# Cascades of Tucson — CARF Technology &amp; System Plan: Input Worksheet

> Purpose: collect the few facts only Cascades/ACG leadership can supply, so the final
> CARF-format Technology and System Plan can be built complete (no placeholders).
> Everything marked **>> NEEDED <<** is an input from you. Everything else is pre-filled from
> ACG's records and is yours to correct.
> Prepared by Az Computer Guru · drafted 2026-06-24. Costs left blank are **[ACG TO PRICE]**
> (we verify, never guess).

---

## Part 1 — Plan header & governance (CARF Section 1 requirements)

| Field | Value |
|---|---|
| Accreditation program | **>> NEEDED <<** (Aging Services — which: Assisted Living / CCRC / other?) |
| CARF manual year / edition | **>> NEEDED <<** (2025 or 2026 Aging Services Standards Manual — so we cite the exact standard number) |
| Standard reference | Technology and System Plan (Section 1 "CARF Plans") — confirm number from your manual |
| Plan period / fiscal year covered | **>> NEEDED <<** |
| Plan owner (Cascades) | **>> NEEDED <<** (suggest: Administrator / Ashley Jensen) |
| Prepared with (IT partner) | Az Computer Guru (Mike Swanson, Howard Enos) — pre-filled |
| Approved/adopted by (leadership) | **>> NEEDED <<** (Executive Director name + title) |
| Date adopted | **>> NEEDED <<** |
| Last reviewed / Next annual review | **>> NEEDED <<** (CARF requires at least annual review with a dated record) |

## Part 2 — Needs basis (CARF: plan must be based on the needs of persons served, personnel, stakeholders)

Draft below — confirm or edit:

- **Persons served (residents & families):** reliable building Wi-Fi and phone service; resident-safety
  monitoring (fall detection); strict confidentiality of personal health information; access to
  assistive/adaptive technology where needed.  **>> confirm / add <<**
- **Personnel (staff & caregivers):** secure on-site access to the clinical record (ALIS) and email;
  dependable phones and workstations; protection against credential theft and lost/stolen devices.  **>> confirm / add <<**
- **Other stakeholders (vendors, payers, regulators):** HIPAA confidentiality, business continuity,
  auditable records.  **>> confirm / add <<**

## Part 3 — Strategic-plan alignment (CARF: plan aligns to the strategic plan)

One paragraph tying technology priorities to Cascades' strategic goals.
**>> NEEDED <<** — please share your top 2–3 strategic goals (e.g. resident safety, census growth,
regulatory standing) and we will write the alignment paragraph.

---

## Part 4 — The eight areas (CARF action-document format)

For each area, fill the four input fields: **Responsible person**, **Estimated/actual cost**,
**Target date**, **Completion date**. Current state / needs / vendor are pre-filled.

### 1. Hardware
- **Current:** Dell PowerEdge R610 server (verified healthy 2026-06-24, all drives online); Synology
  NAS; pfSense firewall; UniFi network (77 APs, 12 switches); ~29 staff PCs; resident/safety devices.
- **Unmet / projected needs:** restore server redundant power supply; install enterprise SSDs already
  purchased; replace end-of-life PCs; longer-term server replacement off the 16-yr-old R610.
- **Possible vendor:** Az Computer Guru (Dell hardware).
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** · Target date: **>> NEEDED <<** · Completion: PSU/SSD pending

### 2. Software
- **Current:** Microsoft 365 (Business Premium); Windows Server 2019; clinical EHR (ALIS); line-of-business apps.
- **Unmet / projected needs:** move 31 users off the suspended M365 license onto Business Premium (time-sensitive); finish staff domain migration; upgrade Windows Home PCs to Pro.
- **Possible vendor:** Microsoft / Az Computer Guru.
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** (license true-up) · Target date: **>> NEEDED <<** · Completion: in progress

### 3. Security
- **Current:** identity-based access control (Entra), MFA, caregiver on-site/approved-device lockdown, isolated voice & resident-data network segments, email filtering.
- **Unmet / projected needs:** enable file-access audit logging on the resident-data share; build audit-retention storage (90-day + 6-year); create emergency break-glass admin accounts with security keys.
- **Possible vendor:** Microsoft / Az Computer Guru.
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** (audit-retention build) · Target date: **>> NEEDED <<** · Completion: pending

### 4. Confidentiality
- **Current:** PHI access limited by role and security group; encryption in transit; single sign-on to ALIS; caregiver PCs auto-lock and sign out; per-room and voice network isolation.
- **Unmet / projected needs:** confirm signed Business Associate Agreement (BAA) with ALIS/Medtelligent; enable SMB encryption on the resident-data share; rotate one historically-exposed credential.
- **Possible vendor:** Az Computer Guru / Medtelligent.
- Responsible person: **>> NEEDED <<** · Cost: minimal/internal · Target date: **>> NEEDED <<** · Completion: pending

### 5. Backup policy
- **Current:** cloud backup (MSP360) **verified running 2026-06-24** — last run succeeded, ~576 GB protected off-site, daily incrementals.
- **Unmet / projected needs:** confirm/extend to full system-image (bare-metal) backup for the server; **run and document a test restore** (CARF looks for this); set/confirm retention.
- **Possible vendor:** Az Computer Guru / MSP360.
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** · Target date: **>> NEEDED <<** · Completion: backup live; image + restore-test pending

### 6. Assistive technology (persons served) — **biggest input gap**
- **Current (known):** Helpany "Paul" resident-safety sensors — ceiling radar fall/motion detection, **no camera, no microphone**; rolling out floor by floor.
- **>> NEEDED — full resident-facing inventory:** nurse-call / emergency-call / pendant system? hearing loops or assistive listening? adaptive/accessible computers or devices? resident/guest Wi-Fi for telehealth or family contact? Anything else residents use to maintain function/independence.
- **Possible vendor:** Helpany / [nurse-call vendor?] — **>> NEEDED <<**
- Responsible person: **>> NEEDED <<** · Cost: **>> NEEDED <<** (vendor-billed) · Target date: **>> NEEDED <<** · Completion: Helpany in rollout

### 7. Disaster recovery preparedness
- **Current:** documented power-outage runbook with scripted clean shutdown and **verified recovery** (June 2026); UPS protection; backup running.
- **Unmet / projected needs:** written DR/business-continuity plan with target recovery times (RTO/RPO); add server redundancy; complete the system-image backup + restore test (links to area 5).
- **Possible vendor:** Az Computer Guru.
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** · Target date: **>> NEEDED <<** · Completion: procedure proven; written plan pending

### 8. Virus protection — **close before survey if possible**
- **Current:** managed antivirus (Bitdefender) on endpoints; Microsoft Defender + email filtering.
- **Unmet / projected needs:** enroll the **main server** and all remaining PCs into managed antivirus; remove the previous IT provider's leftover security agents; run a coverage audit so every device reports in.
- **Possible vendor:** Az Computer Guru / Bitdefender.
- Responsible person: **>> NEEDED <<** (suggest ACG) · Cost: **[ACG TO PRICE]** (per-endpoint) · Target date: **>> NEEDED <<** · Completion: pending

### (Extra, not CARF-required) Communication technology / Services & contracts / Use of AI
- Ashley's list also included these. We will carry them as supplementary sections (phones + Wi-Fi
  device network; vendor/contract register; an AI acceptable-use policy). No CARF fields required, but
  the AI-use policy strengthens the Security area. **>> confirm you want these kept <<**

---

## Part 5 — Supporting evidence the surveyor may also request (status)

| Evidence | Status |
|---|---|
| DR procedure tested + documented | **Have** (June outage runbook + verified recovery) |
| Backup running + successful **test restore** | Backup verified; **restore test owed** |
| Security risk assessment (dated) | Substance exists (HIPAA gap list); **package + date it** |
| Confidentiality controls in place | **Have** (access model, MFA, isolation); audit logging pending |
| Antivirus coverage all devices | **Gap** (server + cleanup) |
| Plan reviewed annually w/ sign-off | **To create** (Part 1 governance block) |

---

## Part 6 — Cost estimates (verified via live web lookup 2026-06-24)

> Per ACG policy these are verified against current vendor/retail pricing, not estimated from
> memory. Sources cited below the table. "ACG labor" draws the prepaid block (48.25 hrs @ $175/hr)
> unless quoted as a separate project.

| Item | Area | Qty | Cost (verified) | Notes |
|---|---|---|---|---|
| R610 redundant power supply (refurb, RN442 717W) | Hardware / DR | 1 | **~$99 one-time** | Restores lost PSU redundancy; cheap, do soon |
| Enterprise SSD 480 GB (Samsung PM893) | Hardware | 2 | **~$320–350 (already purchased)** | Sunk cost; planned install on a maintenance window |
| **M365 Business Premium relicense (31 users)** | Software | 31 | **likely $0 new spend** | Our records show 31 Premium seats already owned + free; reassign the 31 suspended-Standard users to them and drop Standard. If those seats are NOT a paid subscription: $22/user/mo = **$682/mo (~$8,184/yr)**. **Verify subscription status.** |
| Windows Home → Pro upgrade | Software | 5 | **~$495** (~$99/device; ACG to source via CSP, may be lower) | Howard handling keys |
| Replacement workstations (OptiPlex i5 / 16 GB / 512 NVMe, Win 11 Pro) | Hardware | 2 | **~$1,400–1,900** (~$700–950 ea) | Lupe Sanchez EOL + spare for new hire (#32194) |
| Break-glass FIDO2 YubiKeys (5-series) | Confidentiality | 2 | **~$110** (already ordered per records) | Approximate |
| Azure audit-log retention (Log Analytics 90 d + 6 yr archive) | Security | — | **~$50–120/mo** consumption (log-volume dependent) + one-time ACG build | Firm up after measuring actual audit-log volume |
| Managed antivirus, all devices incl. server | Virus protection | — | **Included in existing ACG Bitdefender managed security** + ACG labor to enroll server / remove legacy Datto agents | **Client (Mike) is deploying AV** |
| DR written plan + system-image confirm + restore test | DR | — | **ACG labor (prepaid block)** | Restore test **deferred** per client (revisit after AV + basic items) |
| Security risk assessment (dated package) + file-share audit logging | Security | — | **ACG labor (prepaid block); no license cost** | |
| **Long-term server replacement (PowerEdge T360-class)** | Hardware / DR | 1 | **~$4,000–7,000 configured (formal quote required)** | Depends on spec + Windows Server licensing + CALs; separate project |

**One-time hardware/licensing subtotal (excludes the optional server replacement):**
~$2,300–2,950, of which ~$320–350 (the SSDs) is already spent. Plus ~$50–120/mo Azure. The
server replacement is a separate ~$4–7k project to quote when you're ready.

**Pricing sources (2026-06-24):**
[M365 Business Premium $22/user/mo](https://www.microsoft.com/en-us/microsoft-365/business/microsoft-365-plans-and-pricing) ·
[M365 July 2026 price changes (Premium unchanged)](https://www.stmicro.net/blog/microsoft-365-price-increase-2026/) ·
[Samsung PM893 480 GB ~$160–175](https://www.marigoldsystems.com/products/b-samsung-pm893-480gb-enterprise-sata-ssd-1dwpd-b) ·
[Windows 11 Home→Pro upgrade ~$99](https://learn.microsoft.com/en-us/answers/questions/3923910/how-much-does-it-cost-to-upgrade-to-windows-11-pro) ·
[Azure Log Analytics $2.30/GB ingest, ~$0.10/GB/mo retention, ~$0.02/GB/mo archive](https://learn.microsoft.com/en-us/azure/azure-monitor/logs/cost-logs) ·
[Dell R610 717W redundant PSU refurb ~$99](https://store.flagshiptech.com/dell-poweredge-r610-redundant-power-supply-717w-rn442/) ·
[Dell PowerEdge T360 tower (from ~$1,900 base)](https://www.dell.com/en-us/shop/servers-storage-and-networking/poweredge-t360/spd/poweredge-t360/pe_t360_tm_vi_vp_sb) ·
[Dell OptiPlex business desktop i5/16 GB](https://www.dell.com/en-us/shop/desktop-computers/optiplex-tower/spd/optiplex-7020t-desktop)

---

## What we do once you return this
1. Build the final **CARF Technology and System Plan** (Cascades-branded, ACG as preparer) in CARF
   action-document format, complete with your owners/costs/dates.
2. Package the security risk assessment + DR plan as named attachments.
3. Deliver as a print-ready PDF for leadership adoption and the survey file.
