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2012 business meeting north carolina health care facilities association raleigh nc

2012 Business MeetingNorth Carolina Health Care Facilities AssociationRaleigh, NC

2012 business meeting north carolina health care facilities association raleigh nc1

2012 Business MeetingNorth Carolina Health Care Facilities AssociationRaleigh, NC

Diane Packard


2012 business meeting north carolina health care facilities association raleigh nc2

2012 Business MeetingNorth Carolina Health Care Facilities AssociationRaleigh, NC

Secretary/Treasurer’s Report

Kevin G. Cox

2012 business meeting north carolina health care facilities association raleigh nc3

2012 Business MeetingNorth Carolina Health Care Facilities AssociationRaleigh, NC

Nominating Committee Report

Randy Uzzell

2012 business meeting north carolina health care facilities association raleigh nc4

2012 Business MeetingNorth Carolina Health Care Facilities AssociationRaleigh, NC

Report From Capitol Hill

Neil Pruitt

Ahca forwarding our commitment to quality neil pruitt jr ahca chair
AHCA: “Forwarding our Commitment to Quality”Neil Pruitt, Jr.AHCA Chair

Ahca strategic plan
AHCA Strategic Plan

  • Strategy 1 – Redefining the Consumer Experience

    • Quality as an expectation

    • Focus on customer service

  • Strategy 2 – Becoming Part of the Solution

    • New relationships with CMS

    • Proactive political relationships

  • Strategy 3 – Thinking Differently

    • New payment models

    • Embrace the spectrum of services

  • Ahca strategic plan1
    AHCA Strategic Plan

    • Strategy 4 – Promoting Technology

      • Re-launch LTC Trend TrackerSMon a new platform

      • Enable members of all sizes to evaluate and adopt technology that advances quality and promotes efficiency

  • Strategy 5 – Being Present

    • Member participation in grassroots

    • Member participation in quality initiatives

  • New ahca quality cabinet
    New AHCA Quality Cabinet

    • AHCA Board of Governors endorsed establishing a new overarching Quality Cabinet

    • AHCA Quality Cabinet will coordinate and direct our collective efforts to advance quality of care and quality of life issues

    • Mary Ousley – former AHCA Chair and 2011 Friend of Quality awardee – will serve as Chair

    • Howie Groff – Former AHCA BOG Member and NCAL Chair – will serve as Vice Chair

    • AHCA’s Quality Cabinet will help to guide efforts of AHCA’s:

      • Quality Improvement Committee

      • Clinical Practice Committee

      • Survey/Regulatory Committee

      • Workforce Committee

      • Consumer Experience

    Strategy 1 redefining the consumer experience

    Compiled from opinions of 257,676 employees

    Overall Consumer Satisfaction

    Overall Workforce Satisfaction

    Compiled from opinions of 90,576 residents and 140,828 family members

    Strategy 1: Redefining the Consumer Experience

    Source: The 2010 National Survey of Consumer &Workforce Satisfaction in Nursing Homes conducted by My InnerView.

    Strategy 1 redefining the consumer experience1
    Strategy 1: Redefining the Consumer Experience

    • Since 2009, nursing facility health survey citations have been on a steady decline and have dropped nearly a full percentage point in two years

    Every Medicare and Medicaid certified nursing facility in America must be surveyed once every 15 months

    Conference committee action on payroll tax cut and doc fix
    Conference Committee Action on Payroll Tax Cut and Doc Fix

    • Extends payroll tax cut and physician fee schedule until 12/31/12

    • Therapy cap exceptions process continues until 12/31/12

    • SNFs are a pay-for through a reduction of bad debt coverage

      • Dual eligibles reduced over three years

        • 2013 at 88%

        • 2014 at 76%

        • 2015 at 65%

      • Non-duals will be reduced this year from 70% to 65%

    Bad debt opportunities
    Bad Debt Opportunities

    • AHCA and its Finance Committee will work on budget neutral options to present to policymakers in an effort to limit the impact of the bad debt

    • AHCA to produce state-by-state data for state affiliates to help them fend off additional cuts from Medicaid

    • Any action will take place at the end of the year so Members of Congress will need to be educated on these options in advance

    President s budget
    President’s Budget

    • Challenges

      • Reduce Medicare bad debt payments

      • Penalty for hospital readmissions

      • Threat to market basket

      • Lower provider tax rate

      • Blended FMAP rate formula

      • Opportunities

      • Site neutral bill

      • AHCA’s hospital readmission proposal

    Strategy 2 becoming part of the solution
    Strategy 2: Becoming Part of the Solution

    • Some at CMS, on The Hill and most advocacy groups view the sector as an obstacle to improving quality

    • CMS has rejected our notion that we are the cost and quality solution:

      • “analysis of recent quality measure data related to rehospitalizations, for example, which appears in the March 2011 Report to Congress suggests that quality of care within SNFs has not been improving….We (CMS) do not agree …that shifting patients…to a SNF setting is necessarily more beneficial to the patient…” (SNF PPS Final Rule, August 2011).

    Strategy 2 becoming part of the solution1
    Strategy 2: Becoming Part of the Solution

    • Proving our commitment to improving quality demands that we have better ways to measure our progress

    • Developing better outcome measures that can validate our claims and document our quality efforts is essential

    • AHCA will lead the quality issue by adopting significant quality efforts and programs

    Strategy 3 thinking differently
    Strategy 3: Thinking Differently

    • Beginning in fiscal year 2012, CMS will rank hospitals based on 30-day readmission rate for the top three diagnoses causing the majority of readmissions:

      • Heart attack

      • Heart failure

      • Pneumonia

    • Hospitals that fail to meet CMS’ rehospitalization standards will have a percentage of total Medicare payments withheld:

      • 2013: up to 1%

      • 2014: up to 2%

      • 2015: up to 3%

    Source: Sections 1151 and 3025 of the Patient Protection and Affordable Care Act

    Cms five star system
    CMS Five Star System

    Percent of Facilities Survey Star Rating Ranked within each State


    >20 and <43.33

    >43.33 and <66.67


    >66.67 and <90


    Bottom 20 percent

    within a state

    Top 10 percent (facilities

    with lowest survey score)

    within a state

    Ahca proposed five star
    AHCA Proposed Five Star

    • Proposed recommendations to revise Five Star rating system

      • Expand domains of measures used

        • Hospitalization

        • Rehab

        • Satisfaction

      • Expand measures within existing domain

        • Add turnover and retention

      • Change weights for each domain

      • Use targets/benchmarks to assign star rating rather than percentile ranking

    Strategy 4 promoting technology
    Strategy 4: Promoting Technology

    • LTC Trend Tracker provides members with the ability to benchmark their quality, clinical and financial data

    • Domains - Staffing, Rehospitalization, Survey Findings, Medicare Cost Report, Medicare Utilization, Retention and Turnover, Resident Characteristics, Five Star Ratings, Five Star Staffing

    • Participants – 581 organizations; 4,061 facilities

    • Utilization – 1,300 reports per month (Jan. through Aug. 2011) up from 800 reports per month in 2010

    Strategy 5 being present
    Strategy 5: Being Present – 2011

    • AHCA Board of Governors Adopted Three Quality Principles:

      • Improvement in four clinical measures which are meaningful, measurable, and moveable:

        • 30-Day Hospital Readmission

        • Customer Satisfaction (Post-Acute and LTC)

        • Staff Turnover

        • Antipsychotic Rx Reduction

    • Development of a Therapy Outcome Measurement System

    • Promote Proactive Payment Models (January retreat)

  • AHCA will not be successful without the full support of our members

  • October 2011 public education
    October 2011 Public Education – 2011

    MOTION: To formally replace the term “nursing home” with “skilled nursing care,” augmented by centers where appropriate, to describe our profession.

    State-of-the-Art Rehab Suite – 2011

    Aquatic Therapy Pool

    Private Suites – 2011

    Restaurant-Style – 2011

    Dining Rooms

    Sitting Rooms

    Spa – 2011

    Movie Theater

    Coffee Shop – 2011

    Internet Cafe

    Breaking the nursing home paradigm1
    Breaking The “Nursing Home” Paradigm – 2011

    “The system should not overpay for certain patients, which creates incentives for nursing homes to spiff up their buildings and set staffing levels to entice profitable patients. I encourage CMS to continue taking steps to address these issues.”

    - Stark

    Thank you

    Thank You! – 2011

    2012 business meeting north carolina health care facilities association raleigh nc5

    2012 Business Meeting – 2011North Carolina Health Care Facilities AssociationRaleigh, NC

    CON Construction Rules

    Kristi Huff

    Certificate of need
    Certificate of Need – 2011

    • House Select Committee on Certificate Of Need Process and Related Hospital Issues

    • Committee Charge:

      • To study House Bill 743 and House Bill 812;

      • The legal requirements and process governing DHHS determinations on applications for CON including an analysis of exceptions granted under policy AC-3;

      • Issues related to publicly owned hospitals including the appropriate role of State-owned hospitals;

      • Whether a hospital operating under a Certificate of Public Advantage (COPA) should be required to comply with the same rules, policies and limitations to each county in which it operates;

      • The extent to which a publicly owned hospital should engage in business with an entity having a COPA or operating under an exemption under the CON laws of the state;

      • Any other matter reasonably related to the above.

    Certificate of need continued
    Certificate of Need (continued) – 2011

    • 3 public hearings across the state: Fletcher, Mt. Holly, and Wilmington

    • Topics of discussion include:

      • Appeals process

      • Raising monetary thresholds in the law for diagnostic centers, major medical equipment, renovations, expedited reviews

      • SHCC Appointments made by Governor and legislature

      • Whether State Ethics Act should apply to the SHCC

      • Transparency in the CON process

    Construction rules review
    Construction Rules Review – 2011

    • Governor’s Executive Order 70: identify rules that are burdensome, duplicative, or impose unnecessary costs

    • Nursing Home Physical Plan Rules review – meeting with Construction Section and DHSR leadership

    Construction rules review continued
    Construction Rules Review (continued) – 2011

    • Areas likely to be changed:

      • Exempt certain small projects from a plan review (and fee)

      • Eliminate references to a “nurse’s station” or nursing unit in the rule

      • Bath/shower rooms – for every 120 beds

      • Soiled utility/soiled linen rooms

      • Handrails – maximum opening between handrails of 12 feet

    2012 business meeting north carolina health care facilities association raleigh nc6

    2012 Business Meeting – 2011North Carolina Health Care Facilities AssociationRaleigh, NC

    Payment For Services

    John Barber

    Sam Clark

    What s up with our medicaid rates
    What’s Up With Our Medicaid Rates? – 2011

    There has been some confusion and uncertainty surrounding nursing home rates.

    The state is currently working on a State Plan Amendment that will address multiple rate changes.

    NCHCFA will review the SPA before it is sent to CMS for approval.

    What s up with our medicaid rates1
    What’s Up With Our Medicaid Rates? – 2011

    Provider Assessment Increase

    • The provider assessment, currently assessed at an overall rate of approximately 5.5%, will be increased to 6%.

    • The increase will be approximately $1 per non-Medicare day.

    • The effective date of this change will be January 1, 2012.

    • Medicaid rates will be increased to repay the provider the Medicaid portion of the assessment.

    What s up with our medicaid rates2
    What’s Up With Our Medicaid Rates? – 2011

    Case-Mix Adjustments

    The frozen case-mix will be unfrozen and the rates effective April 1, 2012 will be adjusted for acuity using the December 31, 2011 snapshot date.

    Quarterly CMI adjustments will resume beginning on July 1, 2012.

    What s up with our medicaid rates3
    What’s Up With Our Medicaid Rates? – 2011

    Rate Reduction

    The current 3.51% rate reduction will be adjusted to an amount needed to achieve a 2.17% average reduction for the state fiscal year (July 1, 2011-June 30,2012).

    This will be effective January 1, 2012.

    The rate reduction will be adjusted again effective July 1, 2012 to ensure that the annual reduction in SFY 2013 will be 2.17% plus the impact of any other adjustments approved by the legislature.

    Fair rental value
    Fair Rental Value – 2011

    • Aging of facilities

    • April Updates

      • Cost per square foot $142 increased to $147

      • Most location factors will increase

    Medicare bad debt
    Medicare Bad Debt – 2011

    • The final agreement on Medicare "doc fix" legislation will reduce Medicare reimbursement for uncollectible bad debt, but not as much as in the bill originally passed by the House last fall.

    • Section 3201 - Reducing Bad Debt Payments – This provision would phase down the bad debt reimbursements to 65 percent beginning in FY2013 for providers who are currently being reimbursed at 70 percent, while phasing in the reduction to 65 percent over three years for those who are reimbursed at 100 percent of their bad debt. (88%, 76%, 65%)   

    • Effective for cost reports beginning on or after 10/1/12.

    • The legislation also extends the therapy caps exceptions process through December 31, 2012.

    National issues
    National Issues – 2011

    • Mike Cheek with AHCA will be addressing more of the national issues during the Tuesday morning session.

    Hms credit balance reviews
    HMS Credit Balance Reviews – 2011

    • HMS has completed their first round of reviews.

    • Most of the findings have involved

      • Resident monthly liability in the month moving from Medicare to Medicaid

      • Medicare Part C Co-insurance paid by Medicaid for dual eligible residents

    • NCHCFA recently met with the State and HMS on the outstanding issues.

    • HMS is getting ready to start round two.

    Medicaid racs
    Medicaid RACs – 2011

    • Medicare RACs have been around for several years, but have been concentrating on hospital issues.

    • States are required to contract with Medicaid RACs.

    • NC is preparing an RFP.

    • Can’t review items that have already been reviewed.

    Cost report audits and the mds reviews

    The audits of the 2009 cost reports have been called off. – 2011

    The MDS reviews continue.

    MDS reviews of snapshot dates not used for setting rates are purely educational. Rates are not adjusted.

    After the M&S audit was completed, they choose multiple REHAB RUGs from the CMI report, asked to see the Start of therapy, END of therapy dates and the log showing they were treated. These are strictly information gathering audits that DMA has asked them to do. It is not reflected on the report she gives to center and she says she has no idea of what the purpose of the audits are. She has just been told to gather the data.

    Cost Report Audits and the MDS Reviews

    Medicaid cost report transition

    The Medicaid cost report as you have known it is no more. – 2011

    NCHCFA and other interested parties are currently working with DMA.

    Moving forward, nursing homes will

    Use the Medicare cost report, 9/30 year end not required

    File supplemental schedules to account for certain Medicaid specific items

    More information to come

    Medicaid Cost Report Transition

    Ask the contractor teleconference
    Ask-the-Contractor Teleconference – 2011

    Palmetto GBA had to cancel the February 9, 2012, J11 Part A Ask-the-Contractor Teleconference (ACT). The rescheduled date and time for this ACT is Wednesday, February 22, 2012, from 2 p.m. to 3 p.m. ET. 

    Conference Call Information

    • Teleconference Number:  (866) 449-7848

    • Confirmation Code:  52721579

    Keeping up to date
    Keeping Up-to-Date – 2011

    • Providers should be receiving electronic notices from CMS, Palmetto GBA and Medicaid electronically.

    • Our weekly newsletter, UPDATE, in the next several issues will list how to sign up for these important items.

    2012 business meeting north carolina health care facilities association raleigh nc7

    2012 Business Meeting – 2011North Carolina Health Care Facilities AssociationRaleigh, NC

    President’s Report

    J. Craig Souza

    2012 convention trade show
    2012 Convention & Trade Show – 2011

    Trade Show SOLD OUT for

    30th Consecutive Year

    “Thank You TRADE MEMBERS!”

    2011 Full Registrations – 2011402

    2012 Full Registrations 345

    Future meetings
    Future Meetings – 2011

    2012 Mid-Year Meeting

    August 14-17, 2012

    Marriott Grande Dunes

    Myrtle Beach, SC

    2013 Mid-Year Meeting

    August 6-9, 2013

    Marriott Grande Dunes

    Myrtle Beach, SC

    2013 Convention and Trade Show

    February 10-13, 2013

    Greensboro, NC

    2014 Convention and Trade Show

    February 23-26, 2014

    Greensboro, NC

    Nursing facilities staffing residents and facility deficiencies 2005 2010
    Nursing – 2011Facilities, Staffing, Residents and Facility Deficiencies, 2005-2010

    • Conducted and published by the Department of Social & Behavioral Sciences at the University of California San Francisco.

    • Released in October, 2011

      • Offers calendar year data of the following:

        • Facility characteristics

        • Resident characteristics

        • Nurse staffing (RNs, LVNs, and NAs) hours per resident day.

        • Data on facility deficiencies based on state surveyor evaluations.

    Nursing facilities staffing residents and facility deficiencies 2005 20101
    Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2005-2010

    • North Carolina skilled nursing facilities champion quality improvement and have instituted best practices that are working to transform the health care system for the frail and elderly.

    • This report reflects that as the level of resident need increases and nursing home residents become more medically complex. North Carolina continues to provide the highest level of care and is scoring better than the national average in almost every category.

    Resident characteristics
    RESIDENT CHARACTERISTICS Deficiencies, 2005-2010


    • North Carolina scores decreased from 116.70 in 2005 to 104.46 in 2010 but have consistently remained above the national average. In 2010, the Average Acuity Score for an NC resident was 12.84 points above the national average.

    Facility deficiencies from state surveys


    Facility deficiencies from state surveys1

    Percent of Facilities with Deficiencies

    Average full time equivalents hppd staff 12 2011
    Average Full Time Deficiencies, 2005-2010Equivalents/HPPD –Staff (12/2011)

    Government performance results act
    Government Performance Results Act Deficiencies, 2005-2010

    Restraints %

    Year - NC / Region / Nation

    2003 – 9.4 9.4 7.7

    2011 - 2.5 3.4 2.7


    rate in % 73.4 63.8 64.9

    GPRA Deficiencies, 2005-2010

    Pressure Ulcers - %

    Year NC / Region / Nation

    2003 – 10.1 9.4 8.9

    2011 - 8.4 7.8 7.4


    Rate% 16.8 17.0 16.9

    Five star rating
    Five Star Rating Deficiencies, 2005-2010

    Dec 2011 Dec 2010 Dec 2009

    Five Stars: 16.4% 15.8% 10.8%

    Four Stars: 27.3% 25.6% 26.0%

    Three Stars: 20.0% 20.8% 21.2%

    Two Stars: 19.7% 19.4% 18.6%

    One Star: 16.6% 18.4% 23.4%

    P R E S I D E N T ‘S 2013 BUDGET Deficiencies, 2005-2010

    Skilled Nursing Provisions

    “Reduce Medicare Coverage of Bad Debts”…would reduce bad debt payment to 25% for all eligible providers beginning in 2013. Savings: $36 billion over 10 years.

    “Phase Down the Medicaid Provider Tax Threshold Beginning in 2015”…proposes to limit taxes on health care providers to help finance the State share of Medicaid program costs by phasing down provider tax threshold from 6% to 3.5% beginning in 2014. Savings: $21.8 billion over 10 years.

    “Apply a Single Blended Matching Rate to Medicaid and CHIP Starting in 2017” …Proposes to replace current FMAP formula with a single matching rate specific to each State that automatically increases if a recession forces enrollment and State costs to rise beginning in 2017. This would result in the State’s share of Medicaid to increase and the federal share to decrease. Savings: $17.9 billion.

    P R E S I D E N T ‘S 2013 BUDGET Deficiencies, 2005-2010

    Skilled Nursing Provisions

    “Encourage Efficient Post-Acute Care” ….gradually realign payments with costs through adjustments to payment rate updates in 2013 through 2022. Savings: $10.16 billion savings by 2017, $56.67 billion over 10 years.

    “Adjusting SNF Payments to Reduce Unnecessary Hospital Readmissions”…..reduces SNF payments by up to 3% beginning in 2016 for facilities with high rates hospital readmissions. Savings: $1.95 billion by 2022; $460 million by 2017.

    “Strengthen the Independent Payment Advisory Board (IPAB) to Reduce Long-Term Drivers of Medicare Cost Growth”

    House and senate reach agreement on payroll tax cut sgr

    Skilled Nursing Provisions

    1. Section 3005 –Outpatient Therapy Caps - (summary)

    Extends the therapy cap exceptions process through December, 31, 2012.

    Adds requirements for physician review of the therapy care plan.

    Spending caps ($1,880 in 2012) would be extended to hospital outpatient


    HHS is to collect data to assist in reforming payments for therapy services.

    MedPAC to recommend improvements to outpatient benefit to reflect the individual needs of patients.

    2. Section 3201 –Reducing Bad Debt Payments – (summary)

    Phase down bad debt reimbursements from 100% for dual eligibles to 65% beginning in 2013. Reduction of 12% in 2013, 12% in 2014 and 11% in 2015.

    NC General Assembly Deficiencies, 2005-2010

    Medicaid day weighted cmi
    Medicaid Day Weighted CMI Deficiencies, 2005-2010

    Not used for rates

    Mds reviews
    MDS Reviews Deficiencies, 2005-2010

    Average occupancy
    Average Occupancy Deficiencies, 2005-2010

    Average medicaid rate graph
    Average Medicaid Rate Graph Deficiencies, 2005-2010

    Average nc medicare rate
    Average NC Medicare Rate Deficiencies, 2005-2010

    Medicare average los
    Medicare Average LOS Deficiencies, 2005-2010

    NC Continues to have a higher Medicare length of stay than the US.

    Medicare utilization
    Medicare Utilization Deficiencies, 2005-2010

    New faces in state government after november election
    New Faces in State Government Deficiencies, 2005-2010After November Election**

    • New Governor

    • New Lieutenant Governor

    • New Secretary of DHHS

    • 3 New U.S. House Members

      • Reps. Myrick, Miller and Shuler not running

    • 8 New N.C. Senate Members

    • 28 New N.C. House Members

      **As of February 16, 2012

    General assembly outlook 2012 2013 issues on the horizon
    General Assembly Outlook, 2012-2013 Deficiencies, 2005-2010Issues on the Horizon

    • Medicaid Budget

    • Managed Care

    • Certificate of Need Changes (Appeals, Composition of SHCC, Thresholds)

    • Mental Health Care

    • Health Benefits Exchange

    Have you contributed to the pac
    Have You Contributed to the PAC? Deficiencies, 2005-2010

    Top pacs in n c 2009 2010 election cycle
    TOP PACs in N.C. 2009-2010 Election Cycle Deficiencies, 2005-2010

    1.NC ADVOCATES FOR JUSTICE PAC (Trial Lawyers) $530,400

    2. NC MEDICAL SOCIETY $355,000


    4. BANK OF AMERICA PAC $339,200


    6. NC FARM BUREAU PAC $294,550

    7. NC REALTORS PAC $294,500






    A statewide Deficiencies, 2005-2010

    non-profit leader in focusing on technology, innovation and best practices in long-term care.

    FutureCare of North Carolina is a subsidiary non-profit of the North Carolina Health Care Facilities Association.

    Who Is FutureCare?

    FutureCare Deficiencies, 2005-2010 of North Carolina Board of Directors

    Dr. DarlyneMenscerCarolinas Healthcare SystemDiane PackardRehab and Health Care Village GreenWilliam A. PullyNC Hospital AssociationRobert SeligsonNC Medical SocietyRandy UzzellBritthavenJ. Bradley WilsonBCBSNCJeff WilsonLong Term Care Management ServicesJ. Craig Souza, Vice ChairNCHCFASamuel Clark, Secretary-TreasurerNCHCFAPolly Godwin WelshNCHCFA

    Chris Bryson

    UHS- Pruitt Corporation

    Ken Burgess, Chair

    Poyner Spruill

    Gerald P. Cox

    Autumn Corporation

    Dr. Gordon DeFriese

    Former President

    and CEO of FutureCare

    Cheryl Geddie

    Haymount Rehabilitation

    and Nursing Center

    Dr. Laura Gerald

    NC State Health Director

    Ted Goins

    Lutheran Services for the Aging

    Polly Johnson

    North Carolina

    Foundation for Nursing Excellence

    Deborah Lekan

    Duke School of Nursing

    Cameron Graham Deficiencies, 2005-2010

    Executive Director

    Mandy Richards

    Program Director

    Contact Information

    Cameron Graham

    FutureCare of North Carolina

    Mailing Address

    5109 Bur Oak Circle

    Raleigh, North Carolina 27612



    [email protected]

    FutureCare Staff

    Our Deficiencies, 2005-2010mission is to improve the quality of long-term care for all North Carolinians for the elderly and disabled, with a special focus on skilled nursing care.

    Future Care of North Carolina seeks to achieve its goals by bringing together leaders from across the state from within the long-term care field: researchers, health care foundations, policymakers, quality improvement organizations, and corporations.

    In order to achieve this mission, we need your INPUT and SUPPORT!


    • Develop nursing staff to expert level in order to reduce unnecessary emergency room and hospital admissions

    • Prepare potential residents and family members to access quality and innovative care

    • Increase access to technology and innovative solutions in long-term care

    • Educate the citizens of North Carolina (and lead the nation) on best practices in long-term care


    Medication Error Management Training for Skilled Nursing Staff Using a High-Fidelity Mannequin Simulator

    2. Mouth Care Training for Skilled Nursing Staff

    Current Programs

    Ahca s public education communication campaign

    AHCA’s Public Education & Communication Campaign Staff Using a High-Fidelity Mannequin

    North Carolina Health Care Facilities Association

    2012 business meeting north carolina health care facilities association raleigh nc8

    2012 Business Meeting Staff Using a High-Fidelity Mannequin North Carolina Health Care Facilities AssociationRaleigh, NC

    Chair’s Report

    Diane Packard