periodic in-service training sessions dealing with clients’ rights requirements. Such training sessions shall cover:

1. Informed consent;

2. Privacy and confidentiality;

3. Client complaints;

4. Access to services information; and

5. Right of respect for property and person.

If you become aware of any situation in which a client’s or family’s rights are being violated, you should immediately contact a supervisor or a Compliance Committee member.

3. Confidentiality

AccentCare, Inc. recognizes the paramount importance of confidentiality in the provision of home health care services, and it is our policy to keep all information and records pertaining to a client’s treatment confidential in accordance with applicable law. All personnel and independent contractors with access to confidential information and records are required to strictly adhere to confidentiality policies of our agency. If you become aware of unauthorized or inappropriate disclosure of confidential information or documents by an AccentCare, Inc. employee or independent contractor, you should contact your supervisor or a Compliance Committee member immediately.

4. Conflicts of Interest

A conflict of interest may arise where an employee stands to benefit personally at the expense of AccentCare, Inc., or where an employee is in a position to put his or her personal interests above those of AccentCare, Inc. We believe strongly that all AccentCare, Inc. employees, independent contractors and vendors during the term of their contract, owe a duty of loyalty to AccentCare, Inc. and, therefore, should avoid any actual or apparent conflicts of interest. While conflicts can arise in many different contexts, in general we expect that all employees, independent contractors and vendors during the term of their contract, will put the interests of AccentCare, Inc. ahead of their personal concerns, and will not seek to benefit themselves at the expense of, or as a result of, their affiliation with AccentCare, Inc. We expect all AccentCare, Inc. employees, independent contractors and vendors will become familiar with and obey policies in this area. Suspected violations should be reported immediately to a supervisor or Compliance Committee member.

5. Discrimination and Employment

AccentCare, Inc. is committed to equal opportunity and to the respect for human dignity. Unequal treatment or discrimination based upon gender, color, national origin, age, religious affiliation or belief, disability, sexual orientation, or other non-performance or ability-related grounds is unacceptable. We will hire, promote, retain and contract with individuals based upon their ability to meet bona fide occupational qualifications, and to effectively and efficiently discharge the obligations of their job. Similarly, we do not condone and will not tolerate conduct that demeans or undermines our clients, or that creates or encourages a hostile or oppressive working environment.

AccentCare, Inc. has developed and maintains various employment-related and independent contract-related policies that are available through supervisors. We expect that all employees and independent contractors will be familiar with and will adhere to these policies. Questions or concerns should be directed to a supervisor or Compliance Committee member.

6. Fraud and Abuse

Federal and state laws prohibit certain conduct by, and certain business arrangements for, home health care providers. These include arrangements where goods, services, or office space are provided for some amount other than fair market value in return for referring a client for services or items. These kickbacks and other related practices are generally grouped under the heading “fraud and abuse.” While there are many practices that are prohibited or restricted, there are also several exceptions or “safe harbors” that apply under specified circumstances. The most common fraud and abuse issues arise in connection with referral practices and in vendor relationships.

As a general rule, you must avoid relationships with vendors or other third parties that appear to provide financial incentives for the use of their products or for the referral of clients to them. These incentives, moreover, are not necessarily in the form of cash payments, but may include consulting relationships, lease arrangements with vendors for other than fair market value, and gifts. A useful guide is to avoid arrangements that confer personal benefits to you over and above that which ordinarily would be provided for your services. You must also review with your supervisor any proposed arrangement with clinicians, vendors, contractors or suppliers; or any rebate, bonus or volume discount proposals.

Client referrals to health care entities in which the referring clinician or a relative has an ownership interest also are prohibited under statutes commonly known as the “Stark” laws. There are several exceptions to the Stark prohibitions, but the appropriate course of action is to raise all issues in this regard with your supervisor.

Any concerns regarding this area should be immediately brought to the attention of a supervisor or Compliance Committee member.

7. Gifts and Gratuities

You should be aware that the receipt or giving of gifts by AccentCare, Inc. personnel may raise questions about relationships with our vendors, governmental officials, or others who interact with AccentCare, Inc. We must always refrain from activities that could possibly be construed as an attempt to improperly influence these relationships. You should not offer or receive a gift in circumstances where it could appear that the purpose of the gift is to improperly influence AccentCare, Inc.’s relationship with a vendor, regulator, or other person or entity.

It is AccentCare, Inc.’s policy to reimburse its employees for all reasonable expenses, including meals, entertainment, and travel, that are appropriately incurred while conducting AccentCare, Inc. business. Rarely, therefore, will justification exist for you to permit someone else to pay for such items. We are confident that if you follow AccentCare, Inc. policy and exercise reasonable judgment and common sense with respect to gifts and gratuities, you will avoid situations that might bring you or AccentCare, Inc.’s integrity into question. If you have any questions in connection with the receipt or offer of gifts or entertainment, you should consult the applicable AccentCare, Inc. policy and your supervisor. Any concerns regarding violations of policy in this area should be brought to the attention of a supervisor or Compliance Committee member.

8. Immigration

AccentCare, Inc. is not permitted to employ anyone who is not a United States citizen, unless that person has an appropriate visa or other documentation that allows him or her to legally work at an AccentCare, Inc. agency. If AccentCare, Inc. violates federal immigration laws, there could be significant civil or criminal liability. It is the policy of AccentCare, Inc. to fully comply with the immigration laws and, therefore, no person will be hired without providing AccentCare, Inc. with appropriate documentation of their citizenship or immigration status. Any concerns regarding immigration issues should be brought to the attention of a supervisor or a Compliance Committee member.

9. Information Systems Issues

One of our most valuable assets is our body of confidential information. As an agency employee or independent contractor, you are responsible for maintaining and protecting the information used by you in connection with your job duties. For example, you must not record inaccurate information, make inappropriate or unauthorized modifications of information, or destroy or disclose information, except as authorized. Additionally, no current employee or independent contractor, or former employee or independent contractor may, without the prior written consent of AccentCare, Inc., use for their own benefit or disclose to others any confidential information obtained during their employment or term of engagement.