Georgia is the statewide association of over 150 key not-for-profit and
other mission-focused organizations dedicated to providing quality
housing, health care, community-based and other related services for
older Georgians. The mission of LeadingAge Georgia is to represent and
promote the common interests of its members through leadership,
advocacy, education and other services in order to enhance each
member's ability to serve older Georgians.
Conversations with Ginny
When it comes to public policy, there is so much that we can all be excited about. We’ve had great victories in the past like keeping our Life Plan Communities from being burdened by a bed tax, getting the first rate increase for adult day providers since 1999, helping to re-write the regulations for adult day centers and for assisted living communities/personal care homes. We can also be excited about having Katie Sloan, our president for LeadingAge be such a champion of public policy. She believes and I agree, that we need a strong public policy approach for addressing issues on a global level – issues like keeping services viable throughout the continuum of care. We also have traction on the national level thanks to members heeding the call to contact legislators on important issues like protecting Medicaid and Medicare. But, there is more we can do to be effective both on the state and federal level.
I am excited to say that our national association is seeking input of our members for building our legislative agenda for the future. They will be working with us to host a town hall meeting this summer scheduled for July 11th. The meeting will be an opportunity for our members to weigh in on issues we should be championing on the national level. The more members get involved, the stronger our legislative agenda will be in the future! I encourage you to be part of this important meeting!
So much of what gets done in the legislature is done through relationships and we need to make the most of the relationships that we have with legislators. Just this week Robert Boyles, a retired pharmacist and former president of the Pharmacy Association of Georgia went with me to meet with legislators and advocate for an increase in funding for adult day centers. Thanks to Robert’s great relationships in the legislature we had some fruitful conversations with legislators who can help champion our funding request. Robert is living with Lewy Body dementia and if he can make the trek to the Capitol and leverage his relationships with legislators, we can all rise up to the challenge of building on our relationships to further our legislative effectiveness.
We also have an untapped champions - our residents, clients and their families. Constituents matter greatly to legislators and those we serve have relationships that we don’t know about until was ask. This week, a legislator indicated she wanted to champion funding for adult day centers but needed to better understand how the funding is used. While we explained it, we also reached out to Joe Robbins, an adult day center operator in the legislator’s district. In addition to being willing to talk to the legislator, Joe identified a family member of a client who is a big fan of adult day services and a friend to the legislator. With one phone call to the family member, Joe is helping with the lifting of getting funding.
This fall, we’ll host workshops to maximize our advocacy efforts. Together, we’ll build on the outcomes of the town hall meeting. We’ll identify legislative priorities and develop strategies for successes on the state and federal level. We’ll focus on maximizing relationships including opportunities for engaging those we serve in advocacy efforts like hosting meetings with legislators. We will formalize our plans for maximizing our advocacy effectiveness. We would like to hold the workshops in several areas of the state in order to give members across the state the opportunity to engage with advocacy efforts. If you are interested in hosting a workshop please contact me at ghelms@LeadingAgeGa.org.
Elderly Housing Symposium - RESCHEDULED
The Elderly Housing Symposium has been rescheduled to February 28, 2018.
Click HERE to register
LeadingAge GA|SC Annual Conference on Aging
Whether you're seeking continuing education, transformation in your work experience, impactful learning nuggets, deeper dives into topic areas, learning vignettes which incite action, thought leader discussions, or all of the above—join us for the 2018 LeadingAge Georgia Regional Conference on Aging.
Access up to 15 CORE & ETHICS CEU hours for Certification & Licensure: LNHA, SW, HUD, ALC, PCH, CRCF, etc.
Don't want to be left out of the loop, register today to ensure you're in the headquarters hotel venue:
Hyatt Regency Hotel in Greenville, SC
Click HERE for host Hotel Reservations
Conference Workshops & Highlights
Tuesday, April 17
- Pre-conference: Person Centered Dementia Care Deep Dive
- Leading w/Confidence Today & Tomorrow (Strategy for Payment Reform, Care Coordination Partnerships, and Accessing ACOs and Funding Optimization)
- HUD Compliance: "MOR & More for Emerging Leaders"
- Home Care Success for Today & Tomorrow
- Data Driven Person Centered/Dementia-Friendly Care
- Life on Purpose: "Creating and Environment for Workplace Wellness"
- Staffing & Workforce Challenges – The Strategic & Business Implications
Wednesday, April 18
- Building High Performing Clinical Teams - A Case Study
- What every Senior Living Community Owner/Operator Needs to Know about Asset Protection, Tax Reduction, Estate Planning, & Case Law
- Middle Market Challenges
- Business Growth Strategies for Hospice Leadership
- Alzheimer's Disease and Dementia Care: Risks, Regulatory, and Claims
- Financial Fraud and Elder Exploitation: What is the Key to Prevention?
- Compensation/Retention/ Incentives Practices "Thriving in a Time of Attrition"
- Navigating the Course: "The Most Widely Utilized Finance Options"
- Break away Market Growth
- Fund Development in Your Community with Staff of One or None
- Investing in Individuals: The Key to Retaining your Staff
- Blue Design & Biophillia: "Nature-Design Relationships"
- Project Failing to Launch
- Moderately Priced Housing "An Industry Challenge"
- Census Turnaround
- Gift Acceptance Policies
- Religious Accommodations in the Workplace
- Social Wellness Network "Measured Benefits for your Current and Future Residents/Clients"
- Single Site Communities Networking Reception (invitation only)
Solutions Center Exposition -- What's Trending in the Market Place?
University Partners Vignette on "Research and Trends" in the EDU-Lounge
- Dr. Jennifer Craft-Morgan, Georgia State University
- Susan Hildebrandt, LeadingAge
- Dr. Toni Miles, University of Georgia
- Clemson University Speaker
Thursday, April 19
- Ethics in Leadership
- Indoor Air Quality
- Thriving in a Highly Competitive Environment
- "A Primer to Compare the Not-for-profit vs. For Profit Difference"
- Designing Your Digital Presence specifically for Seniors
- "Employees on Purpose – Building a Culture of Lawful Care for Today's Colleague"
- Discover ways to Best Support Residents & Clients with Sensory Disorders as They Age
- From Trepidation to Transformation: Turning your staff into Champions of Resident-based Technology
- Beyond Brick and Mortar "Making the Move into HCBS"
- Facebook for Senior Living: Using Story Telling to Bring your Community to Life
- Corporate Suite Staff & CEO Round Table Panel on Changes in the Workforce…Succession Planning
- HUD REAC Purpose and Preparedness
- Advance Care Planning to POLST: "Your Wishes Please!"
Who Should Attend
Previous LeadingAge GA | SC | AL Conferences have drawn attendees from across the nation. We welcome emerging leaders and those with extensive experience and expertise in the field of aging and professionals from myriad industries which intersect with our field. Expect to network with individuals from across the full spectrum of care. Join us in the spirit of shared learning and discovery, including CEO's, CFO's, COO's, corporate leadership, executive directors, human resources professionals, administrators, licensed nurses, physical plant engineers/maintenance professionals, marketing professionals, occupancy & admissions professionals, certified nursing assistants, therapists, activity professionals, social workers, wellness directors, physicians, dietary professionals, home care/home health professionals and other direct care providers, care managers, elder care advocates, ombudsmen, policymakers, regulators, consultants, chaplains, educators, researchers, and fund developers.
Click HERE for the Attendee Registration Brochure
Click HERE for the 2018 Exhibitor | Sponsor Prospectus
Save Money on MRO
Looking for savings on maintenance, repair and operations? Whether you are in the market for new appliances and air conditioning units or planning to replace cabinets and furniture, let Value First vendors compete for your business.
There are hundreds of contracts in place that cover virtually everything your community needs.
Reduce Ongoing Renovations Expense
If your community does a significant number of unit turns or renovations throughout the year, Value First can work with vendors to negotiate prices on appliances and other items based on anticipated volume for the year. You achieve cost savings based on total quantity rather than one-off discounts. And, items can be drop shipped as needed so you don't have to worry about storage.
- Ceiling Tile
- Fire Alarm Systems
- Nurse Call
- Security Systems
- Wall Protection
- ....and more
Free Cost Studies
Value First members are eligible to have cost studies done free of charge.
- Food and Dietary Services
- Janitorial and Housekeeping
- Medical Supplies
- Office Supplies
Cost studies help to identify potential savings by comparing what you are currently paying to pricing available, for the same products, through Value First group purchasing organization.
Contact your Value 1st Representative
Georgia ▪ North Carolina ▪ South Carolina
For additional information contact your Value First representative Vanessa Ceasar at (404) 421-3956 or send an email to email@example.com. Value First group purchasing is owned by LeadingAge. This is your GPO!
Unemployment Services Trust
Could Your Community be Overpaying?
Last Year, nearly $30 million in potential unemployment liability was mitigated for over 2,200 nonprofits. Prevent your community from overpaying by gaining valuable insights from the latest webinar recording presented by the Unemployment Services Trust (UST).
The short webinar recording reveals the most common unemployment & HR risks and how to combat those risks. In the webinar, UST covers:
- Reducing unemployment tax liability as a 501(c)(3)
- Benchmarking unemployment costs
- Protecting funding from claims and liability
- Efficiently managing unemployment claims, protests, and hearings
- Avoiding costly HR mistakes
- Getting free outplacement services as a nonprofit
LeadingAge has partnered with UST since 2002 to help our members lower the cost of unemployment at their nonprofit. UST's extensive program, created by and for nonprofits is designed to help communities like yours lower unemployment and HR liability.
To find out if UST can help your community reduce paperwork burdens and unemployment costs, submit a free Unemployment Cost Analysis online. Use priority code 2018LA to expedite the process. Should you have any questions, please contact UST directly at 888-249-4788.
back to top
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for April
April 1 Easter Sunday
April 7 National Beer Day
April 15 Income Taxes Due
April 22 Earth Day
April 27 Arbor Day
April 30 Passover
back to top
LeadingAge Georgia Public Policy Report
By Tom Bauer, LeadingAge Georgia Policy Advisor
The 2018 Georgia General Assembly started Monday, January 8th and-as of this writing-is just passed the one-third mark of its 40 day session. The pace on the House and Senate floors has remained very slow. However, in the last few days committees have begun to meet and pass legislation onto the Rules Committees, which set the floor calendars. Also, leadership has set the calendar for the rest of the session, and the legislature is scheduled to adjourn March 29.
LeadingAge Georgia will be working to achieve success on the items in the 2017-2018 public policy agenda. In addition, LeadingAge Georgia will monitor two legislative issues of the Coalition of Advocates for Georgia's Elderly (CO-AGE), dealing with the identification of direct caregivers to vulnerable adults who have a history of abuse.
Public Policy Agenda/CO-AGE
Many of the issues on the public policy agenda for 2017-2018 require work in the executive branch (as opposed to the General Assembly), but immediate attention will be focused on adult day center issues, particularly related to an increase in the Medicaid reimbursement rate under both the Community Care Services Program (CCSP) and SOURCE.
LeadingAge Georgia staff, including President Ginny Helms, have had several meetings with legislators at the Capitol-including the chairmen of both the House and Senate Appropriations Committees- in order to advocate for at least a 5% increase in reimbursement rates for adult day health center providers,
In addition, LeadingAge Georgia is closely following expected legislation to implement one of the priorities of the Coalition of Advocates for Georgia's Elderly (CO-AGE), which carried over from 2017: establishment of an Abuser Registry to help prevent the hiring of caregivers with a known history of abusing vulnerable adults. With the interest of the Department of Community Health (DCH) the issue has evolved into one to require fingerprint checks. Governor Deal's office and DCH are working on a bill, and LeadingAge is waiting to see which direct caregivers are affected, as well as whether it will require fingerprints for exiting-as well as prospective- employees.
It now appears that one of the other CO-AGE priorities- Medicaid Assisted Living, an issue which also touches upon Leading Age's interest in Georgia, i.e., developing a new waiver to serve persons whose needs are less than those requiring nursing home care, will be addressed after the 2018 General Assembly.
Senior Week at the Capitol
LeadingAge Georgia will be participating in Senior Week at the Capitol the week of February 5. A contingent of residents from Clairmont Oaks will come to the Capitol on February 8 to advocate for CO-AGE priorities.
Leadership Academy - First Event (class is full)
February 14, 2018
February 20, 2017
Service Coordinators Forum Call
February 21, 2018
11:00am - 11:30am
Topic : Senior Legal Aid and Advanced Directives Preparedness
1-712-432-6100 Pass code 27514617
Marketing Professionals/Occupany Specialists Webinar
February 21, 2018
Topic: Detaching from the Outcome: How to Make More Sales by Not Selling
Maintenance Professionals Forum
February 22, 2018
Adult Day Services Symposium
February 23, 2018
Elderly Housing Symposium
February 28, 2018
Certified Eden at Home Training
March 6-8, 2018
Assisted Living Symposium
March 13, 2018
Registration coming soon
Leadership Academy - Second Event
March 14, 2018
March 28, 2018
2018 Annual Conference
April 17-19, 2018
back to top
Random Acts of Kindness
In addition to celebrating African American History month in February, I love acknowledging Random Acts of Kindness week. Although Random Acts of Kindness is recognized nationally February 11-17, I affirm it throughout the year. When we give of ourselves through acts of kindness, it has been scientifically proven that we experience everything from life satisfaction to self-realization and our physical health is significantly improved. We live longer, we have less depression and our well-being and good fortune are increased.
As I contemplated the theme of Acts of Kindness, I was reminded of a story about a man who loved his wife, but as a result of his job, he traveled a lot. He very seldom expressed his love for her. On one of the occasions when he was away, she became sick and died. He did not make it home in time before she passed away. As he grieved and was going through her personal items, he found a journal she kept. In reading her entries about how she longed for special time with him and the lavishing of love she wanted to share with him, he wept. It was on his last trip before she died that he had bought a gift he wanted to surprise her with … he had waited too long and it was too late. I remembered this quote by Ralph Waldo Emerson: "You cannot do a kindness too soon, for you never know how soon … it will be too late."
As we age, we have a better appreciation of life and all that it brings. We feel warm inside when we think of the person, someone we may or may not even know who helped us by simply holding a door open as we approached, maybe gave us a friendly smile in passing, or someone we had not been in touch with for a while who called just to say hello and see how we were doing. How would those acts of kindness make us feel?
Did you know it has been scientifically proven that acts of kindness are good for your health! There was one study from the University of California Berkeley, Greater Good Science Center that found when we help others, we feel more energetic. Those in the study also reported they felt more calm and less depressed and felt an increased feeling of self-worth. When we perform acts of kindness, we are happier and according to research from Emory University, we experience what is called the 'helper's high.' Those who help others have fewer aches and pains. According to author Christine Carter, "Giving help to others protects overall health twice as much as aspirin protects against heart disease."
There are so many benefits of performing acts of kindness, be they random or planned. I also want to include, we have to be kind to ourselves. I was talking with a friend who was agonizing over a particular thing they wanted to do for themselves, but basically expressed discomfort in going through with the idea.
They were concerned about the other things they could be doing for family members or friends. It was something that would enhance their performance and avid love for their hobby. After open discussion, I asked, when was the last time you did something kind for yourself? They had always put other before themselves and was not enjoying their own life and indulging in the passion that made them happy. The moral of the story, let us perform random and/or planned acts of kindness for others not just during one week within the year, but all year round, and let us not forget to be kind to ourselves!
Submitted by Carolyn L. Hartfield
Certified Healthy Lifestyle Coach & Outdoor Adventure Leader
Speaker, trainer and writer
Carolyn is a 2016 recipient of the LeadingAge Georgia Profiles in Positive Aging Award, representing AARP. She was selected as a National Association of Professional Women VIP of the year (2016-2017); In January 2017 she was featured in the Atlanta Journal Constitution (AJC) newspaper, has been interviewed on several radio programs and on the Trinity Broadcasting Network (TBN) for airing during Older Americans Month in May 2017. She is the founder of Hartfield's Hikers, Older People with Active Lifestyles (OPALs) and Walk Outdoors for Wellness! (WOW!). For more information about Carolyn, visit her website at www.CarolynHartfield.com or send her an email at CH@CarolynHartfield.com
back to top
2018 CCNG Advisory Group Meeting Dates & Update
Friday, April 20, 2018 | 9:30am – noon | Location: TBA
Friday, August 24, 2018 | 9:30am – noon | Location: TBA
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Certified Eden at Home Associate Training
Space is limited.
This annual certification will be offered at Lutheran Church of the Redeemer in Atlanta March 6-8, 2018.
Over 200 LeadingAge Georgia members have become Certified Eden Associates over the last four years. Members continue to use the information, materials, and principles in their planning, programming, and to support organizational change to become more person-centered.
This 3-day training empowers participants to serve as change agents, prepared to infuse person-directed practices into the daily operations of their organizations. Participants learn how to apply the Eden Alternative Ten Principles in all settings to create a life worth living for all members of the care partner team. Since education is central to this process, Certified Eden at Home Associates are also prepared to facilitate Eden at Home Care Partner Workshops, a turn-key learning experience designed to share Eden at Home concepts with a variety of care partners (employees, family members, volunteers, and the Elders themselves). Certified Eden at Home Associates focus on inspiring care partners to build collaborative teams that include the active participation of the Elders themselves.
Grant funds are available via the Georgia Institute on Aging thanks to support from Alliant Health Solutions, Inc.
These funds are limited and will provide for a $200 per person refund for no more than two people per LeadingAge Georgia member organization as long as funds last
NOTE: Members receiving grant funds must be able to attend all three days of the certification, must arrive on time and stay for the full day.
If you want to use grant funds, please check with Susan Watkins at LeadingAge Georgia to make sure funds are still available (swatkins@LeadingAgeGA.org).
Register directly with The Eden Alternative and forward your completed registration receipt to Susan Watkins at LeadingAge Georgia (swatkins@LeadingAgeGA.org) to receive your refund.
Early Bird Rate: $495 (sign up 10 days or more prior to training)
Group Rate: $475 (4 or more people from same organization)
NOTE: If you register 4 staff, remember you can only access $400 of grant funds to cover the first two.
NAB approved for 19.5 CEU hours
Click HERE to register
2018 Adult Day Services Symposium
Agenda includes information and updates on the following:
- Regulations and Surveys
Elaine Wright, GA Department of Community Health
- Public Policy Roundtable
Ginny Helms, LeadingAge Georgia; Ned Morgens, Skylark Senior Care; Claire Russell, The Homeplace
- Medicaid Non-Emergency Transportation Update
James Peoples (DCH, Medicaid Transportation)
- Various Shared Learning Topics
Click HERE to register
2017 GADSA Leadership Team
President: Claire Russell, The Homeplace
Vice-Presidents Public Policy: Ned Morgens, Skylark Senior Care;
Aysha Cooper, SarahCare of Snellville
Vice-Presidents of Members: Carla Jones, Rosswoods; Peggy Padgett, Georgia Infirmary Adult Day Health
2018 Training Events
February 20, 2018 GAAP Winter Symposium
Register now for our kick-off event at Redeemer Lutheran Church.
Topic: Care Plan: "GAAP Stantdard of Care in Documentation and Planning for Residents and Client Engagement"
Click HERE to register
July 20, 2018 GAAP Summer Symposia - Save the Date
Activity and Life Enrichment professionals are a critical asset to creating an environment for lives worth living in the senior living and aging services arena.
That's why we're happy to announce the return of the Georgia Associaiton of Activity Professionals! Your significant involvement will ensure the future of this great organization contiues its mission of providing Activity Professionals with quality and affordable opportunities for professional development and personal growth.
2018 GAAP Leadership Team
President: Scott Bassett (Philips Tower, Decatur) firstname.lastname@example.org
Vice-President: Amanda Bennett (Campbell-Stone Sandy Springs; Atlanta) email@example.com@campbellstone.org
Membership: Melissa Scott-Walter (A.G. Rhodes Health & Rehab; Atlanta)firstname.lastname@example.org
Program/Education: Liana Sisco (Lutheran Towers; Atlanta)email@example.com
So much of the success of Activities professionals depends on the networking and ideas shared by those of us "in the trenches". Opportunities for collaboration with peers, in addition to the vendors and speakers, helps to expand our knowledge, our inspiration, and our personal emotional investments in our communities. Every community is different, to be able to attend events that encourage the sharing of our success stories and positive experiences, is vital for the industry as a whole.
- Amanda Bennett, Campbell-Stone Sandy Springs
LeadingAge Georgia Business Connection
The Cost of the Health Care Work Force One of the biggest factors health care providers deal with, when it comes to cost, is labor. Retention, hiring, recruiting and training are all factors that go into the labor cost. Also, since the ACA has been implemented the cost of benefits has risen dramatically in most areas. It is estimated that labor costs make up at least 60 percent of a health care organizations budget (Attendance on Demand, 2015). The very complicated balance faced by all health care providers is reducing labor cost without risking the quality of care being provided. In 2011, the oldest Baby Boomers (defined by those born between 1946 and 1964) began celebrating their 65th birthdays and each day through 2029, 10,000 more will cross that threshold nationwide. As this demographic trend plays out, there will be an increased demand for services providing care for the elderly, with a significant shortage of staff available, (PHCA, 2017).
Key Drivers of Labor Cost in Long Term Care
By 2024, the state of Maine's long -term care industry will need more than 1,900 new workers, from caregivers to administrators, a figure eclipsed only by those needed for hospitals and ambulatory care centers. A rapidly aging workforce, anemic birth rates and declining migration trends all are reasons for concern, a Maine Department of Labor report concluded, (McKnight's, 2016). Complicating matters is an anticipated higher unfilled number of needed specialist slots, attributed the higher nurse wages to a shift in payment and care models, which means new career opportunities for these professionals; and many senior nurses retiring, which puts pressure on facilities to find senior nurses to replace them.
The shift in the reimbursement model is also pushing for organizations to hire more Registered Nurses and Mid-levels over LVN/LPNs that have been utilized heavily in the past. Due to shortages of good consistent staff, wages for lead CNAs rose by 3.09%, to $13.96 an hour, while take-home pay for non-certified nurse aides, also called resident assistants, increased by 3.5%, to $10.90 an hour. Nationally there is an enormous demand for CNAs (Berger, 2017).
It has also been reported that there is not necessarily as big of a "shortage of licensed staff" as reported but an actual shortage of the staff we are willing to hire. For starters, there's increasing pressure for hospitals and other institutions to hire nurses with more education. Decades ago, nurses with an associate's degree (RNs) were reasonably certain of being hired. Today, in Houston, where associate degree nurses make up 40% of newly licensed nurses, it's tough to even get an interview (Newman, 2016).
Possible Solutions to the Staffing Crisis and Excessive Labor Cost
Compensation is critical, to be competitive for the best and most qualified staff an organization must be willing to be competitive with wages. A recent B.E. Smith survey found that compensation was the second most important factor in deciding whether to remain at an organization, (Berger, 2017). Also having a great impact is the competition between long term care providers and hospitals. While a nurse in a hospital may make an average of $35 per hour, it's $30 an hour in a nursing home, according to the Bureau of the Labor Statistics (Newman, 2016). Rural providers also increasingly have a tough time luring and keeping staff. Many families are unwilling to relocate to rural areas and have a difficult time justifying a long commute.
Future Changes That Could Have an Impact
With the move to a value based payment system that looks more like each setting especially long- term care will be significantly decreasing length of stay while increasing the acuity levels in their buildings, the need for increased education and preparation is here. Utilizing new models with the opportunity to create new positions that may be very skilled unlicensed staff. While there are mid- levels on hand to oversee the care. New models like the household models are decreasing the amount of staff but decreasing ratios of licensed staff per patient. The Green House Model is one that has found ways to incorporate a home like setting while patients continue to get skilled quality care with proven successful outcomes.
The long and the short of it, is those that are willing to be flexible will be able to find ways to survive. Those that cannot shake the protocols and staffing patterns of the past will more than likely be left behind. We must begin thinking outside of the box, looking at opportunities to train various staff members to perform duties that may have been done by multiple people in the past. As well as using unlicensed staff to perform carry over activities and working to achieve outcomes that are very goal directed by the licensed staff. Being creative and being flexible and looking at associations with those that were previously viewed as strange bed fellows will create partnerships that save money, improve quality and produce the necessary outcomes.
Attendance on Demand (2015) Long Term Healthcare Trends, Managing Labor Costs. Retrieved from https://attendanceondemand.com/.../longtermhealthcare-laborcosts.pdf
Berger, L. (2017) Salaries for Admins $107k, DONs $93k. Retrieved from http://www.mcknights.com/news/salaries-for-admins-near-107k-dons-93k/article/698222/
Jones, A. (2017) The Cost of Health Care Work Force. Retrieved from https://www.linkedin.com/post/edit/6341092130756321280
PHCA (2017) The Need for Long Term Care Continues to Grow. Retrieved from https://www.phca.org/for-consumers/research-data/long-term-and-post-acute-care-trends-and-statistics
2600 Compass Road; Glenview, IL 30026
Tax Reform Act Overview
Nick Rider, CPA with Mauldin & Jenkins gave the LeadingAge Georgia board a great overview of the changes in the tax code based on the Tax Reform Act of 2018. Three topics that might be of particular interest to our members are the changes in medical expense deductions, the new charitable contribution limitation and individual tax rates and brackets. The good news is the 7.5% medical expense deduction threshold for medical expenses is temporary for 2017 and 2018. The charitable contribution deduction limitation increase to 60% will require members to have even better messaging on the value of mission based services. The changes in the individual tax rates and brackets will result in deductions for most income brackets. However, since there are changes in what is allowed for deductions you may want to share the information with your employees in case they care to adjust their tax withholdings.
Nick Rider generously agreed to share his Power Point presentation with our members. Click here for the presentation.
The Georgia Institute on Aging, LeadingAge Georgia's continuing education arm, is proud to be in partnership with the following industry leaders and experts. These are significant corporate giving partners who help to sustain the mission of the Institute through the provision of underwriting support and scholarships.
They are equally committed to our mission to deliver quality, affordable, leading-edge continuing education, information, and professional development—to ensure that Georgia's talent force, working in the full spectrum of aging services, are prepared and leaders in their craft.
We are fortunate to have a knowledge center fully focused on senior living and related services to enrich the quality of life for older Georgians. Likewise, our corporate giving partners are key collaborators in our success. Please read their profiles and connect with them for solutions within your organization:
Mauldin & Jenkins has provided audit, accounting, tax, and consulting services since 1918. We are committed to providing professional resources to the healthcare and nonprofit industries. Our culture, from the beginning, has been to provide top quality service to every client. Since the firm's inception in Albany, GA we have added offices in Atlanta, GA, Macon, GA, Birmingham, AL, Bradenton, FL and Chattanooga, TN.
Specialties: Accounting | Auditing | Tax – specializing in Not For Profits, Healthcare, Nursing Facility Billing Consulting and Training, Medicare and Medicaid Cost Reports, Reimbursement Consulting, and Receivable and General Ledger Outsourcing. The Firm also serves financial institutions, government entities, entrepreneurial services, closely-held businesses, construction companies, employee benefit plans, individual and estate tax services, manufacturing, real estate, and information assurance services
Jeff Fucito is the Partner-in-charge of Mauldin & Jenkins, LLC's Atlanta office and is the Firm's Not-for-Profit practice leader. Since joining the Firm in 1986, Jeff has specialized in providing audit and tax services to not-for-profit organization. Jeff is past Committee Chair of the Georgia Society of CPA's Not-for-Profit Training Task Force and a past board member of the Georgia Institute on Aging. Jeff has recently presented on not-for-profit tax topics to the Georgia Center for Nonprofits and the Georgia Independent College Association. Jeff resides in Kennesaw, Georgia with his wife Jennifer and their 3 children. Jeff frequently speaks on nonprofit topics, is a trainer for the Georgia Center for nonprofits, he has significant healthcare expertise in reimbursement and financial reporting with over 30 years of experience.
Shannon MacArthur, CPA, is a partner with Mauldin & Jenkins, LLC. Shannon received his BAcc and MAcc degrees from the University of Mississippi in 1998 and 1999 and now lives in Atlanta. Shannon joined Mauldin & Jenkins in 2000 as a staff accountant in the audit department. In his years with the Firm he has become primarily involved with the nonprofit and benefit plan practices, as well as HUD compliance auditing. He provides services in auditing and accounting, tax and consulting. Shannon is a member of the American Institute of Certified Public Accountants, the Georgia Society of Certified Public Accountants, and the Georgia Society of Association Executives.
Value First Inc. is member-driven solution to purchasing in the aging services field. It gives you access to local service and national pricing while supporting your state associations. A jointly owned venture among LeadingAge and 25 State Associations, you can enroll in this program with no commitment and no purchase obligation. Value First will perform free cost studies for members to show all the areas of potential savings.
Learn more by clicking HERE.
Vanessa Ceasar, Southeast Regional Representative
LeadingAge/Value 1st Marketing
Georgia-North Carolina-South Carolina
404-421-3956 | firstname.lastname@example.org
Vanessa Ceasar is the LeadingAge/Value 1st group purchasing organization representative for Georgia, North Carolina and South Carolina. She has over 20 years experience working with nonprofit organizations and in municipal government. Prior to moving to Georgia, Vanessa was the Director of Purchasing & Accounting for New York City's Dept. of Parks and Recreation where she was responsible for allocating the expense budget for all five boroughs (Manhattan, Brooklyn, Queens, Bronx and Staten Island), and for negotiating equipment and material contracts for operation of the city's 28,000 acres of municipal parkland and 14 miles of public beaches.
Georgia-Pacific Professional (GP Pro) is one of the world's leading manufacturers and marketers of tissue, pulp, paper, packaging, building products and related chemicals. The company employs more than 30,000 people at approximately 300 locations in North America and South America.
Beth Gunter, Strategic Accounts Executive
GP Pro | Georgia Pacific
133 Peachtree Street, 36th Floor
Atlanta, GA 30303
Hekman Contract, a division of Howard Miller Clock Company, is an industry leader in design, manufacturing, and insight into the senior living market. Headquartered in West Michigan, Hekman Contract offers unique and compelling products which span resident rooms, dining rooms, lounge areas, theaters, and accent pieces. Products are meticulously designed and crafted in consideration of the diverse needs in senior living. Producing world class products that are fully functional, aesthetically relevant and offer lasting durability is the essence of Hekman Contract..
Bryan Durkis, Principal
Southeast Contract Sales, LLC
2135 A Defoor Hills ROad
Atlanta, GA 30318
Click here for more
Headquartered in Charlotte, NC, DHG ranks among the top 20 public accounting firms in the nation. With more than 1,800 professionals in 12 states, we combine deep experience with a strong commitment to personal service. We are passionate about helping our clients succeed—and we do so through a resourceful approach to solving problems, providing solutions and helping our clients achieve their goals. For those healthcare organizations that wish to thrive in this new economy, they stand at a tipping point where the strategy and tactics they employ today will profoundly impact their opportunity for success in the years to come.
Keith Seeloff, CPA, Partner
Dixon Hughes Goodman LLP
191 Peachtree Street NE, Suite 2700, Atlanta, GA 30303
Keith is the leader of the Senior Living Practice and has more than 30 years of experience in the healthcare industry, with a focus on the senior living industry. Keith and his team provide business and financial advisory services such as strategic planning, financial forecasting, market demand analysis, third party reimbursement, operational audits and systems review. He has been a key participant in more than 100 continuing care retirement community (CCRC) development projects, including startup communities, existing campus repositioning and obligated group financings. Keith has conducted financial analyses of merger and acquisition transactions and financing structures to include valuations, due diligence, projection and market feasibility analyses for proposed and existing CCRCs, assisted living facilities, skilled nursing facilities and other retirement housing projects. Keith is a member of AICPA and LeadingAge. He is an accomplished presenter on topics affecting acute care facilities, skilled nursing providers and home health agencies. Keith holds a B.S. degree in accounting from Ball State University.
Metz currently has more than 160 food service and environmental service accounts in 14 states. Our dining management and environmental services put customers and their guests first. Unlike other foodservice management companies, we are a step ahead of dining and nutrition trends. We constantly adapt our operations, menus, environments and marketing strategies to meet the needs of your guests as well as your organization. Our restaurant-centric approach isn't an accident. We get first-hand knowledge from the franchise brands we operate around the mid-Atlantic region including T.G.I. Friday's, Ruth's Chris Steakhouse, Wolfgang Puck Express and Krispy Kreme. You can expect expertly-made food with the freshest produce, meats and high-quality ingredients when you choose us to assist with dining management. Or, let us help you keep your facilities and property clean, green and attractive with our environmental services. No matter the need, our family-owned and operated business delivers outstanding service adapted for your community and workplace. Let us offer that extra-personal touch.
Environmental Services includes keeping your facilities and property clean, green, and attractive. Designed to keep your facilities looking top-notch, Metz's environmental services include housekeeping, linen and laundry and interior and grounds maintenance.
Metz Culinary Management
Metz Culinary Management is making a concerted effort to expand in the South with the hiring of Jack Brill as Vice President of Business Development for the company's Southern accounts, which include clients in healthcare, long term care, colleges, universities and independent schools. Brill has more than 25 years of progressive experience in the retail and foodservice industry. He has worked with multinational food corporations, independently owned family-run operations and military programs in addition to owning and operating two foodservice companies. Past responsibilities also include national sales management, sales force training and distributor program selling.
Parker Young Construction, Inc. and FireStar, Inc. are independent sister companies with the single common goal of providing superior service to our commercial, residential, government and military customers. Whether working as a team or independently, both share the knowledge and expertise gained from over 25 years of serving as the premiere disaster repair contractor in Georgia and the Southeast. No other company offers the same degree of experience, quality and unsurpassed service our customers come to expect from Parker Young Construction.
A Parker Young Company
Jessica Schmidt is a Major Account Executive at
The Southeast's leader in disaster recovery management, Parker Young Construction, Inc. is the most certified emergency mitigation and restoration firm in the state of Georgia. Her role as Major Account Executive focuses on supporting residential, commercial and Senior Living communities with emergency mitigation, restoration, and construction services for a one stop shop approach to your emergency preparedness and business continuity planning.
Pfizer is a leading research-based biopharmaceutical company. We apply science and our global resources to deliver innovative therapies that extend and significantly improve lives. We make medicines and vaccines that help people when they are sick and prevent them from getting sick in the first place, as well as some of the world's best-known consumer healthcare brands. Every day, our colleagues work in developed and emerging markets to treat, cure and eradicate life-threatening conditions and challenge some of the most feared diseases of our time. Pfizer also collaborates with healthcare providers, governments and local communities to support and expand access to reliable, affordable healthcare around the world. Specialties: To apply science and our global resources to improve health and well-being at every stage of life. We strive to provide access to safe and effective and affordable medicines and health care services to the people who need them.
Melissa Bishop-Murphy, JD, MBA | Senior Director
Mobile: 770 547 1374
Melissa Bishop-Murphy is Senior Director of National Government Relations and Multicultural Affairs for Pfizer, Inc. She is responsible for regulatory, legislative and public policy matters at Pfizer, Inc. Ms. Bishop-Murphy has extensive work experience throughout the Southeast, Washington, DC and Delaware. Prior to her position as Senior Director, she was Director/Team Leader of government relations for the Southeast region of the United States that included the District of Columbia, Virginia, Florida, South and North Carolina, Alabama, Tennessee, and Georgia. She currently lobbies in Georgia, South Carolina, and North Carolina. Additionally, Ms. Bishop-Murphy works nationally to build multicultural coalitions to advocate for greater access to healthcare and pharmaceuticals. She co-chairs Pfizer's Multicultural Center of Excellence.
We are Select Rehabilitation, the leader of rehabilitation professionals. Employing more than 8,000 employees and providing services to approximately 600 facilities throughout 31 states, our company has become one of the nation's premier leaders in contract rehabilitation services. We provide comprehensive physical, occupational, and speech therapy services with qualified licensed professionals in a variety of geriatric clinical settings. Our therapeutic programs emphasize patient-focused, outcomes-driven care that allows patients to achieve and maintain their highest quality of life. We are
Nationally Recognized Clinical and Financial Outcomes therapy organization. To achieve this honor, our regional management teams provide unparalleled daily oversight and support to each client site we service. Our intense focus ensures that no stone is left unturned, no RUG level is missed, no long-term care resident's therapy needs go unmet, and ensures each Select Rehabilitation team maximizes clinical and financial outcomes. Our efforts have earned us an outstanding reputation of providing superior customer service to our clients through dedicated and reliable partnerships. We are proud to be the LeadingAge Georgia Partner for Therapy Services since 2007.
Amy Jones, Director of Business Development, Select Rehabilitation
2600 Compass Road; Glenview, IL 30026
Amy Jones is a former COTA that has been working in Long Term Care for over 20 years. Starting out as a CNA in a rural nursing home Amy's passion for the geriatric population grew into a career. Working in the Rehab industry since 1996, Amy has covered multiple states working in both operations and business development. Amy Lives in Oklahoma and is currently pursuing a degree in Long Term Care Health Care Administration. Amy is currently with Select Rehab and is responsible for the growth of services in 7 states including marketing guidance and support for current clients.
Shaw Industries Group, Inc. offers a diverse portfolio of carpet, hardwood, laminate, resilient, tile & stone flooring products, synthetic turf and other specialty items for residential and commercial markets worldwide.
Headquartered in Dalton, Georgia, Shaw is a wholly owned subsidiary of Berkshire Hathaway, Inc. The company employs more than 20,000 associates with offices; R&D, manufacturing, warehousing and distribution locations; product showrooms; and/or salespeople throughout the U.S., as well as Australia, Brazil, Canada, Chile, China, India, Mexico, Singapore, United Arab Emirates, and the United Kingdom. For more information, visit our corporate page.
As a global floor covering brand, Shaw Contract believes in the impact of design and how to improve how people work, learn, heal and live. Driven by sustainability, our Cradle to Cradle Certified products perform in spaces across the world. The brand has received Best of NeoCon Awards 14 out of the past 15 years and is rated "best overall business experience" by facility managers and designers. The brand is also recognized among Contract magazine's top ten "Brands that Inspire." A brand of Shaw Industries, Shaw Contract combines the expertise of the world's largest carpet manufacturer with the financial stability of a Berkshire Hathaway subsidiary.
Kevin Bettis, Account Manager
1555 Peachtree Street NE Suite 150
Atlanta, Georgia 30309
770 547 1374 (mobile)
Our mission is to start a chain reaction in which we positively impact our community one person at a time by providing technology enhanced therapies that protect and enhance the quality of life for people living with memory loss, their loved ones and caregivers. While medication may sometimes be helpful in treating Alzheimer's disease and memory disorders, the risk of side effects can often outweigh potential benefits. We looked at the risks of these medications and knew there had to be a better way. Using a blend of time-tested therapies and technology, we developed a way to improve quality of life without medications. Relaxed/Calm, Happy, Reassured, Regular and Healthy Appetite.SimpleC is based on the following therapy types music, validation, trusted voice, and reminiscence therapy.You want the best for your residents and SimpleC can help. Many products offer to entertain or solve a specific problem, but few products offer a solution to improve quality of life. We can help each of your residents – From the SimpleC Companion, where we focus on a managed daily routine, healthy habits, celebrating a life story and family interaction; to our Community Connect, where we focus on bringing your community together for activities, entertainment and sharing memories and experiences. Where specialists and training may be costly and difficult to maintain over time with new team members, SimpleC is easy to use and affordable.
Chief Executive Officer
300 Galleria Parkway, Suite 720; Atlanta, GA 30339
Dan has been transforming Senior care through media based non-drug therapy that materially improves quality of life for, and assists in the care of, seniors suffering from memory loss due to age related dementia for over a decade.
We truly believe THW is a unique firm. We are composed of people who are dedicated to serving other people, our clients and the community. Design excellence, attention to detail, financial stability and personal service have made THW a firm valued by clients throughout the country. Our specialties: Architecture, Land Planning, Landscape Architecture, Interior Design, Purchasing, Strategic Planning, Design Led Design Build, Senior Living Design.
Think Forward, and you take a more integrated approach to design, a more comprehensive approach to planning. You work harder to anticipate market change, opportunities, and risks. You design for the whole of life and for sustainability. You bring world class innovation to over 900 commissions in 23 states and four foreign countries.
Jim Hudgins, President
2100 Riveredge Pkwy., Suite 900
Atlanta, GA 30328
As President of THW Design, Jim is involved in all aspects of firm operations as well as manages many of our projects. He has over 30 years of experience in providing master planning and architectural design services for senior living projects. The only reason we've been able to pioneer so many innovations is that our clients are willing to think forward with us. We're grateful for them and for the many opportunities they have given us.
Ziegler is one of the nation's leading underwriters of financing for not-for-profit senior living providers. Ziegler offers creative, tailored solutions to its senior living clientele, including investment banking, financial risk management, merger and acquisition services, investment management, seed capital, FHA/HUD, capital and strategic planning as well as senior living research, education, and communication.
Tad Melton, Director
ZIEGLER INVESTMENT BANKING
4801 Cox Road, Suite 102 | Glen Allen, VA 23060
Phone 804-793-8487 | Cell 804-334-5810
Tad Melton is a Director in the senior living practice at Ziegler. He joined the firm in November 2012 and has 17 years of investment banking experience working with senior living and healthcare borrowers in the Mid-Atlantic and Southeastern United States. Prior to joining Ziegler, Tad had a highly successful career in healthcare and senior living finance with BB&T and UBS Paine Webber. He has served as day-to day banker on approximately $2.75 billion of financings for CCRCs, assisted living facilities, skilled nursing facilities, and hospitals. Project scope included start-ups, repositionings, refinancings, acquisitions and divestitures. In the context of such experience, Tad has direct experience with fixed-rate debt (rated and unrated), variable rate debt (bank loans, BQ loans, variable rate demand bonds), bond ratings, reinvestment contracts, interest rate swaps, and third-party credit enhancement. Tad is a graduate of Randolph-Macon College, where he studied economics and history. He is a member of the Professional Development Committee of Leading Age South Carolina and serves on numerous boards in his local community.
Value-based Population Health
Assessing the terrain in value base population health management
Series 2 of 5
In the early 1800s the names Frederick Tudor and Nathaniel Wyeth were synonymous with the commercial ice shipping business. After learning of the first shipment of ice from New York to Charleston South Carolina in 1799 these two men decided this was their opportunity for fortune. Aware of the tremendous demand for ice in tropical locations their combined innovations, persistence and business savvy allowed them to dominate this industry. Frederick Tudor designed and developed insulating materials that reduced the melting of ice in transport from 66% to less than 8%. He then established ice houses for all his major markets to aid in the preservation and distribution of their product. Nathaniel Wyeth designed a mechanical device that could cut ice more consistently then the manual technique allowing more efficient and effective stacking of the ice once harvested. Their success fueled the growth and profitability of the ice shipping industry. As demand for sources of natural ice grew processes developed to maximize the identification and harvesting of this resource. One account suggests that by 1847 one thousand tons of ice was being removed from Henry David Thoreau's Walden Pond daily1. After suffering early financial setbacks they went on to control the majority of ice shipping in the world and set the price for their product. Both men would leave behind considerable fortunes upon their deaths.
In 1803, while Tudor and Wyeth were attempting to monopolize the collecting and distribution of natural ice, Thomas Moore was being issued a patent for the first refrigeration unit. By 1834 John Hague had developed a working refrigeration device using compressed vapor. In 1844 Dr. John Gorrie designed an air cycle refrigerating machine for making ice and by 1855 Alexander Twining had constructed the first commercial ice making plant in Cleveland Ohio2. Records show that in 1921 there were 5000 mechanical refrigerators produced in the US and that 80% of American farms and 90% of city residences had one of these devices in 19501. In the space of 150 years the ice shipping industry had gone from providing an indispensable commodity for an evolving middle class to near obsolescence. The tectonic shift that dethroned the ice business was driven by the Industrial Revolution and the technological advances it brought which made the efforts invested in ice shipping supply chain efficiency outmoded and irrelevant.
The healthcare industry in America has likewise undergone tremendous change as a result of the Industrial Revolution. One of the best chronicles of that change is Paul Starr's book The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry. For those interested in a deeper dive in the evolution of America's fee-for-service care delivery model I recommend it highly. Starr makes note that physicians were generally the first in most communities to purchase automobiles and telephones because both of these devices increased their availability to clients and turnaround time for service delivery. He also brings insight as to why a payment model based on monetization of units of care would evolve from a fragmented delivery model taking shape in a new Republic built on capitalism. But as the responsibility for the cost of care shifted largely from the individual receiving the services to first the employer of the individual to a government sponsored tax payer underwritten model the treatment of disease evolved from a community specific service governed by colloquial social contracts to the corporatization of American Medicine.
But the history of population health management predates fee for service payments or the American colonies and contributes significantly to the story of modern day medicine. It is a fact that for all the attention that is generated with the advent of new drug therapies or invasive procedures for the health-related maladies that plague mankind today the greatest reductions in deaths from diseases throughout written history are largely due to our collective ability to identify and document the cause of the congenital or acquired conditions and, where possible, mount society supported efforts to eliminate or eradicate them. The mobilization of the communities of Europe during the bubonic plague of the 1300s, the use of Variolation in Africa in the 1700s to provide immunity from smallpox, the eradication of the London Cholera epidemic of 1854, the 1860 publication of The etiology, concept and prophylaxis of childbed fever by Ignaz Semmelweis which led to the widespread practice of routine handwashing by physicians, iodization of salt in 1924 to reduce thyroid disease, the fortification of bread with niacin in 1934 to reduce pellagra, the enrichment of milk with Vitamin D in the 1930s to reduce rickets, the addition of fluoride to community water supplies in 1945 to reduce tooth decay, the vaccines for polio, German measles, diphtheria, and influenza, the Framingham heart study, the eradication of blindness from guinea worm infestations, safety belts for automobiles, the detection and removal of colon polyps to reduce colon cancers and the distribution of clean needles and condoms to reduce the spread of HIV. None of these advancements would have been possible in the absence of the collection, aggregation, analysis, reporting and utilization of data on populations of afflicted individuals in conjunction with a perception of the benefit to society at large from the reduction of illness from these conditions. The importance of this element of the transformation of medicine is critical. First because all of these are examples of primary and secondary prevention-based interventions versus treatment for an individual. Of equal importance, no direct transactional benefit is accrued to the individuals allocating the resources to support them. These advancements are not possible without first understanding the cause of the condition and then designing, developing and deploying resources first for the benefit of those at greatest risk for acquiring the affliction and, as is often the case, on reducing the burden of illness on those in the earliest stages of affliction. Many of these interventions have their origins in the military. Most of them required a level of organizational structure, processes and outcome monitoring and management beyond the singular scope of even the best practitioners of their day. All of them were aided by the marshalling of the resources of society either through civic, non-profit or governmental support for the benefit of the community at large.
The true origin of population health management, then, lies here; in the understanding that even as we have evolved newer methodologies to treat and cure diseases it is our society-funded advancements in prevention and early detection that have led to the greatest decreases in human suffering. Regardless of your political proclivities the evidence here suggests that it takes a village to eradicate or control the greatest health threats to a population. The one patient at a time business model of fee for service medicine evolved alongside and benefitted from the collective wisdom gained from managing community health issues. The aggregation and management of victims of tuberculosis led to the specialty of thoracic surgery, the treatment of injuries in the theater of war led to the field of trauma surgery, the development of antibiotics and the use of helicopter transport for emergency medical services. But with each new diagnostic and therapeutic modality the cost of health care escalated to the point where the expense incurred from the treatment of one individual with a severe illness could exhaust the generational wealth of an entire middle class family. The desire to reduce the risk of financial ruin from catastrophic illness was, in part, the genesis of employee sponsored health insurance. The subsequent belief as a nation that American seniors should be protected from destitution related to the cost of medical care led to the establishment of the single-payer, national social insurance program known as Medicare.
The introduction of Medicare Part A and Part B in 1966 were game-changers for low-income seniors in communities around America and, frankly, for the hospitals and providers that had served them for years without compensation. Prior to the establishment of this citizen-funded, government-managed health insurance option many of these seniors had been turned away from some hospitals or impoverished due to the cost of treatment for a catastrophic illness. But as beneficial as Medicare was its Fee for Service model led to misaligned incentives by compensating for the treatment of illness and not the prevention of disease. The predictable consequence spawned the medical industrial complex, with the design and development of larger brick and mortar medical treatment infrastructures, the buying up of providers of care and the arms-race-like acquisition of health centered technologies to attract and retain this new revenue stream. Early on it became evident that the system as implemented provided little supervision with regard to over-utilization of diagnostic and therapeutic resources, showed disregard for site of service as a variable in care delivery and rewarded poor performance by paying for complications and their resultant prolonged hospitalizations. The financial impact was so great that many of the medical groups, hospitals and drug manufacturers that were opposed to the passage of Medicare in the beginning became less vocal in their protestation of "government intervention in health care" as they began to reap the benefits of more patients with the ability to pay for the increasing cost for their services. By 1973 Congress and the President were enacting legislation in an attempt to manage the rising costs of government funded health care. But despite the best efforts of the executive and legislative branches U.S. healthcare costs as a percentage of Gross Domestic Product continued to grow at non-sustainable rates. This backdrop sets the stage for the tectonic shift in the U.S. healthcare landscape euphemistically known as managed care.
The epochal shift in the health care terrain is being driven by the convergence of three distinct but related factors in managed care: 1) the lack of personal accountability of a large segment of society for their health and well-being, 2) the realization that the fee for service employer-based and government sponsored insurance models reward the treatment of disease vs the prevention or reduction of illness and has led to the current medical industrial complex and 3) that the cost of primary or even secondary prevention of illness is cheaper than treatment by orders of magnitude for most conditions. Health policy in the United States for the last 45 years has been shaped around the second and third of these factors. We have not focused on the first because as a society we lack the desire or the capacity to hold individuals accountable for the modifiable risk factors that drive the majority of preventable deaths in this country. It is a fact that diet, sedentary lifestyle, obesity, smoking and alcohol are the cause of the majority of premature deaths in this country. We have decided as a nation to hold the providers and underwriters of health care costs accountable for increasing the engagement, education and empowerment of individuals with regard to their health.
All substantive health policy in the U.S. since the Health Maintenance Organization Act of 1973 has attempted to shape U.S. health care based on these two premises. The legislative solutions have attempted to catalyze the collaboration of payers, providers and high performing integrated care delivery system by ratcheting down the pool of inflation adjusted per capita dollars available for total cost of care. The architects of these social engineering policies are aware that the current state individual provider's practice, designed for optimization of the fee for service model, lacks to tactics, the team and the tools to successfully meet the performance and quality benchmarks to be competitive in this new environment. One recent study observed that for the average primary care provider with a panel of 2300 members it would take 21 hours a day for them to provide all of the annual acute, chronic and preventive care functions necessary for their membership3. Health policy architects are counting on market forces to drive the evolution of new symbiotic relationships while eliminating non-competitive models and rewarding those that lower costs, improve quality and enhance the experience of the member receiving care. The most sweeping and recent of these solutions is the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. The stated intend of the legislation is to improve access, increase quality and lower the cost of health care through (among other mechanisms) moving the majority of government sponsored health payments to value-based compensation and away from volume based fee for service compensation. As could be expected all major commercial health plans have quickly followed this trend.
So while the Fee for Service based health care delivery industry has invested time, talent and resources toward maximizing profits in a volume-based, unit-cost maximizing, specialist incentivizing, complication rewarding treatment of disease-based business model the payers of health care are economically catalyzing an antithetical care management model that rewards prevention, health maintenance and reduced utilization of services. As in the case of the ice shipping service and refrigeration these two models could co-exist together for a time. But in the same way that the Industrial Revolution gave the refrigeration proponents a competitive advantage over the ice shippers, the Information Revolution that the electronic age as spawned will provide opportunities to change health care delivery in ways that have yet to be imagined. And those changes are not 100 years into the future but are happening today.
Simply stated health care providers today are first and foremost in the information management business. The successful emerging health care organizations will be the ones that collect, store, analyze, report and utilize health information in a manner that delivers the most value to health care consumers and payers. The tactics for doing so and the importance of population health in achieving this goal are the topic of the next installment in this series.
3Annals of Family Medicine; www.annfammed.org; VOL. 10, NO. 5; SEPT/OCT 2012 396
By: Michael Vincent Smith, MD
News Throughout the Spectrum of Aging Services
Assisted Living Communities/Personal Care Homes
Assisted Living Communities Top Nursing Homes for Caregiver Pay
Assisted living communities pay staff nurses (RNs), licensed practical nurses and
certified nurse aides more than do nursing homes, on average, according to the 20th annual "Assisted Living Salary & Benefits Report," published by the Hospital & Healthcare Compensation Service.
Federally Assisted Housing (HUD-Subsidized)
HUD Security/CyberAwareness Annual Training Updated
EIV users are required to complete online security training annually as outlined in HUD Notice H 13-06. To meet this requirement, EIV users must complete the new online CyberAwareness Challenge 2018 training program. At the end of the training, EIV users must save, print and maintain the Certificate of Completion provided.
LeadingAge Submits Three-Year Certification Interim Rule Comments
As previously addressed, HUD is implementing FAST Act provisions that, among other things, allow public housing agencies (PHAs) and multifamily housing owners to conduct less-than-full income and asset verifications for families with 90 percent or more of their income coming from fixed-income sources, so full verification will only be required every three years instead of annually. This interim final rule takes effect on March 12 for owners who wish to take advantage of the new flexibilities.
Home and Community Based Services
2018 Brings Major Changes to HCBS for Veterans
Even though we have seen a positive move towards the use of community home health services by the Veteran's Health Administration, there has been challenges in ordering and paying for adult day services, non-emergency transportation and hospice through the VA CHOICES program and the VA Extended Care budget. Also, the inconsistency in policy concerning utilization and payment of adult day services, and non-emergency transportation has also been a barrier for Veterans to obtain needed services.
Cuts Threaten National Program that Transitions Seniors out of Nursing Homes
Money Follows the Person, a 12-year-old program that helps seniors and people with disabilities move out of nursing homes, may run out of money. The National Council on Aging Monday called the initiative "one of the longest running and most successful Medicaid demonstrations," noting that it has helped more than 75,000 people in 47 states since it was enacted in 2006.
Medicaid Home Care Demand Grows, States Grapple with Spending
More long-term care spending is going toward home- and community-based services (HCBS), according to a recent survey of all 50 states and the District of Columbia by Kaiser Family Foundation. Through the three main Medicaid HCBS programs in 2014— mandatory state plan home health services, personal care services, and Section 1915 (c) waivers—nearly 3.2 million people received services. Forty-seven states offered 287 waivers, which allow states to expand financial eligibility and offer HCBS to seniors and people with disabilities who would otherwise qualify for institutional care.
Life Plan Community/CCRC
How One CCRC Transformed Vacancies into Great Local Publicity
In senior housing, it may prove worthwhile to consider vacant units as unique
opportunities, as opposed to just empty space waiting to be sold. That's exactly what happened recently at Henry Ford Village in Dearborn, Michigan. The continuing care retirement community (CCRC) is the largest of its kind in Michigan as well as the thirdlargest CCRC in the country, with 854 independent living apartments and approximately 900 current residents across all of its care settings.
New Bundled Payment Model May Leave SNFs at Disadvantage
A new voluntary bundled payment model announced this week doesn't focus on costsaving innovations in the long-term care setting and limits benefits for those providers, observers said January 10th. The Centers for Medicare & Medicaid Services Center for Medicare and Medicaid Innovation announced the long-awaited Bundled Payments for Care Improvement Advanced, or BPCI Advanced, on January 9th.
Trump Administration Eases Nursing Home Fines in Victory for Industry
The Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury, part of a broader relaxation of regulations under the president. The shift in the Medicare program's penalty protocols was requested by the nursing home industry. The American Health Care Association, the industry's main trade group, has complained that under President Barack Obama, federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.
Alzheimer's Association Issues New Guidance for Dementia Care in Nursing Homes
The Alzheimer's Association published new recommendations meant to shape
dementia care practice at nursing homes, assisted living facilities and other long-term care and community care providers. The recommendations, posted online and to be published as a supplement to the February issue of The Gerontologist, outline 56 recommendations across 10 content areas.
How Amazon Could Take on Home Care Amazon (NYSE: AMZN) is entering the health care market, and its momentum could carry the retail giant into the home care space. Watching Amazon's actions and guessing at next steps has become a spectator sport, and as the home health care space is in the midst of a major consolidation period, industry players are looking for opportunities to both benefit from Amazon and defend from potential competition.
Expect Labor Challenges to Continue in 2018: Report Expect continued modest growth of approximately 1.5% in the senior living workforce this year, according to Argentum's "Senior Living Labor & Workforce Trends: 2018 Forecasts" report. By comparison, the industry added jobs at a 2.9% average annual rate between 1990 and 2016, states the report, which makes projections using data from the Bureau of Labor Statistics.
Nearly 100% of Caregivers Ready to Leave Jobs At Any Time The competition for labor is old news for many home care agencies, but the number of workers who are ready to jump ship might be surprising even to industry veterans. Specifically, 65% of caregivers are "always looking for a better job," while 97% are open to a job opportunity at any given time, according to new research findings from myCNAjobs.com, a company of Healthcare Research. MyCNAjobs, which is based in Chicago, offers a suite of recruitment tools for senior care workers.
Provider Finds Formula to Beat Industry Averages on Retention Though some senior living providers must focus solely on higher wages or robust benefits to attract and retain top industry talent, that's not the case at Presby's Inspired Life. The Lafayette Hill, Pennsylvania-based nonprofit, which has four senior living communities and more than 30 affordable housing properties in and around the greater Philadelphia area, recently reported that 41% of its workforce had been with the company for five or more years. The faith-based organization also currently has a 24% turnover rate, which falls below such industry benchmarks as the 31% national assisted living turnover rate reported in the latest Assisted Living Salary & Benefits Report from the
Hospital & Healthcare Compensation Service.
Donating Unused Medications
Did you know that you could be donating your unused medications instead of destroying them?
Georgia's long-term-care sector destroys millions of dollars worth of perfectly good medications each year! By opting to donate these medications instead, communities can save valuable staff time, reduce destruction costs, and improve the health of fellow Georgians.
Donation is legal thanks to the passage of HB 897, which created the Georgia Donated Drug Repository Program allowing nursing homes, assisted living, and other organizations to donate unused medications. Donated medications must be unexpired, non-controlled, and in unopened packaging, which includes "bubble" packs with some pills still un-popped.
Watch this WSB/ABC Channel 2 Evening News story to see how this new program is already helping Georgians!
If your community would like to start donating, register with the nonprofit SIRUM here www.sirum.org/register-to-donate/. SIRUM will help train your staff and coordinate your donations. To find out more, download this information packet or contact Gina De Biasi at email@example.com or 650-488-7434.
The Next Big Thing at 2018 CES: Gadgets with an Older Crowd in Mind Every year, CES — that's the Consumer Electronics Show — unveils the world's latest and greatest in technology. Many of the "wow" items are often aimed at younger consumers who are willing to pay dearly to be early adopters. But this year, serving an aging population safely and efficiently emerged as an early, and possibly lucrative, theme.
CAST Releases Cyber Security White Paper CAST has released a Cybersecurity White Paper and a Benchmarking Questionnaire to help LeadingAge members and other aging services organizations understand what cybersecurity threats are, how to mitigate risks, and how to respond if attacked. The Benchmarking Questionnaire will help providers identify best practices, and where providers may be at risk, so that they can work to plug those vulnerabilities.
3 Technology Integration Lessons for Senior Living in 2018 As senior living providers continue to embrace technology to deliver the most up-to-date care techniques, five areas of tech will be booming in 2018: wearables, Internet of Things, telemedicine, voice activation and security. More important than any one technology, though, is how they work together.
Administrator - Calvin Court
See full job description at: http://leadingagega.org/jobmart/public/job/213/
Chief Operating Officer - A.G. Rhodes Health & Rehab
See full job description at: http://leadingagega.org/jobmart/public/job/211/
Director of Operations - Athens Community Council on Aging
See full job description at: http://leadingagega.org/jobmart/public/job/212/
Home Services Director of Nursing - Lanier Village Estates
See full job description at: http://leadingagega.org/jobmart/public/job/210/
Executive Director - Campbell-Stone Apartments
See full job description at: http://leadingagega.org/jobmart/public/job/208/
Executive Director - Wesley Woods of Newnan
See full job description at: http://leadingagega.org/jobmart/public/job/207/
back to top