The Journey of Health Risk Screening Inc.

HRS was established on the principles of person-centered practices. Our founder, Karen Green McGowan was a pioneer in the early formative days of the person-centered movement, generating alternative types of intellectual disability support and treatment methods.

Along with developmental disabilities training courses, adult developmental services, webinars and materials, HRS is the sole developer and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with neurodevelopmental disabilities.

Karen Green McGowen, center left, 1985

Karen Green McGowan began her career in nursing in 1963 when she graduated from Methodist Hospital School (now college) of Nursing in Omaha, Nebraska. She joined the United States Air Force and served as a labor and delivery nurse at Malmstrom AFB in Great Falls, Montana.

Her career in the field of intellectual and neurodevelopmental disabilities began at Glenwood State Hospital School, in Glenwood, Iowa, beginning in 1965. In 1972 she transitioned more than 60 children out of Nebraska’s Beatrice State Home into the community over the next several years.

Glenwood State Hospital School

Karen’s specialty has been with persons labeled medically complex, often labeled (without justification) with profound and severe intellectual disability. She has been a clinical nurse consultant since 1977 and provided technical assistance to more than 40 states and 9 Canadian provinces. She has also served as a technical consultant to the Disability Rights International organization and assisted in assessing needs of physically and mentally challenged persons in Romania, Serbia, the Republic of Georgia, Mexico and Ukraine.

Ms. McGowan has served as an Expert Witness in a number of class action and right to treatment court cases, specifically in Louisiana, Alabama, Pennsylvania, Nebraska, North Dakota and New York among others. She has authored a number of developmental disabilities training manuals for clinicians such as nurses, physicians, therapists and direct care professionals, particularly in the area of Physical and Nutritional Management.

In 1992, while working as part of a federal review panel, she became the lead developer of the Health Risk Screening Tool (formerly known as the Physical Status Review), which has become an industry leader in identifying and managing health risks in vulnerable populations.

On January 1, 2015 she assumed the presidency of the Developmental Disabilities Nurses Association (national) and has since retired this position.

Our Mission

“To assist vulnerable persons to achieve a health status and quality of life comparable to that of the population at large.”

Meet Our Executive Team

Dr. Craig Escudé, MD is a Board certified Fellow of the American Academy of Family Physicians and the American Academy of Developmental Medicine. He is the author of “Clinical Pearls in IDD Healthcare” and “The Curriculum in IDD Healthcare”. Dr. Escude assumed the role as President of HRS in 2018.


Dr. Craig Escudé, MD, FAAFP


Johnathon Crumley has nearly 18 years working the field of Intellectual and Developmental Disabilities in the US and Canada. He is a certified Person Centered Thinking Trainer by The Learning Community for Person-Centered Practices. He has been the Senior Director of Operations for HRS since 2013.


Johnathon Crumley

Chief Operations Officer

Sherry has worked over 20 years with individuals with intellectual and developmental disabilities and is board certified in two nursing specialties – Gerontology and Developmental Disabilities. Sherry started working with Health Risk Screening, Inc. as the Clinical Director in 2015.


Sherry Neal, RN-BC, CDDN

Clinical Quality Coordinator

Rob Refo has been with Health Risk Screening, Inc. since 2010. Rob’s background includes 20 years of training and management consulting of private-practice healthcare professionals. Prior to working with HRS, Inc. he was the Senior Director of Operations for one of the fastest growing consulting companies in the United States.


Rob Refo

Chief Revenue Officer

Brandon Lancaster joined Health Risk Screening in 2019 as our Director of Information Technology. Throughout his career he has amassed experience across the field of IT, including Information Security and Platform Development. His primary responsibility here at HRS is to oversee the continued development, implementation, and support of our tools, such as the HRST.


Brandon Lancaster

Chief Technology Officer

Gina Kugler has been with Health Risk Screening, Inc., since 2014 as the Senior Director of Administration. Prior to joining HRS, Inc. she was the VP Finance for a multimillion dollar video distribution company and held that position for 14 years.


Gina Kugler

Chief Administrative Officer

Dina has been in the medical field since 1995. Most of her career has been spent working with individuals with Mental Health needs for a local government in Virginia. She successfully managed four ICF's, five Group Homes and the medical component of the Day Program. Dina joined HRS, Inc. in January 2019 as Director of Client Services.

Director of Client Services

Dina Pizzurro-Smith BSN, RN

Director of Client Services

Have a Question? Call (727) 437-3201

Monday through Friday: 9am-5pm EST