Janet Lytton has lived in rural America all her life and worked in Rural Health Care the last 27 years.  She lives on an acreage near Shelton, NE with her husband, Gary.  She has been the Director of Reimbursement for Rural Health Development for the last 20 years.  Janet has worked with both Provider Based and Independent RHCs across the United States.  Janet consults on RHC feasibility, certification, billing, coding and does many IRHC cost reports annually, as well as gives workshops and speaks on RHC topics across the country.  She consults on Critical Access Hospitals and assists in their implementation.  She has completed and assisted in numerous feasibility studies and operational analyses for IRHCs, PBRHCs, nursing homes, skilled nursing homes, hospitals and FFS clinics across the U.S.  She is also a licensed Nebraska Nursing Home Administrator and a Registered Health Information Technologist.