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Membership Update

Posted By Jennifer Gill, Friday, August 3, 2018
Updated: Thursday, August 2, 2018

August 3, 2018

The Member Update is published twice a month. If this issue was forwarded to you by a colleague and you would like to receive it directly,
please contact Jennifer Gill at 919-571-8333.

Click on the section you would like to view.
Advocacy & Policy
Strategic Thinking
News & Notes
Professional Development
Value First

Advocacy & Policy

U.S. House and Senate Announce Recess Details
The U.S. House of Representatives will be on recess the month of August through September 3. The U.S. Senate is only scheduled to be on recess August 4-12 and September 1-3. This is a good time to contact your Representative and our Senators about aging issues while they are more likely to be in their home districts. To assist you with this, LeadingAge national and LeadingAge North Carolina are launching Coffee Chats with Congress this summer and fall. This campaign is asking LeadingAge North Carolina members to set up conversations with legislators to discuss the good work you’re doing and the challenges that your community encounters. A comprehensive toolkit has been developed that you can download here.

News from LeadingAge National on Medicare Reimbursement
The following information pertains to providers involved with Medicare reimbursement.

A CMS fact sheet on the final rule, effective October 1, 2018, is also available highlighting the three main provisions of the rule, those being the new case-mix classification system, the Patient-Driven Payment Model (PDPM), and policy updates to the SNF quality reporting program (QRP) and value-based purchasing program (VBP). Of note, CMS states that the rule “moves Medicare towards a more value-based, unified post-acute care payment system” which signals that this is likely foundational to the future concept of a unified post-acute care prospective payment system as mentioned in the IMPACT Act of 2014.

SNFs will receive a 2.4% payment update for FY 2019 based on the Bipartisan Budget Act of 2018. CMS took the recommendation of LeadingAge that organizations that failed to meet the QRP requirements have an update of 0.4% as opposed to -0.1% in the proposed rule with the 2% reduction for reporting noncompliance.

The PDPM proposal retains the implementation date of October 1, 2019. LeadingAge provided comments on the PDPM and other aspects of the proposed rule based on our analyses and input received from our members. CMS has indicated that information on training and education resources and opportunities associated with implementing the PDPM will be available on the CMS website by clicking here. LeadingAge has joined other stakeholder groups in asking CMS for a PDPM stakeholder workgroup to proactively address transition and implementation challenge issues as well as aiding with education and dissemination of CMS guidance.

The Patient Driven Payment Model (PDPM) is a significant change for how Medicare is paying for skilled nursing. The focus on beneficiary clinical characteristics appears to be the clear direction of the future as CMS considers other payment systems, home health as an example, and post-acute care as a Medicare segment. LeadingAge will strive to ensure our members are positioned to transition successfully and in an educated manner.

As we analyze the final rule, we will provide additional information through multiple communication channels. LeadingAge is developing educational resources and opportunities for members and will be announcing initial resources in the coming weeks.

General Assembly Set to Consider Cooper Vetoes of Special Session Work
The General Assembly meets tomorrow to consider overriding Governor Roy Cooper’s vetoes of two bills passed during a surprise special session held last week. The quickly called one-day extra session featured a bill that will likely mean the six proposed constitutional amendments on the ballot in the fall election will not have titles. Republicans noted the bill was necessary because there was fear that the Constitutional Amendments Publication Commission (composed of two Democrats and one Republican and which was established in 2016 to write the titles of Constitutional Amendments) was under pressure to politicize the titles. A second bill approved during last week’s special session would remove the party affiliation from any candidate who switched parties less than 90 days before filing for office. The 90-day deadline was removed by legislators last year when they cancelled judicial primaries this year. The bill was prompted by the fact a former Democrat filed as a Republican for the State Supreme Court race. The presence of two Republicans on the ballot was seen as a potential threat to the re-election of Republican Justice Barbara Jackson. It is expected that the General Assembly has the votes needed to override both of Cooper’s vetoes.

New Guidelines for Medicare Advantage Plans Released
CMS has released new guidance for Medicare Advantage plans’ annual application process. The new guidance shares that “primarily health related” supplemental benefits will be expanded to include many services offered by community-based organizations in the aging network. In the past, supplemental benefits were required to be “primarily health related” and only included items or services to prevent, cure, or diminish an illness or injury. In the 2019 Medicare Advantage Call Letter, CMS announced that they will change the scope of “primarily health related” supplemental benefits to include the following items and services beginning with 2019 applications:

  • Services or items that are used for diagnosis;
  • Services or items used to compensate for physical impairments;
  • Services or items that improve the functional or psychological impact of injuries or health conditions;
  • Services or items that reduce avoidable emergency and health care utilization.

Examples of newly allowable benefits that meet this definition include:

  • Adult day care services
  • Home-based palliative care
  • In-home support services
  • Support for caregivers of enrollees
  • Medically-approved non-opioid pain management
  • Stand-alone memory fitness benefit
  • Home and bathroom safety devices and modifications
  • Transportation
  • Over the counter drug benefits

This new policy provides greater opportunities to integrate evidence-based programs and other key community-based services and supports into Medicare Advantage Plans. To find out more for what this mean for you, click here for helpful information from the National Council on Aging.

Sign Up as a Partner for National Voter Registration Day (September 25)
Did you know there is already a countdown to National Voter Registration Day on September 25? While September may seem far away, the folks at Nonprofit VOTE are encouraging nonprofits to join this national day of action celebrating our democracy. National Vote Registration Day is endorsed by the National Association of Secretaries of State and the National Association of State Election Directors, along with hundreds of nonprofits across the country.

Here are two things you can do:

  1. Sign up as an official partner;
  2. Plan a voter registration drive on September 25, if this makes sense for your community.

NVRD partners receive free field organizing toolkits, promotion materials, and an exclusive training by Nonprofit VOTE. Help register everyone who is eligible to vote! Watch an NVRD video and sign up for the August 16 webinar.

Weigh in On the Future of Transportation Coordination
The National Center for Mobility Management (NCMM) is seeking input from state and local stakeholders to inform the future of transportation coordination. Feedback will help to shape the Coordinating Council on Access and Mobility (CCAM) federal interagency work group plan and focus areas by identifying promising practices, barriers, and challenges around coordinated transportation. Complete the National Transportation Coordination Survey.

North Carolina Public Transit Systems Face Funding Cuts

Public transportation systems around the state will see funding cuts largely due to lower motor fuels tax revenue. The North Carolina Department of Transportation sent notice to 24 public transit systems letting them know how much they would each lose. In total, NCDOT reduced funding in eight areas by $44 million. Half of those areas will suffer an $8.5 million reduction each, including a recurring reduction in the State Maintenance Assistance Program, or SMAP. That cut amounts to more than a quarter of the state funding in that program which helps local public transit systems with maintenance of their fleets.

Strategic Thinking

Member Questions

  • Shuttle Service: Do your colleagues have on-campus shuttles for residents? Click here to download an Excel spreadsheet of responses.
  • Digital Marketing: How do your colleagues manage their digital presence? Click here to download an Excel spreadsheet of responses. Thanks to everyone who sustains this service by responding.

Majority Minority Counties Set to Increase in Next Seven Years
By 2025, projections show North Carolina will have 23 counties in which non-Hispanic whites are not the majority race, sometimes referred to as a majority-minority population. Already, the state has 19 such counties, up from 16 in 2010. And in all but 11 counties, the minority population is outpacing the white population in terms of growth, according to Census Bureau figures. In North Carolina, the change has come largely through natural increase, according to Rebecca Tippett, founding Director of Carolina Demography at the Carolina Population Center at UNC-Chapel Hill which started in 2013. That means simply that the population as a whole has more births than deaths. Data bear this out. Non-Hispanic whites outnumber minorities by wider margins in older age groupings than in younger groupings. For example, there are twice as many whites age 18 and above than minorities of the same age group. But there are nearly as many minorities as whites when looking only at those under the age of 18. Not surprisingly, counties with older populations tend to be less diverse. Similar trends are happening around the nation. A recent study published by Applied Population Lab found that in 2016, for the first time in history, more non-Hispanic whites in the United States died than were born. This was true for a growing number of states as well. In 2016, the study found more non-Hispanic white deaths than births in 26 states, including North Carolina. In 2004, there were just four states for which that was true. Furthermore, the study authors expect the trend to continue.

Where Do We Die?
Americans are more often spending their final days at home or in other community-based settings instead of the hospital, a new study has found. Overall, the proportion of deaths that occur in acute-care hospitals has fallen to below 20%, according to a retrospective cohort study published last month in the Journal of the American Medical Association. That’s a steep drop compared to 2000, when nearly one-third of deaths occurred in hospitals. While hospital deaths are decreasing, the number of deaths in homes and community-based setting, including assisted living facilities, is sharply rising. About four out of every 10 deaths occur in home or community-based settings.

Medicare Slashes Star Ratings for Staffing in 1 in 11 Nursing Homes
July 27, 2018, The New York Times
Click here to read an article on the early effects of the payroll based staffing journal on CMS star ratings across the country. Katie Sloan of LeadingAge national is quoted.

The 7 Cardinal Sins of Marketing in Aging Services (and how to avoid them)
July 30, 2018, McKnight's Senior Living
Marketing folks know that it is always a good idea to stay on top of your community's marketing strategies. This article provides a checklist of common mistakes to avoid and what to do instead.

News and Notes

Blue Cross Blue Shield NC Introduces SmartShopper Program
Blue Cross and Blue Shield of North Carolina has announced that it will provide rebates to many of their customers if they use cheaper doctors and hospitals. Customers will be offered between $25 and $500 per medical procedure for more than 100 procedures. This SmartShopper program will be offered only to companies that pay for their employees’ health insurance and health care. To read more about this click here.

Dogwood Health Trust Foundation May Open Doors in Western North Carolina
Ahead of a potential sale to HCA Healthcare, Asheville-based Mission Health's board of directors has launched its nonprofit, private nonoperating foundation that would spawn from the proceeds of the deal. Mission said the foundation, Dogwood Health Trust, would be a "region-wide resource" enabled to make "significant investments" and develop partnerships in the region. The creation of the foundation has been billed by hospital leaders as a major benefit of the sale of not-for-profit Mission to HCA, a Nashville-based for-profit company. Through new partnerships, the organization hopes to "analyze, understand and address core social determinants of health and well-being" in Western North Carolina, according to a hospital news release.

Charlotte Tapped for 2020 Republican National Convention
Charlotte has been chosen as the host city for the 2020 Republican National Convention which will be held that summer. The 2020 Democratic National Convention will be held July 13-16, 2020, with three cities still in the running – Houston, Miami Beach, and Milwaukee.

2018 Salary & Benefits Report for Life Plan Communities Now Available
The national average hourly rate for CNAs in Continuing Care Retirement Communities/Life Plan Communities (CCRCs) saw an increase of about 3.35%, according to the 2018-2019 CCRC salary and benefits report published by the Hospital & Healthcare Compensation Service (HCS) in cooperation with LeadingAge.

Speaker Available for Your Meetings

Enhance your next board, resident, or staff meeting with a presentation by Tom Akins of LeadingAge North Carolina. As a free member service, Tom is available to offer trend analysis presentations and other topics for your constituents. Contact Tom today to discuss your needs. If you have ever heard Tom speak, you know his enthusiasm for the field is infectious. Please call Jennifer in our office at 919-571-8333 for more information.

Infographic about your Communication Preferences
At Spring Conference in May this year, many of you completed a communications survey to help LeadingAge North Carolina understand how you feel about our newsletters, website, social media, and more. Click here to view an infographic summary of those results. Thanks to everyone who participated. We will use your responses to formulate future communications plans. Please feel free to contact Jennifer Gill our office at 919-571-8333 with any questions.

A Message from Cindy Deporter about the QAPI Program
"QAPI tags will be here in November 2019, which is just around the corner. Before that time, maybe it makes sense to get feedback on your community's program. Alliant Quality is still looking for skilled nursing facilities to participate in a survey whose goal is to help improve quality of care in North Carolina. Participation in this survey is not mandated by CMS for regulatory compliance nor does its completion ensure regulatory compliance. Use this survey as a tool as you begin your work on QAPI and then for annual or semiannual evaluation of your organization's progress with QAPI. The survey should be completed with input from the entire QAPI team and organizational leadership. It is meant to be an honest reflection of your progress with QAPI. The results of the assessment will direct you to areas you need to work on in order to establish QAPI in your organization. So please take a moment to participate in this important project. If you have any questions, please contact Melody Brown at Alliant Quality at 229-624-2051."

Professional Development

Fewer than 2 weeks away!
Management Leadership Series
August 15, 2018
WhiteStone in Greensboro
Facilitated by Rick Schlentz of EXTRA!Ordinary, Inc.

Members: $125
Non-members: $175
4.0 NHA CEUs

Department directors, team leaders, supervisors, and mid managers - would you like a fresh perspective and new ideas about how to engage your team? Plan to join us and learn more about what it takes to create an effective team in this last session of the series. You are welcome to register even if you did not attend the first session. Register online. Download brochure.

In 3 weeks - great speakers and timely topics!
Workforce Summit

August 22, 2018
River Landing at Sandy Ridge
Colfax, NC (between Greensboro and Winston-Salem)

Human Resources professionals and others be sure to register for this informative day that will include a networking lunch with round table discussions. Only $125 for first person, $99 for second person from your community, and $175 for non-members. Earn 5.5 PHR, SPHR and 5.5 NHA credits.


Best Practices for Long Term Care Student Internships
Learn more about internships, workforce knowledge, skills and abilities (KSA), student competency, recruitment and best practices for internships.

Respecting Differences
Respecting differences is essential to staff working well together, building teams, and having the highest customer service possible. There is more polarization and more fear of differences than ever today. We know it is essential and the right thing to do to identify differences, learn respect, and develop tools that staff and residents can use to embrace differences in respectful ways that will enhance everyone’s quality of life.

When a Threat Happens
Learn from a first-hand account of steps taken when a community faced an active threat.

Crisis Management
Workplace Violence, Resident Abuse, Breakdown in the Provision of Care, Privacy Breaches, Natural Disasters… these events have a few elements in common. Our brand is at stake. We have made sincere commitments to our residents and their families - commitments that we intend to keep, commitments that are in keeping with our mission, commitments that we planned and trained for… and then protocol is not followed, security is breached, response systems are overwhelmed. Whatever the scenario, we find ourselves working in “Reaction Mode.” When these events occur, care can be compromised; and then the media walks in. How we respond can impact resident outcomes, regulatory outcomes, and civil and criminal exposure. Hear about how to manage elements of a crisis including media response. Emphasis will be placed on workplace violence examples, but content will be applicable to many different scenarios.


Dave Williams, Appalachian State University, Health Care Management Program
Betsy Finger, Givens Estates
Ed Hillman, Givens Estates
Jeff Hutchins, Penick Village
Caroline Hendricks, Penick Village
John Hessburg, Kitch Attorneys and Counselors
Richard Todd, McGriff Insurance Services (formerly BB&T Insurance)

Register Now
Download Flyer

Registration now open for September!
Mid-Atlantic CCRC/Life Plan Marketing and Communications Symposium

with LeadingAge Virginia and LeadingAge Maryland
September 19, 2018
Covenant Woods Retirement Community
Mechanicsville, VA

Three states - one place! Come network and learn with members from LeadingAge NC, VA, and MD! We have a great day planned with plenty of time to connect and share with peers, including a networking dinner the evening before the symposium.


  • The Digital Tools and Techniques Essential for Senior Living Marketing
    As digital marketing grows in importance for senior living communities, marketers are discovering that one approach does not fit all types of services at a CCRC/LPC.
  • Marketing Your Message with Public Relations
    Learn to use Facebook and engage key audiences by telling your community's most interesting stories. When done strategically, Facebook is a cost effective way to market your CCRC/LPC and to shape your community's public image.
  • Preparing for the Next Generation of Senior Living Consumers
    It’s very clear that senior living is experiencing a shift in consumer preferences, and research shows that Baby Boomers present very different characteristics from previous older adult generations.
  • Creative and Unique Marketing Applications
    A panel comprised of three member communities will discuss their education/community involvement and share best practices.

Speakers from:

Find hotel and dinner information by clicking below:

Download flyer
Register today

RSVP Today!
State Night Out

October 29, 2018
Marriott Philadelphia Downtown
A LeadingAge North Carolina members only social event that is held each year in conjunction with LeadingAge national's Annual Meeting & Expo.

More Information


Maintenance Forum
September 27, 2018
More details to come!

2018 Event and Education Calendar
Please click here to view and print LeadingAge North Carolina's 2018 Event and Education Calendar. Register today! Get inspired and refreshed to stay on top of current trends. We look forward to seeing you.

Advance Care Planning Workshops in August
The NC Partnership for Compassionate Care provides tools for the public to talk about their wishes with family, friends and health care providers, and to execute written advance directives (Health Care Power of Attorney and living will) in accordance with North Carolina state laws. For a list of Advance Care Planning Workshops across North Carolina this month, please click here.

A group purchasing organization of LeadingAge North Carolina.

Sysco and US Foods for Thought

LeadingAge North Carolina members can now buy from Sysco and US Foods through the Value First group purchasing organization.

Value First understands 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 this link to submit your request. For more details contact 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 North Carolina. 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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