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
"Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction, and skillful execution; it represents the wise choice of many alternatives." William A. Foster
LeadingAge Georgia members continuously amaze me with efforts aimed at promoting well-being for older adults. Within the week, an executive director at a life plan community was telling me that his community implemented an evidence based falls prevention program and a director for a HUD affordable senior housing development told me his company is now requiring all staff to take mental health first aid classes.
There are plenty of programs coming up that will help you and your team as you strive to help older adults live well and thrive. A very wise woman who has been serving older Atlantans through her in-home care agency Georgia for over 30 years said that untreated pain associated with chronic conditions is a much bigger problem than we realize – that it causes sleeplessness, leads to anxiety, agitation and causes people to withdraw from the things that bring them joy. She also said we all need to do a better job of utilizing palliative care for managing chronic conditions and enhancing well-being. We heard her and the Culture Change Network chose to make palliative care the focus of our upcoming summit on September 27th. There will be scholarships for CMS approved nursing homes through Civil Monetary Penalty Funds and a limited number of scholarships for LeadingAge Georgia members through grants so please mark your calendars. The CMP scholarships include funds for travel for staff in nursing homes outside of Atlanta. Expect the training to be a person-centered holistic approach to palliative care. There are also CMP scholarships available for staff in nursing homes for Eden training so please check the locations and dates for this training.
Our national conference is coming up October 28-31 and I hope you put this on your calendar. You will have access to sessions that tackle current issues and strategic thought-leadership including: Leadership and Organizational Strategies; Technology and How It Relates to the Future of Senior Living; Innovation and Insights into Health and Aging; Financial and Operational Best Practices; and Workforce and Housing Planning.
I am excited about two other events that I hope to get on your radar. First, our 23rd annual Center for Positive Aging Golf Tournament is coming up on October 8th. Harry Haisten, Jacque Thornton and a host of volunteers are working their magic to plan this event so please put it on your calendar. Finally, I absolutely love our Profiles in Aging celebration which will be on November 4th. It truly is a celebration of lives of individuals who have lived a life with purpose. Please nominate that older adult in your community whose life is a reminder to us all to live on purpose and mark your calendar to join in the celebration that we all love.
Thank you for all you do to promote the well-being of older adults.
Last Call to be included in the New Edition of the LeadingAge GA Resource Guide!
We are pleased to invite you to advertise in our 2018-2019 edition of the LeadingAge Georgia Resource Guide and Membership Directory. The Guide serves as a valuable resource for members and consumers to reach service providers for older adults as well as the products and services needed to manage senior living retirement communities like market and federally funded housing, assisted living communities/personal care homes, adult day services, continuing care retirement communities, nursing homes and rehabilitation services, and other community service programs for older adults in Georgia. Our Guide will be distributed to 100% of the membership as well as service providers for older Georgians, the Aging Service Network, key Georgia Legislators, Hospital Discharge Planners, Department of Community Health and the Division of Aging Services, Area Agencies on Aging, and the Department of Insurance for the State of Georgia. S I G N U P O N L I N E at! www.emconsultinginc.com/adreservation/LAG to be included or contact:
800.572.0011 or 404.806.7204
2018 Profiles of Positive Aging Honoree Entry Form
You're invited to experience an inspiring event with your colleagues and community heroes & heroines for the sixth annual Profiles of Positive Aging Awards Gala. This event is intended to unveil the beautiful truths about aging. On November 4, 2018 (3:00 pm – 5:00 pm), we'll pay tribute to Elders who have changed our lives, achieved a positive aging lifestyle, and continue to give of their tremendous talents and wisdom across our great state and nation.
The Profiles of Positive Aging Gala is designed to support the educational arm of LeadingAge Georgia, the Georgia Institute on Aging. The purpose of the Institute is to provide affordable, quality professional development for individuals working in the field of aging. Currently, the Institute provides education to over 1300 professionals, via 25-30 events each year, who are dedicated to providing the best care and services to older Georgians.
POSITIVE AGING PROFILE ~ ENTRY FORM 2018
A Profile of Positive Aging honors someone who is currently making a difference in your community, your organization, and/or our state/society. It is the gift of legacy. By recognizing someone who exemplifies Positive Aging, you honor those who are standing on the shoulders of years of wisdom and positive aging experiences, who have lived life to the fullest and inspire us by their examples.
Honorees will participate in this special Awards Gala to be held in their honor on November 5, 2018 at the annual "Profiles of Positive Aging Gala". Profiles submitted by August 31, 2018 to the Association office will be evaluated. Elders will be featured along with the 2018 Icon in Positive Aging.
Register your honoree by downloading the entry form or complete the nomination by submitting a brief profile of the individual at: https://form.jotform.com/21493468894166
Mental Health First Aid
Recently, I had the opportunity to take Mental Health CPR. The certifications was very important and it was clear that our entire organization would benefit from the training. I learned that encountering someone with a mental health concern is more common than someone having a heart attack or even chocking. While people are regularly trained in CPR, very few people have any training in how to respond to someone in their life who is having a problem with depression, anxiety, substance use, psychosis or trauma. The earlier a person gets treatment, the less damage the problem causes to that person's education, career, relationships, and health. People are more likely to recover when their community is more understanding and supportive.
During a recent meeting, one of the Executive Directors said that he planned to make it a requirement for all his employees to regularly maintain a certification in Mental Health CPR. That's an astute commitment which will in turn have a great influence on each employee's personal and professional life, and most importantly, have an important impact on the community they serve. Training everyone regardless of position should be an implemented policy of all sectors in the field of Aging.
Karon Winston, Lutheran Towers
Click HERE to register for Mental Health First Aid being held July 12, 2018.
The 23rd Annual Center for Positive Aging Golf Tournament
The competition will be a scramble format, with prizes awarded to the top three teams, both men and ladies. The 1st place team is awarded custodianship of the trophy for a year (won by Lenbrook-Atlanta CCRC). Additionally, there are numerous prizes for longest drives, closest to the hole, and oldest and youngest participant.
2018 Tournament Itinerary
Columbus Day: Mon., Oct. 8th
8:15 am: Registration | Practice Range
9:00 am: Shotgun Start
11:30 am: Lunch on the Fairway
2:30 pm: Presentation of Prizes
Tournament Hosted at RiverPines Golf Club
Enjoy the many attributes of RiverPines. Designed by nature and enhanced by man, this 18-hole Championship Course and Par-3 Course will challenge you with woods, ravines, creeks and ponds. Lush Bermuda grass fairways and carefully-cultivated bentgrass greens will inspire you to play your best as you wind your way through this picturesque Chattahoochee River setting—a short drive from downtown Atlanta.
Ways To Support:
- Hole Sponsorship
- Closest to the Hole Sponsorship
- Register a Foursome
- Register a Twosome
- Donate Golf Balls
- Donate Door Prizes
Click HERE for registration brochure
Sysco and US Foods for Thought
LeadingAge Georgia members can now buy from Sysco and US Foods through Value First group purchasing organization.
We understand that food and dining expenses are often second only to salaries—which is why we encourage members to have cost studies done in this very important spend category. A cost study is a comparison of what you are currently paying, retail or through a different GPO, to Value First GPO pricing. This is a free membership benefit.
Food cost studies include line-item price comparisons, drop-size discounts, rebates, and other data to let members see if there are potential savings by purchasing through Value First.
If you'd like to request a food cost study for your community, simply click HERE to submit your request. For more details call Vanessa Ceasar at 404-421-3956.
Value First, an affiliate of Vizient/Provista, is a group purchasing organization owned by LeadingAge national and twenty-five state associations, including LeadingAge Georgia. Value First is designed to leverage the buying power of thousands of senior service providers across the country to get the best pricing on a comprehensive array of products and services. This is your GPO
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Celebrating Russ Fitzgerald for his impactful leadership and excellence in work ethic. Congratulations on your retirement and next chapter in living Life on Purpose!
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for September
September 3 Labor Day
September 9 Grandparent's Day
September 9 Rosh Hashanah (starts)
September 19 Talk Like a Pirate Day
September 23 Autumn Equinox
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LeadingAge Georgia Public Policy Report
By Tom Bauer, LeadingAge Georgia Policy Advisor
While summer of an election year is sometimes slow-paced in terms of public policy, June was a busy month. LeadingAge Georgia's Public Policy Committee met; the potential issues for the Coalition of Advocates for Georgia's Elderly (CO-AGE) were released; and LeadingAge staff and an adult day center member met with a key member of the Department of Community Health (DCH) to discuss Medicaid Non-Emergency Transportation.
Public Policy Agenda
The LeadingAge (LA) Public Policy Committee met in early June and reviewed LA's public policy agenda and made several changes. The material below presents the initial draft 2018-2019 Draft Policy Issues. There are several new issues, including cost studies for adult day services, Medicaid (enhancement/waivers), continuing care retirement communities (legislation to effect the name change to "lie plan communities), implementation of SB 406, the new fingerprint check legislation (reported in the May Public Policy Report), "health coaches", and funding for increased staffing in nursing homes. Additionally, the "Abusive Transfer of Real Estate Titles" was extensively discussed.
The new issues are highlighted in italics below.
DRAFT LeadingAge Georgia 2018-2019 Public Policy Issues
Position and Involvement:
- Adult Day Services
- Cost Studies
- Medicaid Non-Emergency Transportation (NET)
- Physical and Behavioral Health Needs: Aging in Place
- Medicaid Funded Assisted Living Communities
- Life Plan Communities/CCRCs
- Implementation of SB 406 (Fingerprint check)
Position and Monitor:
- Home and Community-Based Services: CMS Rules
- Community Care Services Program (CCSP)/Service Options Using Resources (SOURCE)
- Proxy Caregiver Rules
- CCRCs/ Department of Insurance
- Property Tax Issues concerning Not-for-Profit Organizations
Position and Involvement:
- Home and Community-Based Services Medicaid (CCSP) and Non-Medicaid
- Adult Day Center Reimbursement Rates
- Financial Resources/Loan Forgiveness for Gerontology Education/Aging Services Professionals
- Health Coaches
- Funding for Increased Staffing in Nursing Homes
Position and Monitor:
- Nursing Home Provider Tax
- Use of Civil Monetary Penalty Funds
As noted, the CO-AGE potential issues, some of which are mentioned above, were released in preparation for the July 12 CO-Age meeting which will begin the consideration/voting process for 2019 CO-Age issues. Members and staff of LeadingAge Georgia will be attending the meeting.
Medicaid Non-Emergency Transportation (NET)
LeadingAge Georgia President Ginny Helms, member Ned Morgens, and Tom Bauer met recently with key Department of Community Health staffer James Peoples to discuss issues involving Medicaid Non-Emergency Transportation as they relate to adult day health centers. Among the items discussed were:
- Lyft/Uber (known as "ride-hail")
- Riders with dementia
- Inappropriate drop-offs
- Driver training
- Use of Standing Orders
- Pay rates for ADH centers who wish to provide transportation to clients
- Door "through" door (pick-up and drop-off) policy
The group had a productive and thorough discussion with Mr. Peoples, who provided information that DCH is considering changes to the NET providers manual concerning "ride-hail" providers. He noted that such transportation is supposed to be a "back-up" to the transportation providers usually used by brokers and that the Department was studying whether "ride-hail" is even appropriate for adult day center clients, in part because so many of them are frail and/or have some degree of dementia.
He also noted that standing orders could be a topic addressed in the manual. One of the problems with standing orders is that one broker requires a standing order to be at least three times a week. This rigidity has caused difficulty for some riders, since the Lyft/Uber option is used as an alternative in such cases.
Mr. Peoples also mentioned that DCH is working on a new request for proposal (RFP) for NET brokers hopefully to be chosen tin time for new contracts to be operational by July 1, 2020. Interest groups will have an opportunity to provide input into the RFP (i.e. standards and policies for NET providers).
Mental Health First Aid
July 12, 2018
GAAP Summer Symposium
July 20, 2018
Fair Housing & Ethics Symposia
July 25, 2018
Leadership Academy Fourth Event
August 15, 2018
Maintenance Professionals Forum
August 29, 2018
Dementia & Mental Health Symposium
September 13, 2018
Registration coming soon
Culture Change Summit
September 27, 2018
Center for Positive Aging Golf Tournament Fundraiser
October 8, 2018
Leadership Academy Fifth Event
October 10, 2018
Adult Day Services Symposium
October 19, 2018
Registration coming soon
LeadingAge National Conference
October 28-31, 20018
Philadelphia Convention Center (Georgia Night Dinner TBA)
Profiles of Positive Aging Gala
November 4, 2018
Information coming soon
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FYI … Fit – Youthful – Inspirational
If you are like most of us, when you see FYI you probably think of For Your Information … well, this is for your information, but, this is a new meaning for FYI for you to consider, it is Fit Youthful Inspirational; it is for you to focus on yourself internally, focus on being Fit physically and mentally, having a Youthful enthusiasm about life, and being an Inspiration to others.
Fit: It is common knowledge that fitness is a vital part of a healthy lifestyle. It is also no secret that simply walking is one of the best ways to get and stay fit physically and mentally, particularly as we age.
Here is a short excerpt from my walking story: It was a Monday morning after a busy weekend and I was lying in bed, waking up to the birds chirping and the daylight coming through the window in my bedroom. As I lay there enjoying the moment, I started contemplating forgoing my morning walk. The bed felt really good after my busy weekend. Instantaneously, the thought came to me, how committed am I to my personal goal to be fit. I surely would not accomplish that goal if I talked myself out of my regular walks. So, if staying fit is my goal, knowing there are so many benefits from walking, there was no further reason to hesitate. I got right up and prepared myself to go out walking.
I first started walking in my neighborhood. After each walk I felt so invigorated and ready for the day. Not only did I feel great physically after my walks, I also experienced a clarity of mind and had much better focus on the activities I wanted to accomplish for the day. A neighbor had introduced me to South Peachtree Creek, PATH Foundation trail in my neighborhood. It was so close, and I never knew it existed. The trail meanders through Mason Mill and Medlock parks. The tree-lined trail includes boardwalks, several bridges, and slight inclines that provide a little bit of a challenge. How could I not want to enjoy nature in this quiet atmosphere with beautiful scenery and clean fresh air. What was I thinking?
How about you … Is there something you already know is the best decision for you to do to reach your goals, but you hesitate? Think about it … how serious are you about accomplishing your goals? Serious enough not to come up with reasons/excuses to proceed. Especially when you know that you will be much better off to work toward your goal.
I have become one of the 'regulars' and have met some wonderful people on the trail. I might add, the majority of us are older adults, some with obvious physical infirmities. Following friendly conversations from time to time, I discovered some with challenges that are not obvious at all. However, we do have at least one thing in common, we are walking for our health and wellbeing.
I remembered that being out in nature, among the trees, and breathing the fresh air can help boost our immune system and actually improve overall feelings of wellbeing. I knew that simply breathing the fresh air, I would be inhaling phytoncides, the essential oils from the trees that have a positive effect on our immune function by boosting our natural killer cells. From the various studies and reports I have read, these benefits have been scientifically proven.
Reminding myself that after each walk, how invigorated I feel as I proceed through my day. I always feel spry, and so glad that I had the walk. There are few things better than connecting with nature.
Youthful: A friend once told me, because of all of the fun outdoor activities I participate in, that I was trying to be young. Was she ever wrong! My fun outdoor activities, including walking, make me feel lively and full of life! I have no desire to try to be young. I am living my best life right now. There is no way I will allow someone, especially someone who does not pursue any physical activities to put a damper on my life. I knew I had to be committed to myself and not let others dissuade me from doing what I know is the best choice for me. I may be seasoned (70 in September), but that does not mean I cannot enjoy the spices of life!
Inspirational: As we age, we learn to reach inside ourselves and provide self –motivation, particularly as we pursue our goals, whatever they are. How we live our lives, whether we acknowledge it or not, we are role models for the young people who are in our lives. We are their inspiration to believe in and achieve their goals. It has been quite a humbling experience whenever a young per son in their 30's or 40's approach me and tell me how I give them hope. That they know that getting old is now a bad thing. They inspire us and we inspire them. It results in a mutual respect. We must engage and every age.
Together we educate, empower and engage each other in our intergenerational relationships. Keep in mind that the way we live our life, is our story. We must choose to write it well, make edits as necessary, and accept that we are a living legend, an inspiration to others!
Carolyn's experience in the health and wellness arena started when she opened her first health food store in 1985 and expanded it to 4 locations. She received her Health Coach certificate from Emory University. She is a 2016 recipient of the LeadingAge Georgia Profiles in Positive Aging Award, representing AARP. She is a National Senior Games (NSG) Athlete earning numerous gold and silver medals; she is featured in the 2017 National Senior Games Non-Ambulatory Athlete Exercise Videos; featured on the TV News Magazine for Baby Boomers 50Plus Prime; she was featured in the Atlanta Journal Constitution (AJC) newspaper; the cover story for the GirlFriends Lifestyle - A Women's Guide to Healthy Living Magazine, Special Edition for the White House Conference on Aging; and interviewed for various other media outlets. She is the founder of Hartfield's Hikers, Older People with Active Lifestyles (OPALs), Atlanta African American Baby Boomers and the Walk Outdoors for Wellness! (WOW!) program. For more information visit www.CarolynHartfield.com or send Carolyn an email at CH@CarolynHartfield.com
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2018 Annual Culture Change Network of Georgia Summit
PERSON-CENTERED PALLIATIVE CARE: A KEY TO WELL-BEING
SAVE THE DATE
September 27, 2018
9:30 am ~ 4:30 pm (6 CEUs)
Older adults often experience pain associated with chronic conditions and acute illnesses. When the pain is not managed, the quality of life for the person diminishes and the person suffers from pain, isolation and depression along fatigue, loss of appetite, difficulty sleeping, and any a host of other symptoms that diminish well-being.
We're calling on all individuals who work with older adults to join us for this important summit on palliative care, to learn best practices and to help ensure that older adult who need palliative care receive it.
We will talk about what palliative care is, how it's different than hospice care, and how it is the key person-centered approach to providing relief from the symptoms and stress of chronic and acute illnesses.
It is all about improving quality of life and well-being for the individual who is experiencing the illness as well as their family/care partners. Palliative Care is not just about treating pain. It also treats depression, It helps give people the strength they need to carry on with daily life.
Research shows that once people know what palliative care is and what it can do, 92% want palliative care for themselves and those they love. We will discuss how we can come together as a community of caring to advance awareness and access to palliative care in Georgia.
Click HERE to register
The Eden Alternative Training
CMP Funds Continue to Support Transformative Culture Change Education to Georgia Nursing Homes Via The Eden Alternative® in Six Locations Throughout The State: Project Space Is Limited
RISE UP for Person-Directed Care in Georgia is a powerful, new grant opportunity that will help nursing homes improve quality of care and quality of life for their residents and advance their culture change journey. Thanks to the Georgia Department of Community Health, grant funds will make it possible for up to six people from each organization to experience the three-day in-person Certified Eden Associate Training, a power-packed culture change certification from The Eden Alternative®. The Culture Change Network of Georgia partnered with The Eden Alternative to bring this wonderful opportunity to Georgia.
Click HERE for more information.
More Choice for People Living With Dementia
Person centered care is central to the delivery of high quality healthcare. In this second article in my series on dementia, I focus on the need for person centered dementia care. Person centered dementia care puts the person living with dementia at the center of all caregiving efforts. It honors individual priorities, preferences, and personality and promotes quality of life regardless of physical or cognitive condition. With person centered dementia care, people living with dementia are active participants in their own care and are given every opportunity to control their environment and the type of care they receive. Family members also play an important role in guiding care.
2018 CCNG Advisory Group Meeting Dates & Update
Friday, August 24, 2018 | 9:30am – noon | Location: TBA
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Adult Day Services Symposium: SAVE THE DATE
October 19, 2018
Information coming soon
2018 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
GAAP Summer Symposium: "When Pinterest Doesn't Match Your Budget"
Pinterest is a wonderful resource for lovely and creative party planning ideas. As activity & wellness life enrichment professionals, our goal is to plan so much more than lovely parties--we want to create opportunities of purposeful engagement. What would a Pinterest party look like through the lens of well-being? Please join us on July 20, 2018 from 9-3:30 p.m. as we flip our perspective on activities into events of purposeful engagement with the residents/clients we serve throughout our communities. As part of our summer symposium, a graphic recorder will be joining us for this interactive activity planning experience. Prepare to be inspired!
Who should attend: novice, intermediate and pro activity, wellness, and life enrichment professionals.
CEUs: 5.5 Hours
Relevant topics covered during the symposium:
- Activities (Flip or Flop)
- The Big Reveal… How to Flip Your Event
- Budget Friendly Activity Planning and Engagement Experiences
- Out of Town Trips/Activity Planning & Proactive Problem Solving by aligning Activities with your Organization's Mission
Click HERE to register
If you have questions, please feel free to contact the following GAAP Leadership Team colleagues:
2018 GAAP Leadership Team
President: Scott Bassett (Philips Tower, Decatur) email@example.com
Vice-President: Amanda Bennett (Campbell-Stone Sandy Springs; Atlanta) firstname.lastname@example.org@campbellstone.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
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
Survey: Older Adults Prefer Assisted Living over Home Health or Nursing Home Care
Older adults' first choice for living arrangements as they age is to stay at home and remain completely independent, according to the latest adviser poll by Key Private Bank. Moving to an assisted living community, however, was a "close second," by far topping being cared for by family or professional caregivers at home or moving to a nursing home.
Federally Assisted Housing (HUD-Subsidized)
LeadingAge Makes Recommendations for RAD for PRAC Implementation
Securing RAD for PRAC has been a priority for LeadingAge since 2015 and, in 2018, it became law, giving senior housing providers the opportunity to bring private financing to the preservation of their post-1990 Section 202 Project Rental Assistance Contract (PRAC) properties. Guidance for the expansion of Rental Assistance Demonstration (RAD) to include Section 202 PRACs (RAD for PRAC) is being developed now that will allow Section 202 PRAC properties to convert their subsidy to Section 8 to allow Section 202 PRAC properties to take on debt or leverage external financing to meet capital needs like other HUD portfolios can and have.
CPD Funding Matrix and Dashboard Reports Posted
The CPD Funding Matrix and Dashboard Reports, as of June 1, 2018, have been posted to HUD Exchange. These reports provide funding information for each city and state that receive CPD program funds, including Community Development Block Grant (CDBG), Continuum of Care (CoC), Emergency Solutions Grants (ESG), HOME, Housing Opportunities for Persons with AIDS (HOPWA), and Housing Trust Fund (HTF). Reports detail the size of each grant received over the past several years, as well as the total amount of funds
currently available to be spent on affordable housing and community and economic development activities.
HUD Salary Survey
LeadingAge Georgia is partnering with Mauldin & Jenkins, LLC for the 5th edition of a HUD benchmarking study available for ALL HUD housing communities located throughout the state of Georgia. You do not have to be a member of LeadingAge Georgia to participate. This survey has been designed due to a number of requests for this information from a number HUD housing communities.
The study will focus on the items:
- Average salaries by position
- Revenue and expense analysis
- Cash reserves
**DEADLINE: Thursday, August 30, 2018 **
To be included in and receive the complementary results of this survey, it must be completed by Thursday, August 30, 2018. The survey should take approximately 15 minutes to complete. The results of the information gathered will allow HUD entities throughout the state of Georgia to compare their performance and other items to other entities in a similar geographical region. This information can be critical to planning and budgeting for future needs.
NOTE: Regarding Staff roles for salary information: Staff with similar roles have a variety of titles in HUD communities. Please review the job description for each position and choose the one that best describes the similar role in your organization. Please note that the data should include information that is effective as of March 1, 2018.
We encourage your participation so the results of this survey will be more valuable with a higher number of participants. All information provided will remain private. The survey results will be free and emailed to all organizations that participate once it is complete.
Thank you for taking the time to participate.
Click HERE to review a PDF version of the full survey.
Click HERE to complete the survey
For more information, visit, www.LeadingAgeGA.org. For membership information, see "Member Benefits" under the MEMBERS tab and contact Ginny Helms at ghelms@LeadingAgeGA.org or (404-872-9191).
Home and Community Based Services
Skeptics Raise Concerns as Private Equity Investment in Home Health Industry Rises
The in-home care industry is seeing record-breaking valuations and a historic pace for mergers and acquisitions. Heavy investment from private equity firms is among the dominant drivers of that action, and not just for in-home care, but for the U.S. health care sector more broadly. As private equity becomes increasingly involved in the health care world, skeptics are starting to question the intentions of these firms and their ability to balance profits with the responsibility of providing high-quality, affordable care.
CMS Proposes Two Changes to Home Health Star Ratings Algorithm
One measure behind home health quality of patient care star ratings may be on its way out, but another is poised to take its place. The Medicare Learning Network, an education and outreach arm of the Centers for Medicare & Medicaid Services (CMS), outlined two recommended changes to quality of patient care star rating methodology on June 25th both having to do with measures related to medication adherence.
Poor Communication Between Home Health, Doctors Leaves Patients 'Lost in the Wilderness'
Despite ongoing efforts to provide seamless transitions of care, patients' journeys from hospital to home still remain full of gaps. Persistent, systemic lapses in communication between doctors, home health providers and patients may be largely to blame.
Life Plan Community/CCRC
CCRC Salary & Benefits Report
The 2018-2019 CCRC Salary & Benefits Report has just been released. A press releasing highlighting data from the results is attached. The Report PDF is currently available, the hard copy will be available in mid-July. The LeadingAge member price is $275 vs. the $350 non-participant rate. The Nursing Home Report will be published the end of July.
The following HCS studies are currently underway:
- Rehab – Due July 23rd, published in September
- Home Care/Hospice – Due August 6th, published in October
For more info contact:
Rosanne Zabka | Director of Reports
Hospital & Healthcare Compensation Service
201.405.0075 ext. 11 | firstname.lastname@example.org
What Skilled Nursing Could Learn from the Manufacturing Sector
As skilled nursing occupancy continues to notch record low after record low, strategies to capitalize on the shrinking pool of residents remain top concerns for operators and investors. And at least one analyst says providers should look to the kind of operational improvements that have helped keep afloat another struggling industry: manufacturing.
Evaluating a Contemplative Care Approach for Nursing Homes
The LeadingAge LTSS Center @UMass Boston has been engaged by the New York Zen Center for Contemplative Care (NYZCCC) to evaluate the impact of NYZCCC's Contemplative Care approach on nursing home residents. The evaluation will also assess the impact of NYZCCC's Resiliency Training on nursing home staff.
Both the Contemplative Care intervention and the Resiliency Training will take place at Isabella Geriatric Center, a LeadingAge member in New York City.
NYZCCC's mission is to "transform the culture of care through contemplative practice, meeting illness, aging, and death with compassion and wisdom."
Documenting the Benefits of Comprehensive Culture Change
Comprehensive adoption of person-centered care and the household model can enhance interactions between nursing home residents and their care partners, improve residents' dining experience, and reduce residents' depressive symptoms.
These are the main findings from a 2017 study by the LeadingAge LTSS Center @UMass Boston. The findings are detailed in a new research snapshot called Documenting the Benefits of Comprehensive Culture Change.
LTSS Center researchers conducted their study at the Francis E. Parker Memorial Home, a LeadingAge member in Piscataway, NJ. Parker funded the study.
Webinar: Strategies to Reduce 30 Day Re-Admissions
July 17, 2018
1:00p.m. - 2:00p.m.
In October 2018, all SNF's will have their Medicare payments adjusted based upon how many residents have been readmitted to the hospital within 30 days from the initial hospital discharge. On the call this month, we will review factors that lead to readmissions and strategies that can impact readmission rates. We will identify resources to assist with program design and processes that impact readmissions.
Adrienne Mims, MD MPH FAAFP, AGSF
Vice President, Chief Medical Officer, Medicare Quality Improvement
Green Spaces Associated with Less Frailty in Older Adults: Study
Green spaces are good for the frailty status of older adults, according to a study published in the latest issue of JAMDA: The Journal of Post-Acute and Long-Term Care Medicine. The authors hope the study will encourage the use of green spaces to promote health and prevent frailty in such populations.
Researchers in Hong Kong measured the frailty status of 4,000 study participants aged 65 or more years, as well as the amount of green space/vegetation around their residences, then followed up with participants two years later; complete follow-up data were available for 3,240 participants.
The frailty status of older adults living in neighborhoods with more than 34% green space at baseline was more likely to have improved over the time period, they found.
Simulation Program Helps Recruit, Train Next Generation of Home Care Nurses The United States is projected to experience a serious shortage of nurses, one that is only expected to intensify as baby boomers age and more frequently become in need of home health services. To recruit and prepare aspiring nurses, many of whom are millennials, nursing schools are launching innovative training programs specifically targeting in-home care.
AARP's New Innovation Focus Could Bolster Aging-In-Place With a new leader helming its Enterprise Innovation division, AARP is making moves to
be a bigger player in this arena, including by creating new products through in-house"startups." The innovations being developed by AARP could boost aging in place by helping people manage chronic conditions such as diabetes.
Fall Prevention Guide Released
The National Alliance for Caregiving has partnered with the National Council on Aging to create a Fall Prevention Conversation Guide for Caregivers. The Guide highlights fall risk factors and ways that caregivers can work with loved ones to develop a falls prevention action plan. This resource provides a guide for starting conversations about falls with loved ones. It also outlines specific falls prevention action steps and highlights additional resources which may be helpful.
Click here to read more.
ARC Launches Empowerline – Services to Help Individuals Maximize Their Independence
ARC Launches Empowerline – Services to Help Individuals Maximize Their Independence (ATLANTA – June 27, 2018) – The Atlanta Regional Commission announced the launch of empowerline, a service designed to connect metro Atlanta's older persons and individuals with disabilities to the information and supports they need to thrive and maximize their independence. Empowerline enhances ARC's existing information and referral service, providing an improved user experience, including:
- A fresh, modern website design that makes it easier for the public to navigate and findthe information they are looking for.
- An engaging, innovative storytelling approach that helps users better understand theservices and supports that are available to meet their particular needs.
- More inclusive branding and messaging to make it clear that services are also availableto families, caregivers, and individuals with disabilities.
Click HERE for more.
FutureCAST Interviews Tommy Hayes and Mary Alice Ryan June's FutureCAST interviews feature two experts discussing their most exciting
initiatives and impressions of CAST's impact:
- Tommy Hayes, Senior Policy Partnerships Manager at Lyft, a LeadingAge
- Mary Alice Ryan, President & CEO of St. Andrew's Resources for Seniors
System, a LeadingAge CAST Patron.
New Technologies Help Seniors Age in Place – and Not Feel Alone Nancy Delano, 80, of Denver has no plans to slow down anytime soon. She still drives to movies, plays and dinners out with friends. A retired elder care nurse who lives alone, she also knows that "when you reach a certain age, emergencies can happen fast." So, when her son, Tom Rogers, talked to her about installing a remote monitoring system, she didn't hesitate.
New Ziegler Fund Targets Senior Living Technology Senior Housing News reports the $37 million fund will primarily target early to midstage, emerging-growth companies that are focused on the aging or post-acute care sectors. The Ziegler Link•Age Fund II, L.P. is Ziegler's second fund in four years targeting companies benefitting this sector. The fund has already reached its limit of 100 investors, which are not-for-profit senior housing providers and other industry professionals who may not have had an opportunity in the past to invest in these types of companies.
Robots May Soon Join Ranks of Alzheimer's Caregivers Robots work on assembly lines and assist doctors in the operating room. They
manage inventory in warehouses and vacuum floors in homes. And one day soon,
they could help care for Alzheimer's patients.
Explosion in Artificial Intelligence Coming for Home Care and Hospitals The use of artificial intelligence (AI) technology in health care is poised to soar
throughout the globe in the coming years, including to support preventive care in people's homes. That's according to a new report from market foresight advisory firm ABI Research. The report defines artificial intelligence (AI) as providing "a device or software program the ability to interpret complex data, including images, video, text, and speech or other sounds, and act on that interpretation to achieve a goal."
3 Wellness Tech Initiatives Senior Living Providers Must Deliver
The wellness revolution in senior living is here to stay, and much of it is powered by technology. In a senior living context, wellness focuses on five main components: the emotional, mental, physical, social and spiritual. Technology touches each of these elements.
To compete in the next decade and beyond, senior living providers must understand what wellness means for their residents, why their residents are demanding it and how technology can deliver it.
Here are three wellness tech initiatives that providers must deliver if they want to remain competitive.
Administrator - Calvin Court
See full job description at: http://leadingagega.org/jobmart/public/job/213/
Bus Driver - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/224/
Cook - Saint Anne's Terrace
See full job description at: http://leadingagega.org/jobmart/public/job/227/
Executive Director - Clairmont Place
See full job description at: http://leadingagega.org/jobmart/public/job/219/
Facility Operations Manager - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/223/
Home Services Director of Nursing - Lanier Village Estates
See full job description at: http://leadingagega.org/jobmart/public/job/210/
Supportive Services Director - Decatur Christian Towers
See full job description at: http://leadingagega.org/jobmart/public/job/222/
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LeadingAge Comments on LTSS Financing Draft Proposal On June 15, 2018 LeadingAge submitted technical comments on the Medicare Long-Term Care Services and Supports Act of 2018 discussion draft rolled out by Rep. Frank Pallone (D-NJ).
LeadingAge Regulatory Round-Up Tools Now Available LeadingAge national is excited to launch the Regulatory Round Up suite of products designed to provide LeadingAge members an exclusive, all-in-one resource for valuable information about federal regulatory initiatives and developments. Included in the suite are Regulatory Round Ups on "Nursing Homes," "HUD Housing," and "Home and Community-Based Services."
Each Round Up includes an introduction that explains how to use the product as well as contact information for LeadingAge Public Policy staff for the particular content area.
Specific features of the Round Up products include:
- A hyperlinked table of contents designed to take you directly to a particular initiative or another portion of the Round Up with just a click of the mouse.
- Key dates at-a-glance provide an overview of the timeline for all initiatives and
developments included in the product.
- Quick reference icons in each individual entry provide an easy way to determine the purview of the initiative (e.g., regulatory, quality, or payment).
- A short, high-level summary provides basic information about each entry
- Sources of additional information gather together in one place resources relating to the particular initiative or entry.
- Important dates and deadlines provide the reader with a visual representation of important milestones
Let's Talk About It
"Let's talk about it" has been LeadingAge's primary message to consumers, policy makers, and members during June 2018. We've asked millennials to "Carry the Conversation" by becoming the voice of long-term services and supports (LTSS). We've been talking with policy makers about a variety of issues that matter to older Americans. And we've provided resources that member organizations can use to frame their internal conversations about important decisions.