2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Diane Packard Presiding 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Secretary/Treasurer’s Report Kevin G. Cox 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Nominating Committee Report Randy Uzzell 2012-2014 Slate of Officers Chair First Vice Chair Secretary/Treasurer Hospital Affiliated Vice Chair Independent Owner Vice Chair Cheryl Clapp-Coleman Kevin Cox Phillip Hill Renee Rizzuti Jim Martin Clapp’s Nursing Center Autumn Corporation Principle Long Term Care Carolinas HealthCare System Tullock Management Company Multi-Facility Vice Chair Non-Proprietary Vice Chair National Multi-Facility Vice Chair District I Vice Chair District II Vice Chair District III Vice Chair District IV Vice Chair District V Vice Chair Member-at-Large Member-at-Large John Barber David Kidder Steven Jones Vickie Beaver Paul Babinski Denise Clapp-Campbell Gary Trullinger Joan Garvey Chris Bryson Mary Beth Turman White Oak Management, Inc. Carolina Adventist Retirement Systems Kindred Transitional Care & Rehab-Raleigh Choice Health Management Services Liberty Healthcare Rehabilitation Services Clapp's Convalescent Nursing Home Sava Senior Care Liberty Healthcare Rehabilitation Services UHS-Pruitt Corporation Principle Long Term Care 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Report From Capitol Hill Neil Pruitt AHCA: “Forwarding our Commitment to Quality” Neil Pruitt, Jr. AHCA Chair AHCA Strategic Plan Strategy 1 – Redefining the Consumer Experience Quality as an expectation Focus on customer service Strategy 2 – Becoming Part of the Solution New relationships with CMS Proactive political relationships Strategy 3 – Thinking Differently New payment models Embrace the spectrum of services AHCA Strategic Plan Strategy 4 – Promoting Technology Re-launch LTC Trend TrackerSM on a new platform Enable members of all sizes to evaluate and adopt technology that advances quality and promotes efficiency Strategy 5 – Being Present Member participation in grassroots Member participation in quality initiatives New AHCA Quality Cabinet AHCA Board of Governors endorsed establishing a new overarching Quality Cabinet AHCA Quality Cabinet will coordinate and direct our collective efforts to advance quality of care and quality of life issues Mary Ousley – former AHCA Chair and 2011 Friend of Quality awardee – will serve as Chair Howie Groff – Former AHCA BOG Member and NCAL Chair – will serve as Vice Chair AHCA’s Quality Cabinet will help to guide efforts of AHCA’s: Quality Improvement Committee Clinical Practice Committee Survey/Regulatory Committee Workforce Committee Consumer Experience Strategy 1: Redefining the Consumer Experience Overall Consumer Satisfaction Overall Workforce Satisfaction Compiled from opinions of 90,576 residents and 140,828 family members Compiled from opinions of 257,676 employees Source: The 2010 National Survey of Consumer & Workforce Satisfaction in Nursing Homes conducted by My InnerView. Strategy 1: Redefining the Consumer Experience Since 2009, nursing facility health survey citations have been on a steady decline and have dropped nearly a full percentage point in two years Every Medicare and Medicaid certified nursing facility in America must be surveyed once every 15 months Conference Committee Action on Payroll Tax Cut and Doc Fix • Extends payroll tax cut and physician fee schedule until 12/31/12 • Therapy cap exceptions process continues until 12/31/12 • SNFs are a pay-for through a reduction of bad debt coverage − Dual eligibles reduced over three years 2013 at 88% 2014 at 76% 2015 at 65% − Non-duals will be reduced this year from 70% to 65% Bad Debt Opportunities • AHCA and its Finance Committee will work on budget neutral options to present to policymakers in an effort to limit the impact of the bad debt • AHCA to produce state-by-state data for state affiliates to help them fend off additional cuts from Medicaid • Any action will take place at the end of the year so Members of Congress will need to be educated on these options in advance President’s Budget • Challenges − − − − − Reduce Medicare bad debt payments Penalty for hospital readmissions Threat to market basket Lower provider tax rate Blended FMAP rate formula • Opportunities − Site neutral bill − AHCA’s hospital readmission proposal Strategy 2: Becoming Part of the Solution Some at CMS, on The Hill and most advocacy groups view the sector as an obstacle to improving quality CMS has rejected our notion that we are the cost and quality solution: “analysis of recent quality measure data related to rehospitalizations, for example, which appears in the March 2011 Report to Congress suggests that quality of care within SNFs has not been improving….We (CMS) do not agree …that shifting patients…to a SNF setting is necessarily more beneficial to the patient…” (SNF PPS Final Rule, August 2011). Strategy 2: Becoming Part of the Solution Proving our commitment to improving quality demands that we have better ways to measure our progress Developing better outcome measures that can validate our claims and document our quality efforts is essential AHCA will lead the quality issue by adopting significant quality efforts and programs Strategy 3: Thinking Differently Beginning in fiscal year 2012, CMS will rank hospitals based on 30-day readmission rate for the top three diagnoses causing the majority of readmissions: Heart attack Heart failure Pneumonia Hospitals that fail to meet CMS’ rehospitalization standards will have a percentage of total Medicare payments withheld: 2013: up to 1% 2014: up to 2% 2015: up to 3% Source: Sections 1151 and 3025 of the Patient Protection and Affordable Care Act CMS Five Star System Percent of Facilities Survey Star Rating Ranked within each State <20 >20 and <43.33 >43.33 and <66.67 >66.67 and <90 >90 Percentiles Bottom 20 percent within a state Top 10 percent (facilities with lowest survey score) within a state AHCA Proposed Five Star Proposed recommendations to revise Five Star rating system Expand domains of measures used Hospitalization Rehab Satisfaction Expand measures within existing domain Add turnover and retention Change weights for each domain Use targets/benchmarks to assign star rating rather than percentile ranking Strategy 4: Promoting Technology LTC Trend Tracker provides members with the ability to benchmark their quality, clinical and financial data Domains - Staffing, Rehospitalization, Survey Findings, Medicare Cost Report, Medicare Utilization, Retention and Turnover, Resident Characteristics, Five Star Ratings, Five Star Staffing Participants – 581 organizations; 4,061 facilities Utilization – 1,300 reports per month (Jan. through Aug. 2011) up from 800 reports per month in 2010 LTC Trend Tracker Growth Multi and Single Organizations 2010 – 2011 700 581 600 500 388 400 346 300 200 235 175 2010 2011 213 100 0 Multi Single Total Strategy 5: Being Present AHCA Board of Governors Adopted Three Quality Principles: I. Improvement in four clinical measures which are meaningful, measurable, and moveable: 1. 30-Day Hospital Readmission 2. Customer Satisfaction (Post-Acute and LTC) 3. Staff Turnover 4. Antipsychotic Rx Reduction II. Development of a Therapy Outcome Measurement System III. Promote Proactive Payment Models (January retreat) AHCA will not be successful without the full support of our members October 2011 Public Education MOTION: To formally replace the term “nursing home” with “skilled nursing care,” augmented by centers where appropriate, to describe our profession. Breaking the Nursing Home Paradigm State-of-the-Art Rehab Suite Aquatic Therapy Pool Private Suites Restaurant-Style Dining Rooms Sitting Rooms Spa Movie Theater Coffee Shop Internet Cafe Breaking The “Nursing Home” Paradigm “The system should not overpay for certain patients, which creates incentives for nursing homes to spiff up their buildings and set staffing levels to entice profitable patients. I encourage CMS to continue taking steps to address these issues.” - Stark Thank You! 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC CON Construction Rules Kristi Huff Certificate of Need • House Select Committee on Certificate Of Need Process and Related Hospital Issues • Committee Charge: – To study House Bill 743 and House Bill 812; – The legal requirements and process governing DHHS determinations on applications for CON including an analysis of exceptions granted under policy AC-3; – Issues related to publicly owned hospitals including the appropriate role of State-owned hospitals; – Whether a hospital operating under a Certificate of Public Advantage (COPA) should be required to comply with the same rules, policies and limitations to each county in which it operates; – The extent to which a publicly owned hospital should engage in business with an entity having a COPA or operating under an exemption under the CON laws of the state; – Any other matter reasonably related to the above. Certificate of Need (continued) • 3 public hearings across the state: Fletcher, Mt. Holly, and Wilmington • Topics of discussion include: – Appeals process – Raising monetary thresholds in the law for diagnostic centers, major medical equipment, renovations, expedited reviews – SHCC Appointments made by Governor and legislature – Whether State Ethics Act should apply to the SHCC – Transparency in the CON process Construction Rules Review • Governor’s Executive Order 70: identify rules that are burdensome, duplicative, or impose unnecessary costs • Nursing Home Physical Plan Rules review – meeting with Construction Section and DHSR leadership Construction Rules Review (continued) • Areas likely to be changed: – Exempt certain small projects from a plan review (and fee) – Eliminate references to a “nurse’s station” or nursing unit in the rule – Bath/shower rooms – for every 120 beds – Soiled utility/soiled linen rooms – Handrails – maximum opening between handrails of 12 feet 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Payment For Services John Barber Sam Clark What’s Up With Our Medicaid Rates? • There has been some confusion and uncertainty surrounding nursing home rates. • The state is currently working on a State Plan Amendment that will address multiple rate changes. • NCHCFA will review the SPA before it is sent to CMS for approval. What’s Up With Our Medicaid Rates? Provider Assessment Increase • The provider assessment, currently assessed at an overall rate of approximately 5.5%, will be increased to 6%. • The increase will be approximately $1 per nonMedicare day. • The effective date of this change will be January 1, 2012. • Medicaid rates will be increased to repay the provider the Medicaid portion of the assessment. What’s Up With Our Medicaid Rates? Case-Mix Adjustments • The frozen case-mix will be unfrozen and the rates effective April 1, 2012 will be adjusted for acuity using the December 31, 2011 snapshot date. • Quarterly CMI adjustments will resume beginning on July 1, 2012. What’s Up With Our Medicaid Rates? Rate Reduction • The current 3.51% rate reduction will be adjusted to an amount needed to achieve a 2.17% average reduction for the state fiscal year (July 1, 2011-June 30,2012). • This will be effective January 1, 2012. • The rate reduction will be adjusted again effective July 1, 2012 to ensure that the annual reduction in SFY 2013 will be 2.17% plus the impact of any other adjustments approved by the legislature. Fair Rental Value • Aging of facilities • April Updates – Cost per square foot $142 increased to $147 – Most location factors will increase Medicare Bad Debt • The final agreement on Medicare "doc fix" legislation will reduce Medicare reimbursement for uncollectible bad debt, but not as much as in the bill originally passed by the House last fall. • Section 3201 - Reducing Bad Debt Payments – This provision would phase down the bad debt reimbursements to 65 percent beginning in FY2013 for providers who are currently being reimbursed at 70 percent, while phasing in the reduction to 65 percent over three years for those who are reimbursed at 100 percent of their bad debt. (88%, 76%, 65%) • Effective for cost reports beginning on or after 10/1/12. • The legislation also extends the therapy caps exceptions process through December 31, 2012. National Issues • Mike Cheek with AHCA will be addressing more of the national issues during the Tuesday morning session. HMS Credit Balance Reviews • HMS has completed their first round of reviews. • Most of the findings have involved – Resident monthly liability in the month moving from Medicare to Medicaid – Medicare Part C Co-insurance paid by Medicaid for dual eligible residents • NCHCFA recently met with the State and HMS on the outstanding issues. • HMS is getting ready to start round two. Medicaid RACs • Medicare RACs have been around for several years, but have been concentrating on hospital issues. • States are required to contract with Medicaid RACs. • NC is preparing an RFP. • Can’t review items that have already been reviewed. Cost Report Audits and the MDS Reviews • The audits of the 2009 cost reports have been called off. • The MDS reviews continue. – MDS reviews of snapshot dates not used for setting rates are purely educational. Rates are not adjusted. – After the M&S audit was completed, they choose multiple REHAB RUGs from the CMI report, asked to see the Start of therapy, END of therapy dates and the log showing they were treated. These are strictly information gathering audits that DMA has asked them to do. It is not reflected on the report she gives to center and she says she has no idea of what the purpose of the audits are. She has just been told to gather the data. Medicaid Cost Report Transition • The Medicaid cost report as you have known it is no more. • NCHCFA and other interested parties are currently working with DMA. • Moving forward, nursing homes will – Use the Medicare cost report, 9/30 year end not required – File supplemental schedules to account for certain Medicaid specific items – More information to come Ask-the-Contractor Teleconference Palmetto GBA had to cancel the February 9, 2012, J11 Part A Ask-the-Contractor Teleconference (ACT). The rescheduled date and time for this ACT is Wednesday, February 22, 2012, from 2 p.m. to 3 p.m. ET. Conference Call Information • Teleconference Number: (866) 449-7848 • Confirmation Code: 52721579 Keeping Up-to-Date • Providers should be receiving electronic notices from CMS, Palmetto GBA and Medicaid electronically. • Our weekly newsletter, UPDATE, in the next several issues will list how to sign up for these important items. 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC President’s Report J. Craig Souza 2012 Convention & Trade Show Trade Show SOLD OUT for 30th Consecutive Year “Thank You TRADE MEMBERS!” 2011 Full Registrations 402 2012 Full Registrations 345 Future Meetings 2012 Mid-Year Meeting August 14-17, 2012 Marriott Grande Dunes Myrtle Beach, SC 2013 Convention and Trade Show February 10-13, 2013 Greensboro, NC 2013 Mid-Year Meeting August 6-9, 2013 Marriott Grande Dunes Myrtle Beach, SC 2014 Convention and Trade Show February 23-26, 2014 Greensboro, NC Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2005-2010 • • Conducted and published by the Department of Social & Behavioral Sciences at the University of California San Francisco. Released in October, 2011 – Offers calendar year data of the following: • Facility characteristics • Resident characteristics • Nurse staffing (RNs, LVNs, and NAs) hours per resident day. • Data on facility deficiencies based on state surveyor evaluations. Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2005-2010 • North Carolina skilled nursing facilities champion quality improvement and have instituted best practices that are working to transform the health care system for the frail and elderly. • This report reflects that as the level of resident need increases and nursing home residents become more medically complex. North Carolina continues to provide the highest level of care and is scoring better than the national average in almost every category. RESIDENT CHARACTERISTICS • AVERAGE SUMMARY SCORE FOR RESIDENT ACUITY USING THE MANAGEMENT MINUTE INDEX 2005 NC 116.70 US 102.20 • 2006 114.90 101.60 2007 114.90 101.30 2008 111.16 99.91 2009 107.46 96.74 2010 104.46 91.62 North Carolina scores decreased from 116.70 in 2005 to 104.46 in 2010 but have consistently remained above the national average. In 2010, the Average Acuity Score for an NC resident was 12.84 points above the national average. FACILITY DEFICIENCIES FROM STATE SURVEYS FINDINGS - DEFICIENCIES FROM QUALITY OF CARE EVALUATION 2005 PERCENT OF FACILITIES WITH NO DEFICIENCIES NC US PERCENT OF FACILITIES RECEIVING A DEFICIENCY FOR ACTUAL HARM OR JEOPARDY OF RESIDENTS NC US 2006 2007 2008 2009 2010 79 percent increase. 6.34 5.51 6.60 6.03 8.21 6.24 14.66 6.86 14.75 6.63 11.35 6.11 25 percent decline. 25.61 25.97 25.47 27.70 20.77 26.57 17.07 25.68 17.56 24.67 19.15 23.36 FACILITY DEFICIENCIES FROM STATE SURVEYS Percent of Facilities with Deficiencies 2009 2010 PHYSICAL RESTRAINTS 60 percent decline from 2005. NC US 8.67 10.78 2.84 8.79 NC US 13.82 20.35 13.00 20.23 NC US 9.60 21.15 11.35 19.69 NC US 0.47 2.84 0.00 2.89 DIGNITY 29 percent decline from 2005. HOUSEKEEPING 39 percent decline from 2005 SUFFICIENT NURSING STAFF PRESSURE SORES 10.21 percent below national average. NC US 10.07 21.16 9.22 19.43 ACCIDENT ENVIRONMENT 19.31 percent below national average. NC US 24.59 45.43 23.40 42.71 Average Full Time Equivalents/HPPD –Staff (12/2011) RN US FTE 7.43 NC HPPD FTE 0.41 7.35 LPN 14.94 0.83 15.53 0.85 NA 44.32 2.42 43.13 2.42 Total 66.13 3.66 67.20 3.67 HPPD 0.40 Government Performance Results Act Restraints % Year - NC / Region / Nation 2003 – 9.4 9.4 7.7 2011 - 2.5 3.4 2.7 Change rate in % 73.4 63.8 64.9 GPRA Pressure Ulcers - % Year NC / Region / Nation 2003 – 10.1 9.4 8.9 2011 - 8.4 7.8 7.4 Change Rate% 16.8 17.0 16.9 Five Star Rating Five Stars: Four Stars: Three Stars: Two Stars: One Star: Dec 2011 16.4% 27.3% 20.0% 19.7% 16.6% Dec 2010 15.8% 25.6% 20.8% 19.4% 18.4% Dec 2009 10.8% 26.0% 21.2% 18.6% 23.4% P R E S I D E N T ‘S 2013 BUDGET Skilled Nursing Provisions “Reduce Medicare Coverage of Bad Debts”…would reduce bad debt payment to 25% for all eligible providers beginning in 2013. Savings: $36 billion over 10 years. “Phase Down the Medicaid Provider Tax Threshold Beginning in 2015”…proposes to limit taxes on health care providers to help finance the State share of Medicaid program costs by phasing down provider tax threshold from 6% to 3.5% beginning in 2014. Savings: $21.8 billion over 10 years. “Apply a Single Blended Matching Rate to Medicaid and CHIP Starting in 2017” …Proposes to replace current FMAP formula with a single matching rate specific to each State that automatically increases if a recession forces enrollment and State costs to rise beginning in 2017. This would result in the State’s share of Medicaid to increase and the federal share to decrease. Savings: $17.9 billion. P R E S I D E N T ‘S 2013 BUDGET Skilled Nursing Provisions “Encourage Efficient Post-Acute Care” ….gradually realign payments with costs through adjustments to payment rate updates in 2013 through 2022. Savings: $10.16 billion savings by 2017, $56.67 billion over 10 years. “Adjusting SNF Payments to Reduce Unnecessary Hospital Readmissions”…..reduces SNF payments by up to 3% beginning in 2016 for facilities with high rates hospital readmissions. Savings: $1.95 billion by 2022; $460 million by 2017. “Strengthen the Independent Payment Advisory Board (IPAB) to Reduce Long-Term Drivers of Medicare Cost Growth” HOUSE AND SENATE REACH AGREEMENT ON PAYROLL TAX CUT & SGR Skilled Nursing Provisions 1. Section 3005 –Outpatient Therapy Caps - (summary) Extends the therapy cap exceptions process through December, 31, 2012. Adds requirements for physician review of the therapy care plan. Spending caps ($1,880 in 2012) would be extended to hospital outpatient departments. HHS is to collect data to assist in reforming payments for therapy services. MedPAC to recommend improvements to outpatient benefit to reflect the individual needs of patients. 2. Section 3201 –Reducing Bad Debt Payments – (summary) Phase down bad debt reimbursements from 100% for dual eligibles to 65% beginning in 2013. Reduction of 12% in 2013, 12% in 2014 and 11% in 2015. NC General Assembly Medicaid Day Weighted CMI 1.0800 1.0600 Medicaid Case-Mix Index 1.0400 1.0200 1.0000 0.9800 Not used for rates 0.9600 June 2003 CMI .94 September 2011 CMI 1.07 0.9400 0.9200 Jun-03 Jun-04 Jun-05 Jun-06 Jun-07 Jun-08 6/30/03 through 9/30/11 Jun-09 Jun-10 Jun-11 Jun-12 MDS Reviews % of Facilities Over Adjustment Threshold (facilities subject to rate adjustment) 90% % of Reviews Over the Unsupported Threshold 80% 77% 2004-5 was the first year of the review process. These reviews were educational in nature and no rates were adjusted. 70% 60% 50% 40% 29% 30% 18% 20% 14% 13% 11% 10% 2009-10, 25% 2010-11, 25% 10% 0% 2004-5, 40% 2005-6, 40% 2006-7, 35% 2007-8, 25% 2008-9, 25% Review Period and Corresponding Re-RUG Threshold Average Occupancy 95% 90% 85% 80% 75% 70% 65% 60% 55% 50% 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 US 87.50% 86.60% 86.70% 86.50% 70.90% 85.10% 85.30% 84.90% 83.40% 83.40% 83.40% NC 91.70% 90.10% 90.50% 89.20% 89.50% 89.20% 88.80% 88.70% 88.00% 87.10% 86.70% Average Medicaid Rate Graph $170 Rebasing 1/1/08 and 10/1/08 $160 147.84 $150 $140 137.88 135.28 139.06 $130 FRV Implemented 1/1/2007 $120 $110 $100 2.3% increase 1/1/11 156.51 159.88 156.90 149.22 3.51% reduction 7/1/11 158.85 155.11 $550 Average NC Medicare Rate $500 483.85 469.22 $450 417.87 $400 $350 $300 424.82 Medicare Average LOS 50 NC Continues to have a higher Medicare length of stay than the US. 45 Days 40 35 30 25 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 US 38.11 37.2 38.06 38.16 38.09 37.69 37.87 37.86 37.1 37.23 36.89 NC 44.32 44.26 44.15 45.77 44.87 43.36 42.41 41.06 38.01 40.66 39.79 Medicare Utilization 16% NC Continues to have a higher Medicare utilization than the US. 14% Medicare Percentage 12% 10% 8% 6% 4% 2% 0% 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 US 8.30% 9.10% 10.20% 11.10% 11.90% 12.60% 13.00% 13.10% 13.50% 13.60% 13.70% NC 9.90% 10.80% 11.90% 13.00% 13.40% 14.20% 14.10% 14.30% 14.40% 14.50% 14.90% New Faces in State Government After November Election** • • • • New Governor New Lieutenant Governor New Secretary of DHHS 3 New U.S. House Members – Reps. Myrick, Miller and Shuler not running • 8 New N.C. Senate Members • 28 New N.C. House Members **As of February 16, 2012 General Assembly Outlook, 2012-2013 Issues on the Horizon • Medicaid Budget • Managed Care • Certificate of Need Changes (Appeals, Composition of SHCC, Thresholds) • Mental Health Care • Health Benefits Exchange Have You Contributed to the PAC? TOP PACs in N.C. 2009-2010 Election Cycle 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ….. NC ADVOCATES FOR JUSTICE PAC (Trial Lawyers) NC MEDICAL SOCIETY PROGRESS ENERGY EMPLOYEES CAROLINAS PAC BANK OF AMERICA PAC NATIONWIDE CAROLINA POLITICAL PARTICIPATION FUND NC FARM BUREAU PAC NC REALTORS PAC NC HOSPITAL ASSOCIATION EASTERN BAND OF CHEROKEE INDIANS DUKE ENERGY CORPORATION PAC 31. NC HEALTH CARE FACILITIES PAC (NCHCFA) $530,400 $355,000 $344,500 $339,200 $302,000 $294,550 $294,500 $277,250 $272,500 $246,500 $98,500 Who Is FutureCare? A statewide non-profit leader in focusing on technology, innovation and best practices in longterm care. FutureCare of North Carolina is a subsidiary nonprofit of the North Carolina Health Care Facilities Association. FutureCare of North Carolina Board of Directors Chris Bryson UHS- Pruitt Corporation Ken Burgess, Chair Poyner Spruill Gerald P. Cox Autumn Corporation Dr. Gordon DeFriese Former President and CEO of FutureCare Cheryl Geddie Haymount Rehabilitation and Nursing Center Dr. Laura Gerald NC State Health Director Ted Goins Lutheran Services for the Aging Polly Johnson North Carolina Foundation for Nursing Excellence Deborah Lekan Duke School of Nursing Dr. Darlyne Menscer Carolinas Healthcare System Diane Packard Rehab and Health Care Village Green William A. Pully NC Hospital Association Robert Seligson NC Medical Society Randy Uzzell Britthaven J. Bradley Wilson BCBSNC Jeff Wilson Long Term Care Management Services J. Craig Souza, Vice Chair NCHCFA Samuel Clark, Secretary-Treasurer NCHCFA Polly Godwin Welsh NCHCFA Cameron Graham Executive Director Mandy Richards Program Director FutureCare Staff Contact Information Cameron Graham FutureCare of North Carolina Mailing Address 5109 Bur Oak Circle Raleigh, North Carolina 27612 919.782.3827 E-mail cameron.graham@futurecarenc.org Our mission is to improve the quality of long-term care for all North Carolinians for the elderly and disabled, with a special focus on skilled nursing care. Mission Future Care of North Carolina seeks to achieve its goals by bringing together leaders from across the state from within the long-term care field: researchers, health care foundations, policymakers, quality improvement organizations, and corporations. In order to achieve this mission, we need your INPUT and SUPPORT! • Develop nursing staff to expert level in order to reduce unnecessary emergency room and hospital admissions Goals • Prepare potential residents and family members to access quality and innovative care • Increase access to technology and innovative solutions in long-term care • Educate the citizens of North Carolina (and lead the nation) on best practices in long-term care Current Programs 1. Medication Error Management Training for Skilled Nursing Staff Using a High-Fidelity Mannequin Simulator 2. Mouth Care Training for Skilled Nursing Staff AHCA’s Public Education & Communication Campaign NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION 2012 Business Meeting North Carolina Health Care Facilities Association Raleigh, NC Chair’s Report Diane Packard