Skilled Nursing Facility Services



Our strength lies in having a team of professionals with years of health information, utilization and quality management, coding and classification, and fiscal services expertise working in and managing various sized departments in hospitals and ambulatory centers. This team has become expert in handling difficult and devastating situations.

Our team comes to you equipped to handle today's problems. And today's health information management environment is one that is dynamically changing. Unlike past years when the medical record department was primarily an archival storage area, today's Health Information Department Directors are challenged each day to respond to the myriad of changes. These challenges require that a Director is able to maintain current work production, cost reduction, regulatory compliance and respond to fiscal and reimbursement demands; serves as a change agent to develop and motivate staff, focus on customer relations, encourage innovation, and foster collaboration between members of the healthcare team; and be a visionary to foresee and actively participate in creating solutions for the future information demands of the healthcare delivery system.

We are confident that the team we will assemble to serve you will prove to be technically strong, highly efficient, and innovative in their approach to serving your organization. Our team will have the support of each other and the corporate team to ensure that we bring to you the "maintenance," "change agent," and "visionary" skills that your organization requires. Each of our clients is unique. Our professionals will approach each engagement as a new set of circumstances knowing that there are no "off the shelf" solutions for any one client.

Our consultants are credentialed, experienced professionals with years of experience in their respective areas of expertise.

Chief Operating Officer

Ms. Dunn is the "nuts & bolts" member of the firm. Her health information management and senior administrative experience in a large teaching hospital and chief financial officer background in a multi-hospital system coupled with her national managed care position with a large health care insurance company allows her to see the health care industry from many perspectives.

Rose is a nationally recognized professional in the health information industry and has served as President and Board member of the American Health Information Management Association, the national association for health information professionals. During her career of more than thirty (30) years she has spoken publicly on numerous occasions, held adjunct faculty positions in baccalaureate and master degree programs, and has authored a prolific list of publications. In 1997, Rose was awarded AHIMA's highest honor--the Distinguished Member Award and 2008 AHIMA's Legacy Award.

Rose has written or edited several texts including The Legal Manual for Missouri published by the Missouri Health Information Management Association, Supervisory Management for Healthcare Organizations published by W.C. Brown, Haimann's Supervisory Management for Healthcare Organizations published by McGraw Hill, Finance Principles for the Health Information Manager published by AHIMA, Haimann's Healthcare Management published by Health Administration Press, Guide to Release of Information, More with Less: Best Practices for HIM Directors, Coder Productivity and published by HCPRO, and in Health Information: Management of a Strategic Resource, the Finance chapter of a text published by W.B. Saunders.

She has served in temporary HIM and Patient Account management positions resulting in successfully reducing accounts receivable; eliminating backlogs; reducing incomplete records; improving department image; creating climates of cooperation between medical records, patient accounts and registration; and, often, creating climates of collaboration between the HIM/medical records staff, medical staff and administration. Rose has extensive experience involving staff in and effectively implementing work restructuring and reengineering projects.

Rose also has facilitated strategic planning sessions and provided Performance Improvement training for hospital boards and medical staffs. Her knowledge of the computer-based patient record has allowed her to initiate the planning for paperless environments at her clients.

Ms. Dunn is instrumental in establishing refined managed care networks based on qualitative measurements and credentialing efforts. She has directed provider relations, customer service, utilization management and outcome profiling activities for third party payers.

In addition to the Eastern Missouri, Missouri and American Health Information Management Associations, Rose is a Fellow in the Health Care Financial Management Association and American College of Healthcare Executives, a Certified Managed Care Professional, and a member of the American Institute of Certified Public Accountants.

Ms. Dunn holds a B.S. and M.B.A. from St. Louis University.


Jane Werner Jane E. Werner, RHIT, CCS, CRC
Vice President
Coding Compliance Services
AHIMA Approved ICD-10 CM/PCS Trainer

Jane is our seasoned diplomat. Her experience in health information services spans all aspects of medical records including department management, coding, and classification, release of information, quality assurance and transcription. In addition, Jane has been extensively involved in physician practice management services including compliance coding audits, documentation reviews, and managed care activities.

Proficient in ICD-9-CM and CPT-4 coding systems, Jane has performed DRG validation services and serviced coding staffs in areas that require modification to meet fiscal intermediary requirements. Jane serves as a lead Team Member in our Operational Assessment activities and focuses on record processing activities to optimize coding and reimbursement, reduce accounts receivables, and reduce incomplete records. Jane has acute and ambulatory facility management experience. She served in temporary management capabilities for several organizations ranging in size from 200-900 beds and has in-depth Joint Commission experience. At one of our largest acute care, tertiary, teaching facilities, Jane took the department through the accreditation survey and received no recommendations!

Her excellent physician relations skills is the trait that gives her the reputation as "diplomat" by our clients. Jane is an active member of the Eastern Missouri, Missouri and American Health Information Management Associations. She also is a member of HFMA.

Deanna Peterson Deanna Peterson, MHA, BS, RHIA, CHPS
Vice President, Health Information Consulting Services

Deanna’s expertise in regulations, compliance, quality improvement, document imaging, release of information and department management span a variety of healthcare settings. In her management roles, she has successfully implemented electronic signature, participated in the selection process of an EHR, coordinated Periodic Performance Reviews for Joint Commission and organized the outsourcing of transcription for a multi-hospital system. She also assists long term care facilities in both Missouri and Illinois with documentation compliance, medical records policies and procedures and privacy issues.

Deanna has managed HIM departments in large teaching institutions and community hospitals.  Her success rate in reducing backlogs, implementing efficient workflow processes, establishing effective clinical documentation improvement programs, and improving employee morale and physician satisfaction are just a few of the accomplishments that our clients mention.

Deanna received her B.S. in Health Information Management and M.H.A. from Saint Louis University. She is a member of the Eastern Missouri, Missouri and American Health Information Management Associations and is currently serving as President of EMHIMA.

Pam Scott Pamela L. Scott, RHIT, CCS, CRC, CCDS
Assistant Vice President, Coding Compliance Services
AHIMA Approved ICD-10 CM/PCS Trainer

Pam is one of our coding and classification consultants who also routinely leads and/or participates in Coding Compliance Reviews. Our clients often compliment her on her caring attitude and quality of her work. In the past, she has served as a Financial Data Manager, participated in Quality and Performance Improvement programs, and has expertise in all types of inpatient and outpatient coding activities. Pam also is experienced in Tumor, Myocardial Infarction, and Head and Spinal Cord Injury Registries. Ms. Scott has experience with alternative care facilities such as dialysis centers and long term hospitals, has provided on-site and off-site one-on-one training/oversight for new coders, and assists clients with inpatient and outpatient coding support. Ms. Scott obtained her RHIT in 1990, has coursework in business, accounting, management training and nursing. She is a member of AHIMA, MoHIMA, and EMoHIMA. She has spoken on a variety of coding related topics.


Bill Remmich Bill Remmich, MBA, FHFMA, CPC-H, CCS
Assistant Vice President, Coding Compliance Services
AHIMA Approved ICD-10 CM/PCS Trainer

Bill is a seasoned executive with 25 years in senior leadership positions. He has held positions of Interim Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, and Controller/Director of Finance in major affiliated catholic systems, small to middle market health organizations, stand-alone and government health providers, profit and non-profit.  Since 2007, Bill has been a principal member of coding compliance teams. He also has strategic, facility and financial planning, revenue cycle, and information management skills. Bill is a member of AHIMA, HFMA, and KSHIMA.


Maria Brooks Swims Maria Brooks-Swims, RHIA, CCS, CRC
Assistant Vice President, Coding Compliance Services
AHIMA Approved ICD-10 CM/PCS Trainer

Maria is our world traveler and now resides in Alabama. Maria has HIM Management experience serving as a Director and Assistant Director of HIM and a Coding Manager, consulting expertise conducting coding compliance reviews and providing coding guidance to clients, and performing coding support services for our clients.

Maria’s travels throughout the US and overseas has provided her with experience with inpatient (DRG, MS-DRG) and outpatient (APC) coding, data collection for state agencies, HMO DCG-HCCs, and establishing a coding internship program. A graduate of St. Louis University’s Health Information Management Program, Maria is an active member of AHIMA and Alabama Health Information Management Association.

Susan Begemann Susan Begemann-Kassebaum, RHIA, CCS
Senior Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer

Susan has extensive experience in all aspects of clinical coding and classification. She has worked at large and small acute care facilities. She is an active member of the American Health Information Management Association and Eastern Missouri Health Information Management Association. Susan's extensive experience with DRG coding has allowed her to serve as one of our Coding and Compliance Auditors. Susan provides coding support to many of our clients.

Susan graduated from St. Louis University's Health Information Management Program. She achieved Dean's Honor List status three consecutive years at St. Louis University.

Susan Arcuri Susan Arcuri, LPN, CCS
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer

Sue offers an extensive coding history for community and teaching facilities. She lives in the heart of the Poconos and is one of our full-time remote coding specialists with expertise in inpatient and outpatient coding and concurrent DRG and documentation improvement skills. Sue’s prior patient care experience as an LPN gives her both a clinical and information integrity perspective. Sue is an active member of the American Health Information Management Association.

Anti Stackhouse Anita Stackhouse, CCS
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer

Originally from Florida, Anita now resides in the "cold" Northeast. She has extensive inpatient coding skills. Anita has served as a Coding Coordinator and posesses a comprehensive knowledge of ICD-9cm Guidelines, MS-DRG Reimbursement Methodology and CMS Reporting Guidelines. She experienced the RAC demonstration project first hand, has experience in HPMP reviews,and computerized coding and abstracting systems.

Christine Geiger Christine E. Geiger, MA, RHIA, CCS, CRC
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer

Chris has more than 25 years of health information management experience. She has worked at large and mid-sized health care facilities in many roles where she gained a thorough understanding of HIM. Her coding career spans approximately 20 years working in hospitals as both an employee and a consultant. Chris’ extensive background includes also working in the related function of Quality Assurance. Chris holds a Masters from Washington University and a Bachelors degree from St. Louis University. She is an active member of the Missouri and American Health Information Management Association.

Barbara Reynolds Barbara Reynolds, BS, RHIA, RN, CCS
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer

Barbara's extensive experience includes serving as a Utilization Review Specialist, DRG Consultant, Coding Specialist and Medical Chart Auditor. She has worked in hospitals and coding educational settings. Most recently, Barbara has been providing RAC Readiness assistance and coding support for our clients. She is a graduate of St. Louis University's Nursing program and University of Kansas's Health Information Management program. Barbara is a member of AHIMA and MoHIMA.


Elizabeth Giustins Elizabeth Giustina, BA, CCS-P, CRC
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer
AAPC ICD-10-CM Implementation Trainer

Ms. Giustina's career in healthcare dates to the early 1980s at a large East Coast teaching hospital as the billing manager for a 400 physician practice.
In her patient financial services career, she developed a coding quality check for the clerical staff in five outlying sites, performed Evaluation and Management audits and PATH audits, and implemented a charge capture process for the OB department. For clients she provides compliance reviews and education on the documentation required to support E&M levels, conducted OIG response audits and developed coding policy manuals and coding education. Additionally, she has held HIM management positions. Ms. Giustina is an active member of AHIMA and MGMA. Elizabeth obtained her degree from the University of Maryland Baltimore County.

Karen Bell Karen Bell, AAS, RHIT,CCS
Coding Consultant and AHIMA Approved ICD-10 CM/PCS Trainer
AAPC ICD-10-CM Implementation Trainer

Karen joined First Class Solutions, Inc. in 2015 and brought her 11 years of coding experience with her. She is experienced in both Inpatient and Outpatient Coding and supports two of our clients with their coding needs. Karen also has experience auditing of inpatient and outpatient coding and is recognized for her knowledge of CCI edits, scrubber issues, and code discrepancies. She obtained her Associate Degree of Applied Science in Health Information Technology from Missouri Western State University. Karen is an active member of AHIMA and MoHIMA.

Lian Collins Lian Collins, BS, RHIA
Health Information Management

Lian joins First Class Solutions Inc. with experience in enterprise master patient index (EMPI), data integrity, and process improvement. She has worked on an EMPI team as a Data Integrity Analyst, where she helped develop reports and processes that reduced the total number of duplicates, and trained staff on best practices. At a large academic health center, she participated in an initiative to backload data into Epic for a new provider to ensure continuity of care. She has assisted our clients with their patient identity clean-up and record retirement projects. She has also researched regulatory requirements for record retention and assists our long term care clients with records audits and survey readiness. Lian has a bachelor’s degree from Saint Louis University in Health Information Management with a minor in Information Technology Management and holds professional memberships in AHIMA, eMHIMA, and MoHIMA.


David Vence David Vence, MHI, MA, BS, RHIA, CPC
Assistant Vice President, Professional Coding Compliance Services

David has experience in just about everything! Filing, analysis, educating physicians on documentation requirements to support the care they delivered and their claimed services, and coding. He also has a great sense of humor and is our firm’s internal comedian. As AVP, David is the team leader of our professional coding and compliance experts. David's audit experience includes serving as a coding and documentation compliance auditor for a medical practice of over 400 academic-based physician. His expertise in E&M compliance issues allows him to provide advice to our clients about over/under coding, supervising physician, NP vs. PA services, cloning, level and modifier assignment, and a host of other ProFee issues. Mr. Vence has worked with First Class Solutions, Inc. since 1996 and has never hesitated to travel to clients to help them with their coding backlogs and coding compliance needs. A graduate of St. Louis University's Health Information Management program, David holds a bachelor’s degree from St. Louis University and a master’s degree from Webster University. He is active in AAPC, AHIMA and local HIM associations and has presented on several coding related topics at a national as well as regional level. David also is the recipient of a Distinguished Service Award from St. Louis University.


Ben Burton Benjamin Burton, JD, MBA, RHIA, CHPS, CHC, CRC, CPC-A
Consultant, Health Information Management

Ben joins First Class Solutions with impressive credentials and work history. Ben’s experience includes serving as a hospital HIM Director, Privacy Officer, Coding and Billing Specialist, and instructor for Stephens College. Additionally, he has been involved with information systems/EHR conversions, compliance management, quality management, and, as an attorney, experience with drafting, critiquing and editing contracts and investigated tort claims. Mr. Burton is a member of HCPro’s Advisory Board for HIM Briefings and has served on several AHIMA Councils. He is a graduate of St. Louis University and an active member of the Maine and American Health Information Management Associations and the American and Missouri Bar Associations


Jan Lyons Janice R. Lyons, BS, RHIT
Coding Consultant

Jan's 20 years of experience includes extensive coding experience for hospitals (inpatient and outpatient services), urgent care centers, and clinics. Additionally, she has served as an HIM Director for both acute care hospitals and for an emergency medical services organization. Ms. Lyons has worked in Performance Improvement (directing several quality improvement departments in her career). She is an active member of AHIMA, IHIMA, and the National Association for Healthcare Quality.


Sally Frese Sally M. Frese, MSN, RN, BC, CPC
Senior Professional Coding Consultant

Sally has extensive experience in healthcare which includes clinical services and care, leadership, consultation and education.  She has fourteen years of experience as a healthcare compliance educator and auditor responsible for the development and implementation of a multitude of documentation, billing, coding, regulatory and compliance programs for a 350 member academic health practice. She has also served as a medical documentation, coding and compliance consultant. 
Sally is a certified professional coder and is a board certified advanced practice nurse with more than twenty-five years of experience as a psychiatric clinical nurse specialist and consultant.  She is a faculty member of the Saint Louis University School of Nursing and is active in clinical, educational and research activities.  Sally is the recipient of several awards recognizing her expertise and contributions to clinical care.  She received her bachelors and masters degrees from St. Louis University.

Cassie Adams Cassie Neff, RHIT
Coding Consultant

Cassie joined First Class Solutions, Inc. in 2013 and lives in Kansas. She provides inpatient coding support for our clients but has both inpatient and outpatient coding skills. She has successfully completed the Elsevier ICD-10 training program. Ms. Adams is an honors graduate of Hutchinson Community College where she obtained her associates degree in Health Information Technology. She is a member of the American and Kansas Health Information Management Associations.

Tammy Laffin Tammy Laffin, CCS
Coding Consultant

Ms. Laffin joined our firm in 2013 after relocating to Oregon. She is a graduate of the Coding Specialist Program of Loma Linda University School of Allied Health. She provides inpatient coding support for our clients and has extensive experience coding for the complex environments of teaching facilities. In addition to inpatient coding skills, Tammy has outpatient and interventional radiology coding skills. She has successfully completed the Elsevier ICD-10 training program. Prior to venturing into the coding arena, Tammy was a financial counselor for a large teaching hospital. Ms. Laffin is an active member of the American Health Information Management Association.

Katrina Harrison, CCS, AHIMA Approved ICD-10CM/PCS Trainer
Coding Consultant

Katrina joined First Class Solutions in 2015. She has large, teaching, hospital coding experience. During her decade+ career, she has worked in almost all positions in an HIM Department and understands the positional workflows and interdependencies. Katrina has fine-tuned skills in all facility outpatient coding areas including Interventional Radiology, Infusions, and Cardiac Catheterizations.

Joan Shutter Joan Shutter, RHIA, RHIT, CCS, CHTS-PW, CRC
Coding Consultant

Joan joined First Class Solutions in 2014. She has a long career in HIM including being a HIM director, guiding long term care facilities, and coding. Joan brings 30+ years of coding experience to our clients. She lives in sunny Hawaii but grew up in the Midwest. A graduate of the University of Wisconsin, Joan holds both an RHIT and RHIA and bachelors in business administration (finance concentration). In addition to working full-time in health information management roles, she has taught a variety of courses, including health information technology, medical coding, migration to EHR, and fundamentals of anatomy and physiology for the Community College System, Kapi’olani and Leeward campuses, in Hawaii.

Mary Phelps Mary P. Phelps, BS, RHIA, CCS
Coding Consultant

Mary has more than 30 years’ experience in the health care industry. In addition to inpatient and outpatient coding expertise including interventional radiology and cardiology, she previously held certifications in and has experience in Clinical Documentation Improvement and Tumor Registry. Mary is recognized as a subject matter expert with MS-DRGs, CPT-4/HCPCS, ICD-10 coding assessments, outpatient and inpatient reimbursement and compliance related issues. She has helped clients with ICD-10 assessments spanning across a facility’s people, process and technology needs, conducted ICD-10 training and analyzed documentation needs. As a national speaker, Mary has address ICD-10 topics involving both inpatient and outpatient documentation improvement strategies. Mary is known for her collaborative approach with hospital administration, clinicians and coders to improve coding process flows and DNFB reduction. In addition to her Health Information management degree, Mary holds a BS in business administration. She is an active member of AHIMA and NCHIMA.




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