Laura Gramenelles, a Director at Simione Consultants, has worked in home care since 1985, including five years in management and over twenty years in consulting. Her home care experience covers the spectrum from direct-care provider to agency operations, policies and procedures, regulatory compliance, and performance improvement. Laura’s consulting experience includes organizational and operational design, workflow analysis, productivity improvements, training, compliance, policy and procedure development, and performance improvement plans and implementation. In addition, to speaking engagements, Laura’s employment has included Director-level positions where she was responsible for the operations of a multi-state agency. An RN with a BSN from the University of Rochester, Laura has specific expertise in OASIS scoring and diagnosis coding and has achieved certification as a COS-C and HCS-D and is an AHIMA-Approved ICD-10-CM trainer.