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Member Update

Posted By Jennifer Gill, Friday, February 7, 2020
February 7, 2020

The LeadingAge North Carolina Member Update is published twice monthly.
Click on a section header to view that section.

Awards 2020 - due February 28
Advocacy & Policy
  |  On the Road
Strategic Thinking
  |  Member Question
   News & Notes  |  Value First


 
Shine a light on your member community with a 2020 award nomination(s).
The categories this year include a new one called Workplace Excellence.


This year we are asking for 3-5 photos to accompany your one-page nomination. If selected, photos will be used at the LeadingAge North Carolina Annual Conference awards recognition luncheon on May 20, 2020 at The Omni Grove Park Inn in Asheville.

    Nominations are due February 28, 2020.   
Submit yours today!

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Bed Tax Update - a Federal Issue

We’ve heard back from a number of sources that outreach by staff and residents at our member communities has been tremendous! CMS received more than 4,000 comments nationwide and our own Congressional delegation received thousands of letters from North Carolina. The comment period on the proposed Rule is now closed and CMS will proceed to final rulemaking in light of feedback they received (a copy of LeadingAge North Carolina’s letter to CMS can be found by clicking here). In the meantime, a “Dear Colleague” letter was circulated in the US House of Representatives encouraging Members of Congress to sign on to a letter to CMS urging that the rule be withdrawn or CCRCs be exempt. We were in contact with members of the North Carolina delegation (as were a number of residents) encouraging them to sign on to the letter. We’re working to ascertain a timeline for next steps and will share that as it becomes available.

Sales Tax Update - a State Issue
We’re meeting with key stakeholders and policymakers at the General Assembly’s to update them on the sales tax issue and gain perspective on both the substance and timing of the Department of Revenue’s new interpretation of CCRCS as “retailers.” At the same time, we’ve engaged counsel to help us in drafting potential solutions. Until we have potential solutions in hand and perspective from committee staff and leadership, it would be premature to reach out in mass to elected officials about the issue. As soon as we have those items in place, we’ll reach out with information about a timeline for any phone calls/letter writing campaign. We’ve also asked our counsel for their perspective on how our members should be dealing with the sales tax issue in the interim as we work legislatively to resolve this challenge. We are working closely with the North Carolina Continuing Care Residents Association on this and other issues and continue to value their partnership.

LeadingAge National Releases 2020 Policy Roadmap
LeadingAge National unveiled its 2020 Policy Priorities, a comprehensive roadmap of policy goals, actions, and resources. Nearly 3,000 LeadingAge members participated in 32 Town Hall Conversations across the country during 2019, offering thoughts and comments about “what keeps them up nights” and federal policy changes that could free them up to do what they were established to do: provide mission-driven, consumer-centered services. LeadingAge North Carolina’s Public Policy Committee is busy crafting priorities for our work with the General Assembly (this year's short session is slated to begin in late April.)

Update on Medicaid Block Grant Announcement
The Trump administration announced its new “Healthy Adult Opportunity” program and guidance last week. The optional program allows participating states to receive a block grant for a specific population enrolled in Medicaid — adults under the age of 65 who aren’t eligible for Medicaid on the basis of disability or who aren’t eligible under a state plan.

These new waivers would allow states to establish a block grant (or per capita cap) waiver for adults between ages 19 and 64 enrolled in Medicaid. The guidance allows for such waivers at the option of states and there is no requirement that a state adopt a block grant waiver. Notably, states cannot establish this program for children and older adults 65+.

In its announcement, CMS stated that states have the potential to share in savings that result from these waivers and can use those savings to reinvest in their Medicaid programs. It is very unlikely, however, that any block grant waiver would result in significant funds available for such reinvestment. In fact, the purpose of block grants is to reduce spending on the Medicaid program, often to reallocate state dollars to other programs and policy areas. There is also the potential that reduced federal Medicaid funding as a result of these waivers could cause states to make cuts to other aspects of their Medicaid programs to make ends meet, including reduced rates and more restrictive eligibility criteria for long-term services and supports.

While it is likely there will not be an immediate impact on many of the services provided by our member communities, there are definitely downstream impacts to consider:

If North Carolina did adopt a block grant, it would be limited only to the under 65 adult without disabilities population – so mostly an expansion population. Long term services and supports wouldn’t be subject to the waiver, but we can envision a situation in which a state adopts a waiver, then doesn’t have enough money to cover the costs and ultimately looks to make cuts elsewhere in Medicaid to make ends meet. If they did that, home and community based services would likely be where they would look. This could come in the form of reducing waiver slots, cutting rates, cutting entire service lines, restricting eligibility or, in all likelihood, some combination of these.

The proposed block grant waivers are at a state’s option. Democrats have historically opposed these and per capita caps, also allowed in the new waiver. This was the big Medicaid issue during health reform in 2017. While anything is possible in the policy arena, it remains to be seen whether North Carolina or any other state would adopt a waiver like this as long as they have a Democrat as governor (Governor Roy Cooper is already on record opposing the new waiver).

As with any policy issue, the best action is to continue to provide high quality services and look for every opportunity to showcase your mission to policymakers and key stakeholders in your community. We’ll continue to monitor the issue and provide updates as the situation evolves.

Housing and Assistance Animals: New Guidance
On January 28, HUD issued new guidance to clarify “how housing providers can comply with the Fair Housing Act when assessing a person’s request to have an animal in housing to provide assistance because of a disability.” The 19-page guidance, which should be very helpful to all types of housing providers, includes two sections. The first is about accessing a person’s request to have an animal as a reasonable accommodation under the Fair Housing Act. The second section provides guidance on information that an individual seeking a reasonable accommodation for an assistance animal may need to provide to a housing provider about their disability-related need for the requested accommodation, including supporting information from a health care professional.

2020 Voting Requirements
Voters will not be required to show photo ID for the March 3, 2020, primary election. Be sure to provide residents and staff with the most up-to-date voting information by clicking with the NC State Board of Elections website.

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  • Revenue Laws Study committee meeting - Raleigh
  • LeadingAge North Carolina board of directors meeting - Brookridge Retirement Community - Winston-Salem
  • LeadingAge North Carolina Foundation board of trustees meeting - Brookridge Retirement Community - Winston-Salem
  • Member visit, Covenant Village - Gastonia
  • Member visit, Aldersgate - Charlotte


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2020 Trends Quick Scan Now Available
Thanks to our friends at LeadingAge Maryland for putting together this great 2020 Trends Quick Scan.

2020 Census: What it Means for Members
What will the 2020 Census mean for your community? Get the facts and spread the word by clicking on the U.S. Census 2020 webpage. In addition, LeadingAge national has compiled Frequently Asked Questions for your reference.

Coronavirus: An Ounce of Prevention
Amidst all the global coverage of the novel coronavirus, communities with sensitive populations need to keep an eye on prevention. LeadingAge national has prepared several resources to help member communities prevent the spread of the virus. Please click here to access the information from national.

In addition, the North Carolina Department of Health and Human Services has prepared a fact sheet, frequently asked questions and more. Please click here to download and view the information from NCDHHS. If you have general questions about 2019 novel coronavirus, you may call the NC Division of Public Health at 1-866-462-3821.

What You Need to Know about the Flu
From October through May, the NC Division of Public Health provides weekly updates on the spread of Influenza in North Carolina. Click here to view this page and bookmark it for reference. The CDC also provides updates on activity across the nation, as well as prevention, treatment, fact sheets and more. Click here to view these resources.

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Responses to the most recent question are available to download by clicking the text below.

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Save the Date for the LeadingAge NC Annual Conference & Expo
The LeadingAge North Carolina Annual Conference will be May 18-21, 2020 at The Omni Grove Park Inn in Asheville. We're busy finalizing details and can't wait to gather with you this spring. Be on the lookout for more info in the coming weeks. Registration will be announced via social media, email, and website in early spring.

Save the Date: Manager Training Seminar
April 16, 2020
8am-5pm
Friends Homes Guilford
Greensboro, NC
Target audience: managers, directors, team leaders, supervisors
More details to come!

2020 Event and Education Calendar Now Available
Mark your calendar for these LeadingAge North Carolina events and programs in 2020. New this year is a Fall Conference on September 24 in Colfax designed specifically for Department Directors and Managers/Supervisors in HR, marketing, finance, social work, nursing, maintenance, wellness, and fundraising. Watch for more details!

LeadingAge National Webinar: Crisis Communications - Messaging Negative Publicity
This webinar will take place on Wednesday, February 26 from 2-3 p.m. and details a strategic approach to communications that allows organizations to establish and maintain control of their message while mounting a defense against negative publicity. Click here for more information and to register.

Upcoming Special Days/Weeks/Months
Days, weeks and public awareness events to celebrate in February, March and April.

Have Job Openings?
Contact Jennifer Gill with the job title, description, and how to apply and she will post it for you under the Careers tab on the LeadingAge NC website. It's free!

In Case You Missed It
Click below to read our most recent newsletter.

Follow @LeadingAgeNC on Social Media
Stay connected in 2020. Be sure you are following @LeadingAgeNC on Twitter, Facebook, and Instagram. You'll be up-to-date whatever comes your way!

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A Note from your Value First Representative


When it comes to balancing resident satisfaction and food service costs, you face many challenges. As specialists working with senior living and long-term care communities, Value First can help you provide your residents with nutritious and satisfying meals that fit your budget. However, our support goes far beyond helping you reduce food costs. Our tools and resources can support your entire operation by reducing costs and improving efficiencies at every step of your supply chain.

It all starts with a cost study where we’ll work with your purchasing team to analyze your current expenses and give you line item comparison on exactly how we can help you save. As the new year started we have already seen successes in a number of food cost studies.

Please take advantage of this, it only takes a few minutes from your end, and Value First does all the leg work.

If you are currently using CINTAS but not through our program, please take a look at this. CINTAS and Value First in partnership with Vizient are offering members with incredible savings, click here for more information.

Please contact me, Bobby Bernal, at 850-509-8112 or email me.

I will walk you through the few easy steps.

Please click here for the NEW Value First vendor catalog.

Thank you and I look forward to seeing you on the road.

Robert "Bobby" Bernal, Value First Regional Southeast Manager
C: (850) 509-8112 | Email

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LeadingAge North Carolina
222 N. Person Street, Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


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Member Update

Posted By Jennifer Gill, Friday, January 17, 2020
Updated: Thursday, January 16, 2020
January 17, 2020


The LeadingAge North Carolina Member Update is published twice monthly. Click on a section header to view that section.

Awards 2020 - now open!
Advocacy & Policy
  |  On the Road
Strategic Thinking
  |  Member Question
   News & Notes   |  Leadership Academy  |  Value First


2020 awards nominations are now open.
Nominate a special person or program today!   

 
Please find a moment to shine a light on your community with a 2020 award nomination(s). Take a look at the categories including a new one called Workplace Excellence and prepare your submission today. 

This year we are asking for 3-5 photos to accompany your one-page nomination. If selected, photos will be used at the LeadingAge North Carolina Annual Conference awards recognition luncheon on May 20, 2020 at The Omni Grove Park Inn in Asheville.

    Nominations are due February 28, 2020.    
Submit yours today!

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General Assembly Set to Return for Short Session on April 28
The General Assembly came back to Raleigh earlier this week for an attempt at overriding Governor Roy Coopers veto of the state budget. They were unsuccessful and recessed until the start of the short session, slated for April 28, 2020.

Potential New Tax for CCRCs (the first of two!)
The North Carolina Department of Revenue has announced plans to levy a new tax on residents of continuing care retirement communities. The new tax, in the form of a sales tax levied on all monthly fees for the states 22,000 CCRC residents, would amount to an approximate 7% increase in fees paid by our states senior citizens who live in this much-needed form of housing. CCRCs have an estimated $2 billion impact on the states economy each year…and with the coming demographic age wave, a new tax of this type could significantly affect future construction and viability. As the states population ages, the need for housing will increase. A new tax on senior citizens will place North Carolina in an unfavorable light regionally and will make it more difficult to continue to attract new residents and maintain our current waiting lists. LeadingAge North Carolina is partnering with the North Carolina Continuing Care Residents Association to provide information about the impact of this new tax on our states senior citizens, including outreach to all 170 members of the General Assembly, local elected officials, and the media.

Many observers are wondering why the North Carolina Department of Revenue is instituting this new tax, when CCRC residents have never been taxed in this way. In 2014, the NC Legislature passed an omnibus Revenue Act meant to modernize tax law. Bundled services were part of the new legislation. CCRCs were considered “health care facilities” giving them relief from the new legislation. At this point, the department has indicated it now considers CCRCs to be retailers,” equating them to industry titans like Walmart, McDonalds, and Spectrum. The department has even communicated in writing that it wants to charge CCRC residents sales tax on singing groups that provide entertainment for residents, installation of appliances when they are broken, medical supplies, and emergency response pendants.

LeadingAge North Carolina is in the process of communicating with these key stakeholders at the General Assembly and will provide additional information when it is appropriate to reach out to state elected officials with concerns about the new sales tax interpretations.

Potential New Tax for CCRCs (the second of two!)
CMS is proposing a new rule that would result in a bed tax for all CCRCs in North Carolina. Currently, North Carolina exempts CCRCs from paying these nursing home provider taxes (bed tax). This new rule would negate that exemption in North Carolina and negatively affect CCRCs in seventeen other states.

Nursing Homes in North Carolina currently pay a bed tax. The money paid is then matched by the federal government and returned to the nursing facilities via additional Medicaid funding.

CCRCs largely do not receive Medicaid funds. Yet, with the loss of this exemption, CCRCs across the state would be required to pay a tax on all of its health care beds, amounting to millions of dollars in new taxes without any financial benefit of any kind. The only way CCRCs could afford this tax would be to increase resident fees.

CMS is accepting comments on the proposed rule up to February 1. We request you consider urging Senators Richard Burr and Thom Tillis and your Member of Congress to protect CCRCs from this potential new Medicaid tax.

Should you wish to reach out to your federal elected officials, please contact Senator Richard Burr, Senator Thom Tillis, or CLICK HERE to search for your specific Member of Congress.

Advocacy 101: What Nonprofits Can (and Can’t) Do in Election Years (and Every Day)
In this election year, a timely webinar offered by the NC Center for Nonprofits on Thursday, January 30, 2020, 10:00am to 11:00am. More details and register.

2020 Voting Requirements
Voters will not be required to show photo ID for the March 3, 2020, primary election. Be sure to provide residents and staff with the most up-to-date voting information by clicking with the NC State Board of Elections website.


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  • LeadingAge State Executives Forum meeting - Ft. Meyers, FL
  • NC Department of Revenue meeting - Raleigh
  • LeadingAge NC Public Policy Committee meeting - Raleigh
  • Value First State Executives meeting - Raleigh
  • CCRC/LPC Tax Issues phone call - Raleigh
  • Medicaid Fiscal Accountability Regulation LeadingAge Member Call-In
  • LeadingAge NC Leadership Academy - Scotia Village, Laurinburg
  • Member visit - Baptist Retirement Homes, Winston-Salem


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How We Survive the Surveillance Apocalypse
The Washington Post; December 31, 2019
In a world where so many others are collecting our personal data, it’s legitimate to worry whether they’re doing enough to protect it. What can you do to protect your data?

Why Caregivers Could Have So Much Influence in Coming Elections
MarketWatch; January 10, 2020
Two of America’s most influential advocates for caregivers, Maria Shriver and Ai-jen Poo, recently partnered on a poll that examines the state of caregiving in our country. One of the poll’s most significant findings, according to Shriver and Poo: We are a nation of caregivers in crisis, unified across political party lines in support of solutions, and that could influence the election. Visit the News and Notes section below for the most up-to-date information on 2020 elections in North Carolina.

Rich People Don’t Just Live Longer. They Also Get More Healthy Years.
The New York Times; January 16, 2020
A new study published on Wednesday found that while education and social class had some effect on health in old age, neither was nearly as significant a factor as a person’s wealth. What could your community do to address this issue at a societal level?

Great Leaders Understand Why Small Gestures Matter
Harvard Business Review; January 13, 2020
What if we took just a moment to think a little smaller, to act a lot more humbly, to elevate the person-to-person interactions that lead to more meaningful relationships?

8 Ways to Work Smarter in 2020
The New York Times; December 29, 2019
Take hold of your future and define your own path by taking charge of your happiness at work, using your strengths more wisely, avoiding drama and more. Anytime is a good time for a fresh perspective like this opinion piece.

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Your peers across the state have questions and you have answers. It's incredibly helpful. So ask away! Responses to the most recent question are available by clicking the text below.

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What is the 2020 Census?
On behalf of your community's residents and staff, get the facts and spread the word about the 2020 Census by clicking on the U.S. Census 2020 webpage.

Save the Date
The LeadingAge North Carolina Annual Conference will be May 18-21, 2020 at The Omni Grove Park Inn in Asheville. We're busy finalizing details and can't wait to gather with you this spring. Be on the lookout for more info in the coming weeks. Registration will be announced via social media, email, and website in early spring.

2020 Event and Education Calendar Now Available

Mark your calendar for these LeadingAge North Carolina events and programs in 2020. New this year is a Fall Conference on September 24 in Colfax designed specifically for Department Directors and Managers/Supervisors in HR, marketing, finance, social work, nursing, maintenance, wellness, and fundraising. Watch for more details!

Have Job Openings?
Contact Jennifer Gill with the job title, description, and how to apply and she will post it for you under the Careers tab on the LeadingAge NC website. It's free!

In Case You Missed It
Click below to read the most recent newsletter.

Follow @LeadingAgeNC on Social Media
Stay connected in 2020. Be sure you are following @LeadingAgeNC on Twitter, Facebook, and Instagram. You'll be up-to-date whatever comes your way!

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Elevate your leadership.
Apply to the LeadingAge North Carolina Leadership Academy.


Applications are due online by January 31, 2020 and can be accessed by clicking on this link. Communities are limited to nominating one individual (multi-site organizations may nominate one individual per campus or service setting).

Those selected for the Academy will:

  • Read, reflect on, and discuss leadership principles with Fellows and leaders from across the state.
  • Broaden their vision and exposure to the field.
  • Mature under the guidance of their assigned coach and the Academy facilitator.
  • Gain confidence and clarity, becoming even stronger contributors at their communities.
  • Prepare and present an action learning project.

Kick off for the 2020-21 class is this May 21-22, 2020 in Asheville. Tuition for the program is $2,000 and includes full registration for both the 2020 and 2021 annual conference (a $1,300 value!). Scholarship assistance is available.

For more information and the application, visit our Academy webpage by clicking on this link.

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Value First

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LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org

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Member Update

Posted By Jennifer Gill, Friday, January 3, 2020
Updated: Thursday, January 2, 2020
January 3, 2020

The LeadingAge North Carolina Member Update is published twice monthly. Click on a section header to view that section.

Advocacy & Policy  |  Strategic Thinking
   News & Notes   |  *NEW Leadership Academy  |  Value First

North Carolina General Assembly Set to Return on January 14
Both chambers of the North Carolina General Assembly will return to Raleigh on January 14 for a special session. Most prognosticators expect the mid-January session to last for only a couple of days, just long enough for legislators to get a sense of whether enough votes exist on the Senate side to overturn the Governor’s late fall veto of the budget. We expect the short session to begin in late April or early May.

Medical Expense Tax Deduction Makes the Finish Line Just in Time
Almost lost in all the hubbub of action taken just before the holidays is great news on the medical expense deduction front. The spending bill passed by Congress and signed by President Trump preserves – for another two years – the 7.5% adjusted gross income threshold for deducting medical expenses not covered by insurance. Without this provision, the threshold would have risen to 10% on January 1, reducing the amount of medical expenses that could be deducted and making the deduction available to fewer taxpayers. Our member communities and their residents were particularly helpful in providing information to federal lawmakers about the impact of the proposed increase. We will continue working to make the 7.5% threshold permanent.

Affordable Senior Housing Sees Critical Funding Increase
The year-end spending bill also provides $793 million, a 17%, $115 million increase over fiscal 2019 funding. Advocacy throughout this past year by LeadingAge and its members was key to this significant increase for the program. Highlights of the bill’s housing provisions:

  • $90 million for new Section 202 homes, a LeadingAge priority and a big increase over fiscal 2019’s $51 million. After being zeroed out for several years, new Section 202 construction has gained a total of $251 million since fiscal 2017.
  • A directive for which LeadingAge advocated requiring HUD and CMS to collaborate on initiatives in which affordable senior housing will serve as a platform for coordinating health, wellness, and supportive services for older adults. $500,000 is provided for this collaborative effort, which will also involve the use of Medicare and Medicaid funds.
  • $100 million to fully fund the renewal of existing grant-based service coordinators.

Medicare Advantage Supplemental Benefit Toolkit Unveiled
A new toolkit from LeadingAge will help guide members through understanding how Medicare Advantage supplemental benefits work, assessing the activity in each member’s market, evaluating the opportunity and which plans to approach, and providing a template for making the case to Medicare Advantage plans about the benefits of the services you provide in terms the plans understand.

When Managed Care Plans Must Pay Out-of-Network Providers
A new white paper from LeadingAge national discusses when and how skilled nursing facilities can get paid by a Medicare Advantage plan when they don’t have a contract and aren’t a network provider.

Latest Edition of Regulatory Tracker Now Online
LeadingAge’s Regulatory Roundup 2.0 is a quick and easy tracker to help members find pertinent rules and federal regulations, with timelines for submitting comments and links to any comments LeadingAge may have submitted.

LeadingAge NC Public Policy Committee Kicks Off 2020 Meeting Schedule
LeadingAge North Carolina’s Public Policy Committee will hold its first meeting of the new year on January 10. The committee will receive an update from Lu-Ann Perryman, LeadingAge NC’S lobbyist, discuss draft national policy priorities, and preview upcoming state issues. Members of the committee include Jonathan Erickson (chair), United Methodist Retirement Homes; Zane Bennett, Plantation Village; Kyle Dilday, Retirement Living Associates; Pam Fox, Twin Lakes Community; Shane Gabis, The Cypress of Raleigh; Jefferson Kaighn, Acts Retirement-Life Communities; Adam Melton, Galloway Ridge; Lee Syria, United Church Homes and Services; and Jeff Weatherhead, Aldersgate.

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Most-Read Health Stories in 2019
NC Health News; December 30, 2019
These are the 2019 North Carolina Health News stories that grabbed people's attention, and got passed around and shared widely. Most of the subject matter will affect your community in one way or another from the opioid epidemic and Medicaid expansion to upheaval in (mostly rural) hospitals, to mental health and clean water.

What's Coming for Healthcare in 2020? Health Executives Weigh In
Fierce Healthcare; December 31, 2019
From hospital executives to tech companies leaders, here's a look at some of their expectations in healthcare for 2020 and beyond.

Senior Living Braces for Changes in 2020 as Top Challenges Remain
McKnight's Senior Living; January 2, 2020
Leaders in the field, including LeadingAge national CEO, Katie Smith Sloan, comment on what the future holds for senior living, including occupancy challenges, and the overall changing landscape of services.

Looking Ahead: Hospice in 2020
Hospice News; December 19, 2019
The hospice space is evolving and providers will likely spend much of 2020 girding themselves for more change, including movement towards value-based payment models, accelerating industry consolidation, and possible changes to reimbursement, among others. The article includes comments from LeadingAge's Mollie Gurian, director, hospice, palliative and home health policy for LeadingAge national.

The New Era of PDPM is Here: What’s Next?
McKnight's Long-Term Care News; December 11, 2019
Now that we’re in this new era of PDPM, what should facility management teams, care providers and other stakeholders focus on as the industry moves into this uncharted territory? What can long-term care leaders do in the short term to help guide this change with providers and staff? The article shares how you can thrive under PDPM. Read more.

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2020 Event and Education Calendar Now Available
Mark your calendar for these LeadingAge North Carolina events and programs in 2020.

PDPM Readiness Available at LeadingAge National Learning Hub
Check out the latest on PDPM readiness at the LeadingAge national Learning Hub.

In addition, for your reference conference recordings are now available from the LeadingAge Annual Meeting in San Diego on topics such as fundraising, Medicare Advantage, Ageism, Design, Dementia, behavioral health and more. If you have questions or feedback, please contact Kevin Bradley.

Have Job Openings?
Contact Jennifer Gill with the job title, description, and how to apply and she will post it for you under the Careers tab on the LeadingAge NC website. It's free!

In Case You Missed It
Click below to read newsletters from the past two weeks.

Follow @LeadingAgeNC on Social Media
Stay connected in 2020. Be sure you are following @LeadingAgeNC on Twitter, Facebook, and Instagram. You'll be up-to-date whatever comes your way!

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Start 2020 by investing in our field's workforce.
Apply to the LeadingAge North Carolina Leadership Academy.
Applications are due online by January 31, 2020.


Selected Academy fellows will:

  • Read, reflect, and discuss leadership principles
  • Engage with emerging leaders across the state
  • Visit the General Assembly and the Department of Insurance
  • Meet leaders in the field 
  • Tour other communities
  • Present an action learning project
  • Grow under the guidance of our coaches and facilitator
  • Become even stronger contributors at their communities
  • Gain confidence
  • Question established thinking
  • And much more!

One applicant per community, please, from any department with any amount of experience. A nomination from your community must be approved by your CEO/Executive Director.

Academy fellows meet four times a year, starting and ending with the LeadingAge NC Annual Conference. Kick off for the 2020-21 class is this May 18-21, 2020 in Asheville. Tuition for the program is $2,000 and includes conference registration. Scholarship assistance is available.

For more information, check out our updated Academy webpage which includes:

  • Application and Letter of Commitment
  • Brochure
  • Curriculum
  • 2020-21 Meeting Schedule
  • Core Themes
  • Faculty
  • Action Learning Projects
  • Alumni
  • Testimonials
  • Current Fellows

Please feel free to contact us at 919-571-8333 with any questions. Enrich your leadership skills and apply today! We look forward to hearing from you.

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Value First

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LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


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Member Update

Posted By Jennifer Gill, Friday, December 20, 2019
Updated: Thursday, December 19, 2019
December 20, 2019

The LeadingAge North Carolina Member Update is published twice monthly. Click on a section header to view that section.

Advocacy & Policy | On the Road | Strategic Thinking
Position Papers  |  News & Notes   | Volunteer Spotlight
*NEW Leadership Academy  | Value First

Increased HUD Funding Approved
The final fiscal year 2020 appropriations package was released by House and Senate leaders on December 16. The bill is expected to pass the House and Senate and be signed into law by the President by midnight December 20. For HUD’s Section 202 Housing for the Elderly account overall, the bill provides $793 million, a 17% increase over FY19’s funding level for the account. Funding for the Section 202 account is $115 million above the 2019 enacted level and $149 million above the President’s budget request for FY20. The bill provides $90 million for new Section 202 homes, a key LeadingAge priority. Click here for more information about the spending bill and related provisions.

Medical Expense Tax Deduction Preserved
The spending bill preserves the 7.5% adjusted gross income threshold for deducting medical expenses not covered by insurance for another two years. Without this provision, the threshold would have risen to 10% on January 1, reducing the amount of medical expenses that could be deducted and making the deduction available to fewer taxpayers. We have urged Congress to extend the 7.5% threshold because long-term services and supports are the largest single category of medical spending for which most people have no coverage. In addition, the deduction makes life plan communities more affordable by enabling residents to deduct the portion of fees that prepays their potential long-term care expenses. We will continue working to make the 7.5% threshold permanent.

Senators Address Legislation to Address CNA Training Lockout Issue
Sen. Mark Warner (D-VA) and Sen. Tim Scott (R-SC) introduced bipartisan legislation (S. 2993) in the Senate that will end the mandatory 2-year CNA lockout for nursing homes if they have been fined over a certain threshold amount. This legislation will provide relief and help to ensure that our members can provide quality care for residents. Click here to contact your Members of Congress and share your support on this important issue.

Public Policy Committee Sets Meeting Dates
The LeadingAge North Carolina Public Policy committee has finalized their meeting schedule for the first half of 2020. The committee will meet on January 10, February 11, March 10, April 30, May 26, June 18, and July 16.

CMS Proposed Rule Could Impact Nursing Home Provider Taxes and Supplemental Payments
CMS has published the Medicaid Fiscal Accountability Regulation (MFAR) Proposal on the Federal Register. This proposed rule would make significant changes to key parts of state Medicaid financing structures for nursing homes and hospitals and would, among other items, preclude CCRCs from being exempted from North Carolina’s provider tax.

For nursing homes, including CCRCs with nursing homes/health centers, the most significant proposed changes are to provider taxes and supplemental payments. Listed below is a summary of key provisions of the MFAR proposal as they relate to nursing homes. A full crosswalk comparing current policy to the proposal is available from LeadingAge national here.

Provider taxes would not be banned outright under the proposed rule. CMS is, however, proposing to set new criteria for which revenue generated by provider taxes would or would not receive federal matching funds, and state provider taxes would face new scrutiny under the proposed regulation. Current policy requires that provider taxes be broad-based and uniform (or, in other words, be applied to providers equally), and that if states want more targeted tax structures, like a bed tax, it must receive a CMS waiver to do so. This process would not change under the proposed rule, and states would still be able to receive these waivers from CMS, but the considerations of what would be allowed under those waivers would change. Specifically, states would be disallowed from receiving federal funds for taxes that “impose undue burden” on the Medicaid program. Such “undue burdens”, per the proposal, include:

  1. Taxing providers that provide less Medicaid services at lower rates than those that provide relatively more Medicaid services.
  2. Medicaid services, in general, being taxed more than non-Medicaid services (except when excluding Medicare/Medicaid revenue).
  3. Not taxing, or taxing at a lower rate, groups of providers with no Medicaid services compared to other groups (e.g., those that take Medicaid).

In addition to these cases, the proposal also says that a tax would impose an undue burden if it,

“excludes or imposes a lower tax rate on a taxpayer group defined based on any commonality that, considering the totality of the circumstances, CMS reasonably determines to be used as a proxy for the taxpayer group having no Medicaid activity or relatively lower Medicaid activity than any other taxpayer group.”

In other words, CMS would have significant latitude determining whether a provider tax and any provider tax exclusions or “discounts” would comply with the proposal if finalized. This could very well mean that exclusions or lower taxes for CCRCs, for example, could be determined disallowable. Further, current policy does not allow providers to be guaranteed to be held harmless under provider taxes. This means taxes can’t be levied with the understanding that any funds a provider pays will eventually circle back to them. CMS proposes new language in MFAR that would allow CMS to more closely look at arrangements between providers, states and other relevant entities – including arrangements not in writing or legally enforceable – to determine if providers have “reasonable expectation that the taxpayer will receive a return of all or any portion of the tax amount.” If CMS reaches that conclusion, provider taxes could be further jeopardized.

LeadingAge North Carolina, in concert with LeadingAge national and other organizations, will work aggressively to provide CMS with information about the detrimental impact to residents of the proposed changes.

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LeadingAge North Carolina staff travels the state offering education, advocacy, and networking. Here’s where we've been recently:

  • Direct Care Workforce Meeting - Raleigh
  • LeadingAge NC Public Policy Committee conference call
  • Member visit - The Cypress of Raleigh, Raleigh

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A Recession Hasn’t Arrived (Yet). Here’s Where You’ll See It First.
The New York Times; December 12, 2019
Five months after last summer's recession, the situation has improved, but risks remain. Here are key indicators to watch for signs of trouble.

What the “Best Companies to Work For” Do Differently
Harvard Business Review; December 12, 2019
What makes a company culture great? To explore this question, the authors spent three years researching 21 of the best places to work in the United States. They offer five general principles about why what they do is so successful.

New Tech Ideas for Aging Well
Kiplinger's Retirement Report; December 16, 2019
These products were highlighted at AARP's Innovation Labs Grand Pitch Finale for their ability to offset difficulties aging adults face with everyday tasks while also helping caregivers.

Would You Let a Robot Take Care of Your Mother?
The New York Times, December 13, 2019
Robotic companions are being promoted as an antidote to the burden of longer, lonelier human lives. At stake is the future of what it means to be human. Read this opinion piece.

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Thanks to LeadingAge North Carolina Platinum business members CliftonLarsonAllen, WeaverCooke, and BB&T Capital Markets for sharing their position papers. Click on a title below to download a PDF.

These papers are also available from our website by clicking here. Or visit www.LeadingAgeNC.org and under the Resources tab, select Position Papers.




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2020 Event and Education Calendar Now Available
Mark your calendar for these LeadingAge North Carolina events and programs in 2020.

Health Care Spending Jumps Again
A new study from the U.S. Centers for Medicare and Medicaid Services found a small one percent decrease in American retail drug prices in 2018 — the first decline in more than 40 years — but a significant jump in the cost per person for private health insurance. The study, which was published in the journal Health Affairs, says that last year health care spending overall grew by 4.6 percent to a total of $3.6 trillion, or an average of $11,172 per person. If you felt like you were spending more on out-of-pocket fees such as insurance deductibles and co-payments in 2018 , those also increased last year by 2.8 percent.

Check Out the New W-4 Tax Withholding Form
The New York Times; December 13, 2019
The first major redesign since 1987 is simpler and reflects tax code changes, the I.R.S. said. Workers should make sure it also reflects what they owe.

PDPM Readiness Available at LeadingAge National Learning Hub
Check out the latest on PDPM readiness at the LeadingAge national Learning Hub.

In addition, for your reference conference recordings are now available from the LeadingAge Annual Meeting in San Diego on topics such as fundraising, Medicare Advantage, Ageism, Design, Dementia, behavioral health and more. If you have questions or feedback, please contact Kevin Bradley.

Meet the New Director of LPC Services & Policy at LeadingAge National
Dee Pekruhn joined LeadingAge this month as Director of Life Plan Communities Services & Policy. Dee brings years of experience with LeadingAge and three of its member communities to her new position. Read more.

Have Job Openings?
Contact Jennifer Gill with the job title, description, and how to apply and she will post it for you under the Careers tab on the LeadingAge NC website. It's free!

In Case You Missed It
Click below to read newsletters from the past two weeks.

Follow @LeadingAgeNC on Social Media
Stay connected through the busy holiday season. Be sure you are following LeadingAge NC on Twitter, Facebook, and Instagram. You'll be up-to-date when the new year starts!

2019-20 LeadingAge NC Member Directory
The updated member directory is now available online! Go to http://LeadingAgeNC.org and click on the Directory tab.

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Board members of LeadingAge North Carolina volunteer their time and expertise to enrich the field of aging services. We are grateful to welcome Chip Cromartie to the board this year. Read on to learn a little more about Chip, who is executive director at Well-Spring Solutions in Greensboro.

1. How did you get into the field of aging services and what was your first job?
In my early years, I spent a lot of time with my grandfather, who taught me about life, the value of hard work and how to age gracefully. My outlook from the very start was that older adults are a valuable resource, and they can provide us with experience, knowledge and warmth. In college I volunteered in long-term care, which further supported my interest in working with older adults. I was naturally drawn to aging services right out of school and started my career as the Assistant Program Director for an adult day health center in Greensboro, NC.

2. If you could wave a magic wand, what is the one thing you would like to do for the population we serve?
In his book, Faces of Aging, Dr. Nader Robert Shabahangi asks wouldn’t it be great if we looked forwarded to growing older like a child looks forward to growing up? I think we would be a lot closer to making this a reality if we could wave a magic wand and create a society in which all older adults are appreciated, treated with dignity and viewed as valuable resources to be cherished.

3. If you could swap jobs with a staff member for a day, what would you want to try and why?
The lifeblood of every aging services provider is the front-line staff. They are the direct link to quality care. These staff members deserve our best in leadership and support. To truly walk in their shoes for a day would be an honor.

4. What makes LeadingAge NC’s mission meaningful to you and what factors do you believe will affect the Association’s mission in the months and years to come?
The breadth of LeadingAge NC’s mission is inspiring because it recognizes we can strengthen our members not only by providing them with direct value, but also by developing our future leaders and broadening the possibilities of aging. I firmly believe our focus on advocacy, education, innovation and collaboration positions our association and its members well for the coming years as we face increased regulation, workforce challenges, a seemingly ever-changing health care system and evolving consumers. Together, we can drive positive change and outcomes for older adults.

5. When you are not working, what do you do to relax and recharge your batteries?
I enjoy spending time with my family, riding my motorcycle, Scouting, exercise and reading.

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Applications for the LeadingAge North Carolina
Leadership Academy Class of 2021 are now open!


Build tomorrow’s leaders and invest in our field's workforce.
Apply to the LeadingAge North Carolina Leadership Academy.
Applications are due online by January 31, 2020.

Selected Academy fellows will:

  • Read, reflect, and discuss leadership principles
  • Engage with emerging leaders across the state
  • Visit the General Assembly and the Department of Insurance
  • Meet leaders in the field 
  • Tour other communities
  • Present an action learning project
  • Grow under the guidance of our coaches and facilitator
  • Become even stronger contributors at their communities
  • Gain confidence
  • Question established thinking
  • And much more!

One applicant per community, please, from any department with any amount of experience. A nomination from your community must be approved by your CEO/Executive Director.

Academy fellows meet four times a year, starting and ending with the LeadingAge NC Annual Conference. Kick off for the 2020-21 class is this May 18-21, 2020 in Asheville. Tuition for the program is $2,000 and includes conference registration. Scholarship assistance is available.

For more information, check out our updated Academy webpage which includes:

  • Application and Letter of Commitment
  • Brochure
  • Curriculum
  • 2020-21 Meeting Schedule
  • Core Themes
  • Faculty
  • Action Learning Projects
  • Alumni
  • Testimonials
  • Current Fellows

Please feel free to contact us at 919-571-8333 with any questions. Enrich your leadership skills and apply today! We look forward to hearing from you.

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Value First

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LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


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Advocacy in Action

Posted By Jennifer Gill, Friday, December 13, 2019
Updated: Thursday, December 12, 2019
December 13, 2019



Tell Congress to Support the Medical Expense Tax Deduction

The medical expense tax deduction is vitally important to older adults with high out-of-pocket medical costs and has enjoyed broad bipartisan support for over 75 years. Unfortunately, the lower 7.5% threshold of adjusted gross income (AGI) expired at the end of 2018 and it now stands at 10%. Thus, older adults are only entitled to deduct medical expenses in excess of 10% of their AGI. Congress is currently considering whether to return the threshold to 7.5% of AGI.

We urge you to contact Sen. Richard Burr, Sen. Thom Tillis, and your United States Representative and urge them to support extending that provision permanently, or at least through 2019. Email your lawmakers today by clicking on this link that will take you directly to a LeadingAge national website that will make the process simple and quick.

People aged 65 and over often have high out-of-pocket medical expenses relative to their incomes. Thousands of them will end up paying far higher taxes unless the lower threshold is extended. Residents of life plan communities can utilize this deduction for a portion of their entry and/or monthly fees that qualify as medical expenses, making this form of medical care in their retirement housing far more affordable for many older adults.

CMS Proposed Rule Could Impact Nursing Home Provider Taxes and Supplemental Payments
CMS has published the Medicaid Fiscal Accountability Regulation (MFAR) Proposal on the Federal Register. This proposed rule would make significant changes to key parts of state Medicaid financing structures for nursing homes and hospitals and would, among other items, preclude CCRCs from being exempted from North Carolina’s provider tax.

For nursing homes, including CCRCs with nursing homes/health centers, the most significant proposed changes are to provider taxes and supplemental payments. Listed below is a summary of key provisions of the MFAR proposal as they relate to nursing homes. A full crosswalk comparing current policy to the proposal is available from LeadingAge national here.

Provider taxes would not be banned outright under the proposed rule. CMS is, however, proposing to set new criteria for which revenue generated by provider taxes would or would not receive federal matching funds, and state provider taxes would face new scrutiny under the proposed regulation. Current policy requires that provider taxes be broad-based and uniform (or, in other words, be applied to providers equally), and that if states want more targeted tax structures, like a bed tax, it must receive a CMS waiver to do so. This process would not change under the proposed rule, and states would still be able to receive these waivers from CMS, but the considerations of what would be allowed under those waivers would change. Specifically, states would be disallowed from receiving federal funds for taxes that “impose undue burden” on the Medicaid program. Such “undue burdens”, per the proposal, include:

  1. Taxing providers that provide less Medicaid services at lower rates than those that provide relatively more Medicaid services.
  2. Medicaid services, in general, being taxed more than non-Medicaid services (except when excluding Medicare/Medicaid revenue).
  3. Not taxing, or taxing at a lower rate, groups of providers with no Medicaid services compared to other groups (e.g., those that take Medicaid).

In addition to these cases, the proposal also says that a tax would impose an undue burden if it,

“excludes or imposes a lower tax rate on a taxpayer group defined based on any commonality that, considering the totality of the circumstances, CMS reasonably determines to be used as a proxy for the taxpayer group having no Medicaid activity or relatively lower Medicaid activity than any other taxpayer group.”

In other words, CMS would have significant latitude determining whether a provider tax and any provider tax exclusions or “discounts” would comply with the proposal if finalized. This could very well mean that exclusions or lower taxes for CCRCs, for example, could be determined disallowable. Further, current policy does not allow providers to be guaranteed to be held harmless under provider taxes. This means taxes can’t be levied with the understanding that any funds a provider pays will eventually circle back to them. CMS proposes new language in MFAR that would allow CMS to more closely look at arrangements between providers, states and other relevant entities – including arrangements not in writing or legally enforceable – to determine if providers have “reasonable expectation that the taxpayer will receive a return of all or any portion of the tax amount.” If CMS reaches that conclusion, provider taxes could be further jeopardized.

LeadingAge North Carolina, in concert with LeadingAge national and other organizations, will work aggressively to provide CMS with information about the detrimental impact to residents of the proposed changes.

Aging Services Issues: Capitol Hill Status
The 116th Congress is moving toward the end of its first session. Because of partisan wrangling over issues unrelated to long-term services and supports, it has been difficult for Congress to reach the consensus necessary to pass even routine legislation. Click here for a comprehensive look at where aging services issues stand as we reach the end of the calendar year.

Keep Safety AND Compliance in Mind When Decorating for the Holidays
Celebrating the holidays can be an uplifting experience for both residents and staff. However, decorating can sometimes lead to some unintended consequences. Here are some quick tips to help ensure your organization maintains a safe environment that is compliant with the Life Safety Code.


LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


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Member Update

Posted By Jennifer Gill, Friday, December 6, 2019
Updated: Thursday, December 5, 2019
December 6, 2019

The LeadingAge North Carolina Member Update is published twice monthly. Click on a section header to view that section.

Advocacy & Policy | On the Road | Strategic Thinking
Position Papers  |  Member Questions  |  News & Notes  
*NEW Leadership Academy  | Value First

Congress Needs Calls for Housing Action
On December 2, LeadingAge issued a call to action, urging our members to call and email their representatives and senators in support of funding for new homes in HUD’s Section 202 Housing for the Elderly program. Just before Thanksgiving, Congress made progress on year-end spending negotiations and is now finalizing details of HUD’s fiscal year 2020 appropriations bill.
The House and Senate spending bills are far apart on a key LeadingAge priority: funding for new housing under the Section 202 Housing for the Elderly program. The House bill includes $140 million for new Section 202 homes. The Senate bill includes $0 (zero) funds for new Section 202 homes. And, the current Continuing Resolution is funding HUD programs at fiscal year 2019 levels through December 20. Funding at FY19 levels past December 20 could be inadequate for some HUD programs, including Section 202 communities with Project Rental Assistance Contracts. LeadingAge members are asked to contact their representative and senators with these key messages:

  • Retain the House bill’s $140 million for new Section 202 homes in the final FY20 HUD bill.
  • Enact a final FY20 HUD bill before December 20 to avoid additional Continuing Resolutions.

Click here to access the easy-to-use "Contact Congress" tool for this issue.

New Incentives for Charitable Giving Could Help Offset Reductions in Middle-Class Giving
Because of the structural federal tax changes in the "2017 Tax Cuts and Jobs Act", more than 21 million Americans stopped using the charitable deduction last year. Preliminary data suggests that this tax law change has led to a small reduction in individual donations supporting the work of charitable nonprofits. In a new blog post, the North Carolina Center for Nonprofits analyzes the latest trends in charitable giving and explains why new federal or state incentives for charitable giving – such as a universal, non-itemizer charitable deduction – are critical to sustaining the work of nonprofits in communities.

State Judges Review NC Congressional Maps
Earlier this week, a panel of North Carolina judges ordered a new U.S. House district map that Republican state legislators drew last month be used in the 2020 elections. The Associated Press reports that the Court decided that there was not time to scrutinize the boundaries further for any left-over extreme partisan bias. The judges agreed it was too late in the election cycle to receive evidence and testimony that would be necessary to consider detailed redistricting arguments from the lawmakers and from Democratic and independent voters who challenged the latest congressional maps. The North Carolina primary for hundreds of state and local elected positions is March 3, and candidate filing opened Monday. The judges had suspended congressional filings for all 13 seats while they reviewed the case, but the judges’ unanimous order said the State Board of Elections should now start receiving filings from U.S. House hopefuls based on the new district seats.

Aging Advocates Need to Know About These Bills
The North Carolina Coalition on Aging (of which LeadingAge North Carolina is a member) has pulled together a list of legislation that was passed in 2019 that is likely of most relevance to aging interests in the state. Click here for a look at this comprehensive recap.

Governor Signs Legislation Making Absentee Ballot and Early Voting Changes
Governor Roy Cooper has signed into law a bill (S.683) that makes several changes to election laws to help prevent absentee ballot fraud and to increase access to early voting. The bill would permanently restore the last Saturday of the early voting period. The bill also ensures that many nonprofits that serve homebound seniors and individuals with disabilities can continue to provide assistance with absentee ballot requests to the people they serve.

Legislature Returns
The General Assembly will return on January 14, 2020 for what is expected to be a brief session. A budget veto override and health care legislation could possibly be considered at that time. The General Assembly’s short session will start in late spring.

Certificate of Need Lawsuit Allowed to Proceed
A Wake County Superior Court judge is allowing a lawsuit to proceed that could dramatically change how doctors and hospitals operate in the open market. The suit, filed by Dr. Gajendra Singh, a general surgeon in Winston-Salem, challenges the constitutionality of North Carolina's CON provisions, the process through which state regulators approve granting a license to provide certain medical services. The Department of Health and Human Services and the North Carolina Healthcare Association are named as defendants in the case, and jointly filed a motion to dismiss. The motion was denied just before Thanksgiving, thus allowing the case to proceed. According to the DHHS website, the CON law "restricts unnecessary increases in health care costs and limits unnecessary health services and facilities based on geographic, demographic and economic considerations." Dr. Singh's issue emanates from his desire to purchase a new MRI machine for his practice. Singh, though, cannot legally do that without a CON, and the state thus far has not determined there is sufficient need for a new MRI machine in Singh's area. In a lawsuit filed in July 2018, Singh's attorneys label the law "arbitrary, irrational, and protectionist legislation" because it infringes on his right "to participate in the health-care market."

CMS Updates Emergency Preparedness Requirements
Effective November 29, 2019 CMS has made two revisions to emergency preparedness requirements for nursing facilities. Read a summary of the rule’s impact prepared by LeadingAge National.

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LeadingAge North Carolina staff travels the state offering education, advocacy, and networking. Here’s where we've been recently:

  • Member visit - Arbor Acres, Winston-Salem
  • Member visit - Piedmont Crossing, Thomasville
  • Member visit - Salemtowne, Winston-Salem
  • Member visit - The Presbyterian Homes, Colfax

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The Unending Indignities of Alzheimer’s
The New York Times; December 1, 2019
Be sure to read this heart-wrenchingly honest account of one family's struggle to care for a loved one living with Alzheimer's.

Fertility Rate in U.S. Hit a Record Low in 2018
The New York Times; November 27, 2019
The rate of births fell again last year, according to new government data, extending a lengthy decline as women wait until they are older to have children.

We Need a Major Redesign of Life
The Washington Post; November 29, 2019
Disruption is here. We're living longer than ever. This article takes a fascinating and creative look at how we could reshape our culture to support our longer life spans.

Preparing for Economic Uncertainty: Are Your Operations Teams Ready?
Russell Reynolds Associates; October 22, 2019
Senior operations and supply chain executives believe an economic downturn will happen within the next 18 months. Are you prepared? This article sets out the steps that you can take to get ready. Read more.

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Thanks to LeadingAge North Carolina Platinum business members BB&T Capital Markets, CliftonLarsonAllen, and WeaverCooke for sharing their position papers. Click on a title below to download a PDF.

These papers are also available from our website by clicking here. Or visit www.LeadingAgeNC.org and under the Resources tab, select Position Papers.




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Thanks to everyone who responds to member questions. Click on the links below to download a spreadsheet of responses to the member question on that topic.

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Report: More Americans Dying at Younger Ages
A new report published in the Journal of the American Medical Association says more Americans are dying at younger ages despite greater spending on health care in the U.S. than in any other country. Mortality and life expectancy rates for Americans between the ages of 25 and 64 are getting worse, with increases in suicides, drug overdoses and alcohol-related liver disease, among other factors. The study estimated that there were 33,000 excess midlife deaths between 2010 and 2017, and the negative trend was found across gender, race and ethnicity. Read this insightful Washington Post article from November 26, 2019 for more detail.

Hackers Disrupt Skilled Nursing Facility Operations
More than 100 nursing homes spread across the country are having trouble paying employees and ordering necessary medications for residents due to a ransomware attack on an IT support company for long-term and post-acute providers. The attack happened last Sunday against Virtual Care Provider Inc. by Russian hackers and has affected 80,000 computers and 110 nursing homes, the Milwaukee Journal Sentinel reported. With our technology-dependent world, it’s more important than ever that our security infrastructure is up-to-date.

Have Job Openings?
Contact Jennifer Gill with the job title, description, and how to apply and she will post it for you under the Careers tab on the LeadingAge NC website. It's free!

In Case You Missed It
Click below to read newsletters from the past two weeks.

Follow @LeadingAgeNC on Social Media
Stay connected through the busy holiday season. Be sure you are following LeadingAge NC on Twitter, Facebook, and Instagram. You'll be up-to-date when the new year starts!

2019-20 LeadingAge NC Member Directory
The updated member directory is now available online! Go to http://LeadingAgeNC.org and click on the Directory tab.

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Applications for the LeadingAge North Carolina
Leadership Academy Class of 2021 are now open!


Build tomorrow’s leaders and invest in our field's workforce.
Apply to the LeadingAge North Carolina Leadership Academy.
Applications are due online by January 31, 2020.

Selected Academy fellows will:

  • Read, reflect, and discuss leadership principles
  • Engage with emerging leaders across the state
  • Visit the General Assembly and the Department of Insurance
  • Meet leaders in the field 
  • Tour other communities
  • Present an action learning project
  • Grow under the guidance of our coaches and facilitator
  • Become even stronger contributors at their communities
  • Gain confidence
  • Question established thinking
  • And much more!

One applicant per community, please, from any department with any amount of experience. A nomination from your community must be approved by your CEO/Executive Director.

Academy fellows meet four times a year, starting and ending with the LeadingAge NC Annual Conference. Kick off for the 2020-21 class is this May 18-21, 2020 in Asheville. Tuition for the program is $2,000 and includes conference registration. Scholarship assistance is available.

For more information, check out our updated Academy webpage which includes:

  • Application and Letter of Commitment
  • Brochure
  • Curriculum
  • 2020-21 Meeting Schedule
  • Core Themes
  • Faculty
  • Action Learning Projects
  • Alumni
  • Testimonials
  • Current Fellows

Please feel free to contact us at 919-571-8333 with any questions. Enrich your leadership skills and apply today! We look forward to hearing from you.

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Value First

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LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org

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Advocacy in Action

Posted By Jennifer Gill, Friday, November 22, 2019
Updated: Thursday, November 21, 2019
November 22, 2019

Medicaid Managed Care Transformation Suspended
The North Carolina Department of Health and Human Services announced earlier this week that the transformation to a system of managed care for providing Medicaid services will not begin on February 1, 2020. Instead, current and future Medicaid beneficiaries will continue to rely on the existing fee-for-service system. Department officials did not have a new date for when the transition might occur. In announcing their decision, the Department pointed to the inability of the General Assembly and the Governor to reach a budget compromise. The General Assembly closed its session last week without an end to the impasse and with no funds dedicated to the transformation project. The Governor’s veto in late June of the General Assembly’s proposed budget was in large part predicated on the spending plan not including any funds for Medicaid expansion. Providers enrolled in Medicaid will continue to bill the state through its NCTracks system, the Department said.

Paycheck to Paycheck Homeownership Affordability Calculator
Paycheck to Paycheck is an interactive online tool from the National Housing Coalition that allows users to research and compare rental and homeownership affordability challenges of workers in 81 occupations in 259 metro areas nationwide.
The tool provides data to compare ‘Income Needed’ and ‘Median Salary’ in up to three metro areas at a time for aging services related occupations including:

  • Affordable Housing Occupancy Specialist
  • Laundry Worker
  • Computer Support Specialist
  • Maintenance Worker
  • Social Worker
  • Nurse
  • Food Prep Worker
  • Office Clerk
  • Groundskeeper
  • Home Health Aide
  • Housekeeper
  • Physical Therapist
    Nursing Aide

The website highlights affordability challenges workers face in five job categories in the construction industry: carpenters; electricians; heating, ventilation, and air conditioning (HVAC) mechanics; maintenance workers and plumbers. We know we have an affordability crisis when the men and women who build our homes can’t afford to live in most of them. The same is true for the aging services field, when members of the workforce can’t find or afford homes. You can apply the same methodology to create reports that focus on aging services occupations.

New Discharge Planning Rule Effective Next Week
CMS's new discharge planning rule goes into effect next week on November 29. This rule impacts hospitals and home health agencies, requiring a formal discharge planning process. As part of this requirement, hospitals and home health agencies are required to share nursing homes' quality measure and resource utilization data. CMS recommends the use of the SNF QRP data, available on the Nursing Home Compare website, along with any other "compare" sites and information that meets the patient's goals for discharge. What does this mean for our members? Hospitals and home health agencies will need to comply with the rule. Our members with skilled nursing facilities should also be aware of this rule, as it may impact referrals and census. LeadingAge has posted this information in the Nursing Homes group on the LeadingAge Member Community and recommended that nursing homes keep an eye on their quality measure data, utilizing the Five Star Analysis Reports to see how they might improve. As a reminder, the next Nursing Home Compare update is scheduled for December 4.

Three U.S. Senators Question Private Equity Firms Stakes in Nursing Homes
Senators Elizabeth Warren (D-MA), Sherrod Brown (D-OH) and Representative Mark Pocan (D-WI) sent letters to four private equity firms that invest in companies providing skilled nursing care, questioning their commitment to quality of care. Click here for a closer look at the issue.

AG Stein and Speaker Moore Bring Added Focus to Scam Callers
Looking to bring more attention to the scourge of unwanted telemarketing calls, North Carolina Attorney General Josh Stein posted a downloadable voice note that people can use as a voicemail message. The attorney general’s office has initiatives to combat telemarketing scams, featuring a hotline (1-877-5-NO-SCAM) that people can call if they have been the victim of a scam. Add to that legislation introduced by House Speaker Tim Moore and signed into law by Governor Roy Cooper (the “Truth in Caller ID Act,” which fines violators up to $5,000 for multiple transgressions), and it’s easy to see why North Carolinians are fed up with unwanted calls. Click here for Stein’s voicemail message.


LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


Tags:  Advocacy in Action 

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Inclusion Insights November 2019

Posted By Jennifer Gill, Thursday, November 21, 2019
Updated: Thursday, November 21, 2019

14th edition
November 21, 2019


Inclusion Insights is a quarterly publication of LeadingAge North Carolina highlighting news, research, and best practices in diversity, equity, and inclusion.

Do you have an article or information to share in this newsletter?
Please contact Jennifer Gill.


Leadership

Getting Over Your Fear of Talking About Diversity
Harvard Business Review; November 8, 2019
This author provides four truly actionable steps to help leaders fully engage on this topic. Don't let your fear of making a misstep hold you back from a diverse, equitable, and inclusive workplace.

The Anxiety of Being the “Only”
Harvard Business Review; October 14, 2019
Being the “only” in the workplace — the only woman, the only person of color, the only one openly suffering from a mental or physical illness — can contribute to existing mental health issues. In this 39-minute podcast, host Morra Aarons-Mele speaks with two experts on the topic: Angela Neal-Barnett, an award-winning psychologist and expert on anxiety among African-Americans, and author of “Soothe Your Nerves,” and Nilofer Merchant, the author of “The Power of Onlyness.”

Board Diversity Includes Disabilities
BoardSource; October 25, 2019
In the United States, we have worked hard to remove environmental and attitudinal barriers in order to promote the inclusion of people with disabilities into all aspects of society. The Americans with Disabilities Act, passed in 1990, is groundbreaking civil rights legislation for people with disabilities. Nevertheless, there still exists limited opportunities for the inclusion of people with disabilities, particularly in the area of leadership, policy, and community governance.

4 Important (and Sometimes Difficult) Steps Leaders Must Take to Create a More Diverse and Inclusive Team
LinkedIn Talent Blog; November 5, 2019
“The culture that you want starts with the leadership that you have,” says Uzo Akotaobi, VP of HR, diversity and inclusion, and learning and development at Prologis. “You can want diversity all day. But once you get that diverse talent, what do you do with it?”


Workforce

How Unpredictable Work Hours Turn Families Upside Down
The New York Times; October 16, 2019
New research shows that African Americans, Hispanics and other minorities — particularly women — are much more likely to be assigned irregular schedules, and that the harmful repercussions are felt not just by the workers but also their families.

The Future of Work in Black America
McKinsey & Company; October 2019
Research shows that automation trends may be widening the racial wealth gap. This article reveals possible interventions that may help African American workers prepare for the future.

Three Reasons Why a Latinx/a/o Talent Strategy Drives an Inclusive Culture
Diversity Best Practices; October 1, 2019
Patricia Mota, President & CEO for the Hispanic Alliance for Career Advancement, provides three of many reasons why a Latinx/a/o talent strategy drives an inclusive culture.

What Matters to College Students Today
Axios; September 21, 2019
Hint: race, diversity, and inclusion were by far the most discussed issues among student editors across public and private universities, community colleges, liberal arts schools, Historically Black Colleges and Universities and religious universities in all 50 states.


Resources

What LeadingAge Members Need To Know About LGBT Aging
Check out this free webinar available to members from the LeadingAge national Learning Hub. This 13-minute QuickCast provides an overview of how to create an LGBT inclusive environment for residents/clients, staff and families.

TED Talks: Why Diversity Matters
These TED Talks highlight how diversity of thought, perspective, language, culture and people have a unique advantage in today's globalized world.

Have a resource you’d like to share in this newsletter?
Please contact
Jennifer Gill.


Celebrations

North Carolina’s 1st LGBT Senior Co-Housing Under Construction
The Rainbow Times; September 7, 2019
Village Hearth Senior Cohousing in Durham, North Carolina, the first LGBT Senior Cohousing Community in North America, is on course for occupancy in Spring of 2020. This 28 single-story home community on a 15-acre wooded lot near central Durham is more than a set of structures; it represents community, camaraderie, and safety for the residents who will occupy these special homes. Read more about this groundbreaking project.

Have a celebration you’d like to share in this newsletter?
Please contact Jennifer Gill.



Online

Is your community SAGE-certified or seeking such certification? If so, please contact Jennifer Gill with your community's name so that we can include it in the next edition of this newsletter.

LeadingAge North Carolina | 222 N. Person Street, Raleigh, NC 27601
919-571-8333 | info@leadingagenc.org | www.leadingagenc.org

Tags:  Inclusion Insights 

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Member Update

Posted By Jennifer Gill, Friday, November 15, 2019
Updated: Thursday, November 14, 2019

November 15, 2019

The LeadingAge North Carolina Member Update is published twice monthly.
Click on the headers below to view that section.


Advocacy & Policy  |  On the Road
Strategic Thinking  |   *NEW Position Papers   
Member Questions
  |  News & Notes
  Professional Development  |  Value First

NC General Assembly Adjourns Long Session
Late last week, the NC General Assembly adjourned its 2019 long session without a Senate vote on an override of Governor Roy Cooper’s veto of the state budget for FY2019-21 (House Bill 966). Instead of enacting a full budget, legislators have taken a piecemeal approach to the state budget. Under state law, recurring funding from last year’s state budget automatically continues for the current fiscal year. To address many of the state’s new funding needs and various policy provisions that are necessary for the effective operation of state programs, legislators have passed 21 “mini-budget” bills this fall. Governor Cooper has signed 14 of these “mini-budget” bills into law and has vetoed one of them. Six of the “mini-budget” bills remain on his desk for his consideration.

LeadingAge NC Testifies at NC Board of Nursing
LeadingAge North Carolina was invited by the North Carolina Board of Nursing to provide testimony on scope of practice issues for LPNs. Earlier this week, Tom Akins provided testimony to the Board’s Education and Practice Committee concerning LeadingAge North Carolina’s perceptions regarding current and future LPN practice. Click here for a look at our testimony.

CMS Announces Medicare Premium Increases
CMS late last week announced the 2020 premiums, deductibles and coinsurance amounts for the Medicare Part A and Part B programs. Beneficiaries living in skilled nursing facilities will see their daily coinsurance for days 21 through 100 of extended care services during the benefit period rise from $170.50 in 2019 to $176 in 2020, an increase of 3.2%. Medicare Part B premiums will also be rising for seniors. The standard monthly premium will increase from $135.50 in 2019 to $144.60 for 2020, an increase of 6.7%. Annual deductibles also will increase from $185 for 2019 to $198 for 2020, an increase of 7%. CMS attributes the increases to rising spending on physician-administered drugs.

Donors May Use IRA Charitable Rollover on State Taxes in 2019
Governor Cooper signed into law on November 1st House Bill 399 that, among other things, increases charitable giving in North Carolina by extending the IRA charitable rollover – a popular federal tax incentive for charitable giving – to state taxes. Individuals aged 70½ and older may make tax-free (for federal tax purposes) distributions to nonprofits from their individual retirement accounts. In previous years, North Carolina donors who used the IRA charitable rollover had to pay state taxes on these charitable contributions. The new law ends this state tax on donations to nonprofits through IRAs, simplifying the process for donors and allowing them to contribute more fully to nonprofits from their IRAs. This change is particularly important now that the IRA charitable rollover has become a more attractive giving option for some donors after the federal Tax Cuts and Jobs Act was passed in December 2017. Donors may begin to use the IRA charitable rollover on their taxes this year.

Protecting Veterans from Scammers
A bipartisan set of U.S. Senators last week petitioned the Veterans Administration to take specific steps to protect veterans from unscrupulous scammers. Click here for a look at their letter and the particulars of their request.

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Here's where LeadingAge North Carolina staff has been recently:

  • Congressman David Price Senior Affordable Housing round table - Chapel Hill
  • LeadingAge NC joint program with Senior Dining Association - Plantation Estates, Matthews
  • North Carolina Board of Nursing testimony - Raleigh
  • NC Department of Insurance CCRC Without Walls meeting - Raleigh

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Why Connector Managers Build Better Talent
Harvard Business Review; November/December 2019
A study of 5,000 managers identified four different types of leaders, with the surprising result that the “always on” manager is less effective at developing employees, even though many companies encourage supervisors to give constant feedback. Instead, the “connector” manager is the most effective, because they facilitate productive interactions across the organization.

1.3 million pension recipients
After three decades in mining, Joe Brown relies on a pension plan through the United Mine Workers of America that provides him and 86,000 other retirees essential monthly benefits that Brown thought he would have for the rest of his life. However, the plan is on track to be insolvent in only three years, and Brown isn’t the only one vulnerable to having his pension deeply underfunded. A new report by HuffPost shows 130 other multiemployer pension plans in the United States are also projected to be insolvent in the next two decades, affecting more than 1.3 million pension recipients.

A Retirement Community That Comes To You

The New York Times; November 8, 2019
Though some at-home programs date to the 1990s, there are still very few. Across the country, nearly 2,000 CCRCs, mostly nonprofits, serve about 745,000 residents. Only 32, in about a dozen states, have added at-home programs. But more senior living organizations are considering this approach, a possible answer to a perpetual conflict: older Americans are very likely to need long-term care, but often loathe the thought of leaving their homes.

New Recruitment Tools from National
LeadingAge national recently updated their website to include an entire section on recruitment. Visit the page.

Monday Morning Minute is back!
This week Ruth Katz of LeadingAge discusses the IMAGINE paper and Susan Hildebrandt of LeadingAge shares about the new workforce recruitment section. Watch it here.

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Thanks to LeadingAge North Carolina Platinum business members WeaverCooke, BB&T Capital Markets, and CliftonLarsonAllen for sharing their position papers. Click on a title below to download a PDF.

These papers are also available from our website by clicking here. Or visit www.LeadingAgeNC.org and under the Resources tab, select Position Papers.




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Thanks to all who respond to questions from fellow members. Click on the link below to download responses to the most recent question about nursing scholarships and event reservations.

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2020 LeadingAge NC Conference RFP Closes November 29!
Share your expertise in the field of aging services by submitting a proposal to be a presenter at the 2020 LeadingAge North Carolina Annual Conference and Expo May 18-21 in Asheville, NC. Submissions are due later this month on November 29, 2019.

Cybersecurity Risk Management in Aging Services
This LeadingAge national webinar provides best practices for managing cyber threats, minimizing risk, and implementing compliance work plan initiatives related to technology.

Wednesday, Nov. 20
2-3 p.m. ET
Member Rate: $99
Learn more and register

2019-20 LeadingAge NC Member Directory
The updated member directory is now available online! Go to http://LeadingAgeNC.org and click on the Directory tab.

Follow @LeadingAgeNC on Social Media
Now that fall has kicked off, be sure you are following LeadingAge NC on Twitter, Facebook, and Instagram. You'll be up-to-date on all the latest news, research, and programs!

In Case You Missed It

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Employee Health & Benefits Webinar Series
Sponsored by Marsh & McLennan Agency,
a LeadingAge NC Platinum Member
3rd Thursdays Monthly from 2-3pm

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Value First

LeadingAge North Carolina members can enroll in Value First and participate in other Group Purchasing Organizations at the same time. The portfolio of more than 500 vendors includes food distributors, medical supplies, therapy, facility operations, furniture, equipment, technology, and construction services.

Accessing your Vizient Catalog has now also been made easier than ever! To find out how to register and access the online catalog, click on the graphic below.

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LeadingAge North Carolina
222 N. Person Street, Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


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Advocacy in Action

Posted By Jennifer Gill, Friday, November 8, 2019
Updated: Friday, November 8, 2019
November 8, 2019


LeadingAge NC, NCHCFA, and Others Collaborate on Letter to Congressional Delegation
Earlier this week, LeadingAge North Carolina, the North Carolina Health Care Facilities Association, and others collaborated on a letter to the North Carolina Congressional delegation sharing our concerns about the CNA training lockout issue. Adam Sholar, CEO at NCHCFA, played a key role in this initiative. We continue to look for ways to leverage our voice with others in North Carolina to reach common goals.

Governor Roy Cooper Signs Into Law a Major Legislative Priority for LeadingAge North Carolina
Senate Bill 537 provides for a seat on the North Carolina Medical Care Commission for an individual “affiliated with a nonprofit continuing care retirement community.” The NC Medical Care Commission plays a key role in the financial health of our member communities and this action will help ensure that the Commission benefits from the wisdom of our membership’s collective knowledge.

As with any success, a number of folks shepherded this particular issue over the finish line:

  • Members of the Conference Committee that produced the final language approved by both chambers worked tirelessly to craft a bill that could garner support. Those conferees include Senators Ralph Hise, Joyce Krawiec, Harry Brown, and Andy Wells, as well as Representatives Josh Dobson, Donna McDowell White, and Donny Lambeth.
  • From the Department of Health and Human Services, Mark Payne and Matt Gross were especially helpful.
  • The LeadingAge North Carolina Public Policy Committee, chaired by Jonathan Erickson from United Methodist Retirement Homes, was instrumental in identifying this issue and pushing to keep it at the forefront.
  • None of our efforts would have been successful without the sustained hard work of our lobbyist, Lu-Ann Perryman…a very special thanks to her.

We’ll keep you informed as the opportunity becomes available to weigh in on potential nominees to the Commission. In the meantime, we hope you’ll celebrate with us!

Skilled Nursing Regulatory Update from LeadingAge Annual Meeting
LeadingAge national’s Division of Nursing Homes Director Evan Shulman last week presented a skilled nursing regulatory update at the LeadingAge Annual Meeting in San Diego. Presenting via a live remote feed, Mr. Shulman touched on a number of key topics before fielding questions from audience members. Click here for a comprehensive summary of Shulman’s presentation.

Final Bill Elusive as Senate Passes HUD Funding
The Senate passed its fiscal year 2020 HUD appropriations bill on October 31. The House passed its HUD FY20 appropriations bill in June. The two bills must be reconciled. Before the two can be reconciled, House and Senate Appropriations Committees must agree on spending limits for each of the 12 subcommittees, including the one that funds HUD. Without this subcommittee allocation agreement, the enactment of a final bill cannot occur.

The Senate’s bill is written under funding caps agreed to by the House, Senate and White House after the House’s HUD bill was passed. Because of the caps, the Senate has about $34 billion less in overall spending (across all the appropriations subcommittees) than the House bill does. The Senate’s HUD appropriations bill (which also includes funding for the Department of Transportation) is $5 billion below the House’s Transportation-HUD bill for FY20. For example, the Senate bill does not provide any funds for new Section 202 homes; the House bill provides $140 million. LeadingAge housing advocates are urging $600 million for new Section 202 homes in FY20.

Besides a lack of consensus on how to allocate funding among the 12 subcommittees, whether funding for a border wall should be included in an FY20 appropriations bill is a major area of disagreement. Funding for a border wall triggered the 2018 – 2019 longest-ever partial government shutdown.

Federal programs, like those funded by HUD, are now operating under a Continuing Resolution until November 21. Under the CR, programs are funded at FY19 levels for the duration of the CR. It’s very possible the CR will be extended until sometime in December, or even early in 2020. Another shutdown is also a possibility.

16th Annual LeadingAge Ziegler 200 Report Now Available
LeadingAge and Ziegler (a leading U.S. underwriter of financings for not-for-profit senior living organizations) announced the release of the 16th Annual LeadingAge Ziegler 200 (LZ 200) report. This report is a ranking and analysis of the nation’s 200 largest, most complex not-for-profit senior living organizations across the country as of December 31, 2018. It also outlines relevant business trends in the industry to showcase the variety of older adult services and offerings provided in the sector.

“Since the beginning of the LZ 200 report 16 years ago, we have helped drive change and innovation for older adults,” said Katie Smith Sloan, president and CEO of LeadingAge. “This year’s report demonstrates the significant role that LeadingAge members have in the aging services field and highlights the latest trends in the industry, like the continued increase in memory care offerings and the importance of resident engagement. Through this report, the entire sector can understand the latest technologies, services and growth opportunities that are driving the industry forward.”

The 2019 LZ 200 listing shows that senior living providers have grown primarily through community expansions and renovations, and affiliations. Nearly 30% of the total number of units for all senior living systems in the LZ 200 are represented by the 10 largest providers. The 2019 top 10 largest not-for-profit multi-site senior living organizations include:

  1. National Senior Campuses - Catonsville, MD
  2. The Evangelical Lutheran Good Samaritan Society - Sioux Falls, SD
  3. Acts Retirement Services, Inc. - West Point, PA
  4. Presbyterian Homes and Services - Roseville, MN
  5. Ascension Senior Living - St. Louis
  6. Trinity Health Senior Communities - Livonia, MI
  7. Covenant Living Communities & Services - Skokie, IL
  8. HumanGood - Pleasanton, CA
  9. Benedictine Health System - Duluth, MN
  10. Retirement Housing Foundation - Long Beach, CA

North Carolina was represented in the LeadingAge-Ziegler Top 200 by ten multi-site organizations, including:

  • Acts Retirement Services, Inc. (3)
  • Trinity Health Services Communities (6)
  • National Church Residences (41)
  • Lutheran Services Carolinas (60)
  • The Presbyterian Homes, Inc. (87)
  • United Church Homes and Services (91)
  • United Methodist Retirement Homes (94)
  • Givens (102)
  • Baptist Retirement Homes of North Carolina (153)
  • Friends Homes, Inc. (162)

The LZ 200 also showed that in the last 10 years, the average annual growth rate in total units was 2.8 %, with independent living and assisted living units growing each year but the number of nursing care beds decreasing. Other key areas of growth and innovation within the senior living industry include:

  • Similar to last year’s LZ 200 report memory care units are becoming an increasingly important component of the annual unit counts with 75% of the 2019 LZ 200’s listing offering specialized memory care units, compared to 60% in 2018.
  • Home-based services, such as home health, home care, adult-day care, continuing care at home (CCaH) programs and Program for All-Inclusive Care for the Elderly (PACE), continue to grow with approximately half of the 2019 LZ 200 offering some type of home and community-based service to nonresidents. However, the CCaH model is continuing to be eliminated from providers as only slightly more than 10 percent of this year’s LZ 200 offer it. This is 2% less than in 2018.
  • Adoption of new technologies slightly decreased as nearly 75% of providers use electronic point of care/point of service documentation systems and electronic health/medical records, compared to nearly 80% and nearly 76% in 2018, respectively. This year’s results on new technologies also showed that adoption of health and wellness technologies, such as medication monitoring or telehealth remote monitoring and care/case management and coordination is generally lower with less than 60% using these types of software. For the first time this year, the 2019 LZ 200 measured social connectedness/resident engagement, revealing that 49.5% of providers are using this technology.
  • Formal joint venture engagements marginally decreased this year with slightly more than 30% of 2019 LZ 200 organizations engaged in a formal joint venture, most commonly with another senior living provider, a health system or a home health/home care agency. However, engagement in a formal health care reform contract has steadily increased since the inception of the LZ report in 2014. This year, more than four out of 10 providers reported engaging in either Accountable Care Organization (ACO) or a bundled payment agreement.

The LZ 200 report is developed annually through a partnership between Ziegler and LeadingAge. It includes more than 200 providers of multi-site systems, more than 150 single-site campuses, and government-subsidized multi-site housing providers. To view the full report, please click here.


LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org


Tags:  Advocacy in Action 

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7/16/2020
Webinar: Identifying and Preventing Functional Decline in the Growing Acuity of AL/IL Communities

7/21/2020
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7/28/2020
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