Voice Leadership Impact Innovation a n n ua l
r e p ort
2014
cover left to right: Periodic meeting of SC Hospice Directors held at the SC TCC office in Columbia; Animated presenter at a TCC conference in Chapel Hill; Another animated presenter at the 2014 TCC Annual Conference in Charleston; SC is well represented at a meeting of the SC Hospice Directors in Columbia.
2014 the carolinas center annual report table of contents Message from Our Board Chair & CEO ............................................................... 3 TCC Board of Directors and Staff ......................................................................... 4 Our Inspiration & Motivation: Mission, Vision & Providing Member Value .......... 5 Delivering Value to Members Legislative and Regulatory Advocacy ......................................................... 6 Technical Assistance ................................................................................... 7 Education .................................................................................................... 7 Peer Networking & Leadership Opportunities ........................................... 8 Information.................................................................................................. 8 Interactive Website...................................................................................... 8 Collaborations............................................................................................. 8 Other Services............................................................................................. 8 Award & Scholarship Winners .............................................................................. 9 Partnerships & Collaborations ............................................................................ 10 2014 Financials ................................................................................................... 12 Share In Our Mission ........................................................................... Back Cover
2014 annual report — 1
A Message From Our Board Chair & President/CEO
TCC’s Board hard at work on your behalf
The Carolinas Center started and ended 2014 with overwhelming optimism. It was a breakout year of welcomed changes, and new staff bringing a combined 45 years’ professional experience in hospice and nonprofit management to our team. More importantly, The Carolinas Center’s staff embraced the challenges confronting your programs and renewed its commitment to providing you with the tools you need to thrive in the dynamic world of healthcare. As the oldest and only hospice association dedicated solely to hospice and palliative care in the Carolinas, our mission aligns with our members’ missions. We honor our mission in all we do — in advocacy, technical assistance, education and peer networking — never diluting or diverting our attention from what matters most to you. Our singular focus is on helping you remain at the forefront of hospice providers in the Carolinas. The Carolinas Center has been graced with exceptional board leadership. Your Board of Directors has demonstrated unwavering commitment and has been energized by change and the opportunities it brings. The board has spent many hours restructuring the organization; examining our mission, vision and values; developing a new ambitious strategic plan; and executing this vision to ensure that our efforts are linked to quality hospice and palliative care throughout the Carolinas. In all that we do, our approach is dignified, intentional, honest, informed and transparent. Our focus is on you, our members, and on the patients and families you serve. We want to encourage you to get involved in The Carolinas Center. Join a Member Interest Group, deliver a workshop at the annual conference, or simply give us a call and tell us what’s on your mind. We want to hear from you! On behalf of the board and staff, thank you for your commitment to The Carolinas Center and for allowing us to serve as your voice in Raleigh, Columbia and beyond.
Cathy Swanson Board Chair
Carol Meyer President/CEO
The Carol i nas Center A nnual R eport 2014 — 3
the carolinas center board of directors Many organizations would have succumbed to the events endured by The Carolinas Center in the past 2 years. But, rather than yield to something overwhelming, TCC has achieved an astonishing resurgence and has returned to its roots of a strong leadership focus aimed solely and specifically at the needs of the hospice community. New leadership and staff additions combined with seasoned employees will allow The Carolinas Center to continue its 40 year history of being the voice of hospice in North Carolina and South Carolina. David B. Clarke President/CEO Catawba Regional Hospice
Cathy Swanson, MPH, Board Chair NC Hospice Provider Representative Caldwell Hospice & Palliative Care
Mark A. Fox, MD, FACP, FAAHPM SC At-Large Member McLeod Hospice & Palliative Care
Veronica McMahon, Chair Elect SC Hospice Provider Representative Lutheran Hospice
Scottie Gaskins NC Hospice Provider Representative Vidant Home Health & Hospice
James “Tab” Haigler, Treasurer NC Hospice Provider Representative Hospice & Palliative Care of Greensboro
Lynn Hardy NC Hospice Provider Representative Carolina East Home Care & Hospice
Pamela “Pam” Melbourne, Secretary SC Hospice Provider Representative Hospice of the Upstate, Inc.
R. Scott Lake, MD SC At-Large Member Roper St. Francis Healthcare
Graham Adams, PhD SC At-Large Member South Carolina Office of Rural Health
Michelle Roseman, MBA, LNHA NC Hospice Provider Representative Catawba Regional Hospice
John E. Barkley, MD, FCCP NC At-Large Member Carolinas HealthCare System
Catherine Harvey Sevier, PhD NC At-Large Member The Generations Study Group
Nancy Corley, RN, CHPCA SC Hospice Provider Representative HospiceCare of the Piedmont
Jeffrey Seymore, MD, FAAHPM SC Hospice Provider Representative Hospice & Community Care
Jean Eckert SC Hospice Provider Representative Hospice of the Carolina Foothills
Denise Watson NC Hospice Provider Representative Mountain Valley Hospice
Richard Foster, MD SC At-Large Member South Carolina Hospital Association
Theresa Younis, Ex Officio Past Chair Agape Senior
staff Yesha Bell-Canady, CEM Education Coordinator
Carol Meyer President/CEO
Marisette Hasan, RN, BSN Vice President, South Carolina Programs
Larry Smith, CPA Director of Finance
Suzanne Jennings Member Services – Special Projects
Marsha Van Hecke Manager of Communications & Member Services
Annette Kiser, MSN, RN, NE-BC Director of Quality & Compliance 4 — The Carolinas Center 2014 Annual Report
our inspiration & motivation mission Promoting excellence in care of people living with advanced illness through high quality palliative, hospice and end of life care.
vision To ensure that all people with advanced illness will have access to high quality palliative, hospice and end of life care.
providing member value You — our hospice and palliative care member organizations, associates, and individuals — are who we work for every single day. Your work and your needs are the driving force behind all we do to consistently advocate on your behalf at the national and state levels where decisions affecting you and those you serve are made. Since 1977, our focused attention and resources have been on hospice and palliative care providers. It is our privilege and our commitment to provide relevant education, regulatory assistance, tools, and information you need to more effectively carry out your missions and visions.
TCC’s technical assistance to our program has been invaluable. We rely on them routinely for both billing and compliance clarification and their knowledge is tremendous. Knowing they are always available to us gives us much more confidence in our operations in the midst of so many regulatory changes. Tina Gibbs, MSW, LCSW Director Firsthealth Hospice & Palliative Care
top left:
Hospice of Iredell County hosts Senator David Curtis at its office in Statesville, NC; top right: TCC staffer, member and partner at an advance care planning event in Charleston, SC; bottom: Periodic meeting of NC Hospice Directors hosted by Hospice of Davidson County Voice • Leadership • Impact • Innovation — 5
delivering value to members As the longstanding leader for hospices throughout the two Carolinas, The Carolinas Center is dedicated exclusively to hospice and palliative care. Since 1977, TCC has been singularly devoted to contributing pertinent and applicable information, tools and resources to our members — assisting you to be viable and visionary in a world that needs this. In 2014, The Carolinas Center led the industry as the voice of healthcare innovation, making an impact on policy, practice and a sustainable future for all hospice and palliative care providers.
legislative & regulatory Advocacy The Carolinas Center is the forward-thinking voice of hospice in North and South Carolina and in Washington, DC. We are singularly committed to representing hospice and palliative care interests, monitoring policy and decision-making with contract lobbyists and resident staff. In 2014, TCC:
top:
TCC staff member Marisette Hasan at the SC Legislature bottom: SC legislative lobbying
• Provided comments to CMS: — To address extensive concerns with the FY 2015 Hospice Wage Index and Payment Rate Update Proposed Rule — To encourage additional payment for advance care planning services in regard to the Revisions to Payment Policies under the Physician Fee Schedule for CY 2015 — To address proposed changes to Part D Payment for Drugs for Beneficiaries Enrolled in Hospice • Provided testimony and information to the NC Board of Nursing on the topic of palliative sedation to assist in their development of a position statement • Partnered with the NC Medical Board to effect changes to two position statements, “End of Life Responsibilities and Palliative Care” and “Contact with Patients before Prescribing” which allows a hospice physician to prescribe controlled substances in an urgent situation for a patient he has not seen • Activated a grassroots network of NC hospice agencies to successfully preserve eligibility for the Aged, Blind and Disabled under Medicaid • Was the only hospice association to partner with the NC Toward Accountable Care (TAC) Consortium to develop the “Accountable Care Guide for Hospice and Palliative Care” • Worked with a statewide group of hospice providers to develop recommendations for reforming North Carolina’s methodology for hospice inpatient bed need • Continued ongoing conversations with NC Division of Medical Assistance staff to address the inequity of the provision of Personal Care Services for patients residing in private homes • Submitted public comments on behalf of its hospice provider members who were seeking adjusted need determinations by the NC State Health Coordinating Council • Provided verbal and written information to the SC Board of Medical Examiners and the SC Healthcare Collaborative to address concerns with hospice physicians prescribing controlled substances for patients they have not examined
6 — The Carolinas Center 2014 Annual Report
• Initiated dialogue and collaborated with SC Hospice provider members regarding hospice quality concerns. The Division of Health Licensing published proposed revisions for HR 61-78 in the Standard Register in fall 2014. TCC led the charge as the voice for the hospice industry and submitted initial recommendations to the Department. The process for the adoption of the proposed amendments for HR 61-78 was not completed in 2014 and is ongoing. TCC will remain active in advocating for the adoption of regulatory changes in 2015 that will enhance the quality of care provided to hospice patients and their families through defined service area locations, in depth survey processes, and clinical outcomes • Under direction of the Board of Directors, renewed the organization’s commitment to a strong advocacy presence by defining the process by which public policy positions are taken by the organization
Technical Assistance The Carolinas Center provides technical assistance from expert staff, and support for critical issues as they emerge. Recognizing the breadth and depth of its in-house hospice expertise, TCC also offers specialty consulting available free to hospice members. These are the topics that were most on your minds—and ours—in 2014: • CMS Regulations • Palmetto GBA • Audit Readiness • QAPI • Billing Changes
• Coding • Database Software • Inpatient Units • Accreditation • Palliative Care
• Serving Veterans • Pediatrics • Advance Care Planning • Marketing Ethics • Volunteer Services
Education The Carolinas Center’s education programs set the standard for hospice and palliative care professional development. Offered in a variety of formats, TCC educational programs are timely, accessible, and affordable and give you the tools you need to succeed in your business:
Thursday, April 16, 2015 10am – 4pm Information and someone to assist you will be available at these locations: Carolinas HealthCare System - Cleveland
Patrick Senior Center
201 East Grover Street, Shelby, NC
909 East King Street, Kings Mountain, NC Call 704-734-0447 for appointment
Neal Senior Center TCC’s compliance help is 100 TR Harris Drive, Shelby, NC Brookdale Shelby E. Marion Street, Shelby, NC our agency lifeline!1425We go to NC Cooperative Extension 130 South Post Road, Shelby, NC staff member Annette Kiser for information, verification and problem-solving, and For more information, please contact Len Byers at 980-487-3855 she is always knowledgeable, responsive and timely! The Compliance MIG’s monthly call is always relevant. We also appreciate her work on the NHPCO regulatory committee and the many other contacts TCC has throughout the hospice industry.
Sue Sciabbarrasi, rn, chpn Director of Quality & Compliance Hospice and Palliative Care of Greensboro
• The award-winning Breakfast for Brainiacs® monthly audio conference on concerns that appeal to both clinical and non-clinical staff; • Webinars that bring timely topics right to you; • One-, two- and three-day conferences that provide targeted education on critical issues and provide invaluable opportunities for networking with your peers; and • Staff-delivered on-site training tailored left: Participants fully engaged at a TCC conference event; right: TCC workshop for your hospice organization leader incorporates music into presentation
Voice • Leadership • Impact • Innovation — 7
Peer Networking & Leadership Opportunities TCC Member Interest Groups (MIGs) provide relevant and supportive forums for members to learn, share, and network with the experts among us in order to advance the state of hospice and palliative care practice in the Carolinas.
A glimpse into the TCC Annual Conference Exhibit Hall
TCC has been a great resource. When I compare them to other state associations, TCC by far exceeds expectations. The information shared on the local, state and federal level is always relevant, timely and accurate. TCC is always my first source for information and assistance. Sylvia L. Singleton, RN Corporate Compliance Officer Caris Healthcare
The Hospice Facilities MIG has been a fixture at TCC for over 15 years. Every quarter hospice facility staff come together to recognize the unique challenges and opportunities presented within a hospice facility. We brainstorm, problem solve and support each other in our work and appreciate the acknowledgment of its importance from TCC. Pat Gibbons, BSN, CHPN Director, Beacon Place Hospice and Palliative Care of Greensboro
In 2014, 10 groups met several times a year face-to-face and/or by telephone conference: • NC Bereavement Professionals • SC Bereavement, Social Work and Spiritual Care Professionals • Quality & Compliance • NC Directors • SC Directors
• Hospice Facilities • Hospice Veteran Partnership • Palliative Care Network • NC Volunteer Managers • SC Volunteer Managers
In 2014, there were 3 working committees—NC Public Policy, SC Public Policy and Education—devoted to positively affecting good outcomes for all members.
Information The Carolinas Center delivers the information you need, when you need it, and in a format you can immediately use. • Weekly e-newsletters, providing up-to-date hospice and palliative care news and information on pertinent topics such as regulations and compliance, billing changes, audit activity, clinical protocols, quality measures, and news from the healthcare industry that affect your work and your decisions • Regular email alerts and social media posts that keep you updated on needto-know information in real time
Collaborations The Carolinas Center works in partnership with organizations and coalitions to advance common agendas. We work with leading organizations in both states and nationally to ensure that TCC members are always represented at the table. See the list of our partnerships and collaborations on pages 10-11.
Other Services • Free employment listings for TCC members • Group purchasing program • Access to TCC’s private health insurance exchange
8 — The Carolinas Center 2014 Annual Report
2014 the carolinas center awards Peter Keese Leadership Award Vicki Dougherty, Palliative Care Coordinator Community Care Plan of Eastern Carolina, Greenville, NC Tamra West Leadership Award Alicia Sterritt, MSW, Director of Compliance Hospice of the Carolina Foothills, Landrum SC
Vicki Dougherty
Sharon O. Dixon Clinical Excellence Award Angelina Brittle, SW Vidant Home Health and Hospice, Greenville, NC Judith Lund Person Hospice Volunteer Award Toni Marley, Volunteer Hospice of Randolph County, Asheboro, NC Spirit of Hospice Award Pam Harper, Home Care CNA Coordinator Hospice of the Upstate, Anderson, SC
Alicia Sterritt
dr. john lusk scholarship award winners Shannon Pointer, RN Hospice and Palliative Care Center of Alamance-Caswell, Burlington, NC
Angelina Brittle
Lauren Patrick, CNA Hospice of Cleveland County, Shelby, NC Kristina Leyden, CEO Richmond County Hospice, Rockingham, NC Linda Gault, Executive Director Hospice of Laurens County, Clinton, SC Jason Clamme, Director of Community Outreach Lower Cape Fear Hospice and LifeCareCenter, Wilmington, NC
Toni Marley
Lynn Brown, RN Roper Hospice, Charleston, SC
Pam Harper Voice • Leadership • Impact • Innovation — 9
partnerships & collaborations
In this time of radical change in healthcare from “volume” to “value” and to population health management, the special needs for persons with advanced illness is gaining attention. Fortunately, The Carolinas Center is recognized for having the focus, expertise and commitment to give voice and to advocate not only for its provider members, but also for all Carolinians with advanced or terminal illness who seek the highest quality healthcare, consistent with their wishes. The Center’s extensive educational offerings and public policy work is done through and with its hospice and palliative care provider members in collaboration with aging organizations, health systems, and others who share this commitment. Like its national counterpart, NHPCO, The Carolinas Center is more than a trade association … so very much more. Pam Barrett, ACSW, FACHE Healthcare consultant and former Hospice CEO
The Carolinas Center values its place at the table with the following organizations and agencies, where we can be your voice for improved hospice and palliative care in the Carolinas. • AARP • Accreditation Commission for Home Care • Alliance for a Healthier South Carolina • The American Cancer Society • American Institute of CPAs • American Society of Association Executives (member) • Association Executives of NC (member) • BCBSNC (Blue Cross Blue Shield of North Carolina) • BCBSSC (Blue Cross Blue Shield of South Carolina) • California Hospice & Palliative Care Association • The Carolinas Center for Medical Excellence Midlands Community Coalition (member) • Hospice Compliance Network • Hospice House Network • Hospice and Palliative Nurses Association (member) • LeadingAge North Carolina • Missouri Hospice & Palliative Care Association • NAHC Forum of States (member) • National Association for Home Care & Hospice (member) • National Council on Medicaid Home Care • National Hospice & Palliative Care Organization (Member) NHPCO Council of States (member) NHPCO Hospice Action Network NHPCO Regulatory Committee (member) Relatedness Workgroup (member) Security Best Practices Workgroup (member) • NC Academy of Family Physicians • NC Alliance for Effective Care Transitions • NC Association of CPAs • NC Bar Association • NC Center for Nonprofits • NC Coalition on Aging (member and officer)
10 — The Carolinas Center 2014 Annual Report
• NC Department of Health and Human Services NC Physician Advisory Group (member) • NC Division of Health Service Regulation NC State Health Coordinating Council NC Long Term Behavioral Health Committee • NC Division of Medical Assistance Long-Term Services and Support Work Group Medical Care Advisory Committee Options Work Group • NC Healthcare Information and Communications Alliance, Inc. (member) • NC Hospital Association • NC Institute of Medicine (NCIOM) • NCIOM Task Force on Alzheimer’s and Related Dementia (member) • NC License to Give Trust Fund Commission (member) • NC Medical Society Ethical & Judicial Affairs Committee Toward Accountable Care Consortium • NC Nurses Association (member) • NC PACE Association • NHDD/SCHDD — National & SC Healthcare Decisions Day • Palmetto GBA Hospice Coalition (member) • SC Bar • SC Board of Medical Examiners • SC Coalition for the Seriously Ill (charter member) • SC Department of Health and Environmental Control • SC Department of Health and Human Services • SC Health Care Association (Nursing Home) • SC Hospital Association Medicaid Expansion Initiative PART Advisory Board (Preventing Avoidable Readmissions Together) SC Society of Chaplains • SC Institute of Medicine and Public Health • The SC Lieutenant Governor’s Office on Aging • SC Medical Association Bioethics Committee • Virginia Hospice & Palliative Care Association
Our membership in The Carolinas Center is a keystone of our success. We take advantage of the high quality and affordable education programs, the timely and accurate compliance expertise, the professional advocacy and legislative voice, and the wonderful relationships and friendships we have developed through TCC across this industry. We are on solid ground as a member of TCC. Linda Harris, RN, MPH Former Executive Director Spartanburg Regional Hospice and Palliative Care Programs
page 10-11, left to right: Medical interns attend a TCC conference; TCC President/CEO Carol Meyers speaks at a NC General Assembly public hearing; Interactive workshop at a TCC conference; Advance care planning event hosted by Hospice & Palliative Care Center, Winston-Salem
Voice • Leadership • Impact • Innovation — 11
financials The Carolinas Center prides itself on being a good steward of our organization’s funds and in our total transparency with our stakeholders. With nearly 80% of our funds going into program services, TCC provides exceptional value to its members and the greater industry.
Statement of activities Support and Revenue
Year Ended December 31, 2014 Unrestricted Restricted Total
United Way Contributions Contributions Hospice Provider Dues Memberships Conference Other Educational Events Sales & Subscriptions Investment Income Miscellaneous Gain/Loss-Disposal of Assets
$18,075 $18,075 45,982 45,982 569,787 569,787 14,600 14,600 84,359 84,359 115,459 115,459 10,952 10,952 9,354 9,354 672 672 (387) (387)
Total Support and Revenue
868,853
Net assets released from restrictions Total Support and Revenue after releases from restrictions
0
868,853
2,474
(2,474) 0
871,327
(2,474) 868,853
Expenses
Program Services Management & General
606,147 201,800
606,147 201,800
Total Expenses Change in net assets
807,947
807,947
Net assets - beginning of year
272,536
113,670
386,206
$335,916
$111,196
$447,112
Net assets - end of year
12 — The Carolinas Center 2014 Annual Report
63,380
0
(2,474) 60,906
Statement of Financial Position Assets Current Assets Cash & Cash Equivalents Accounts Receivable Sales Tax Receivable Inventory Prepaid Expenses Total current assets Equipment Less accumulated depreciation Total equipment - net
December 31 2014 2013 $182,323 $165,727 4,842 27,435 1,139 3,031 3,856 3,013 22,409 10,350 214,569
209,556
We have found that utilizing the education and resources they have available has helped us to improve the overall quality of care that our teams deliver, which in turn means we get to make a bigger difference in the end of life care for our patients and families! Jennifer Beasley Area Vice President of Hospice Operations Amedisys Hospice
36,584 38,445 (24,564) (26,182) 12,020
12,263
Other Assets Investments Total Assets
288,513 283,035 $515,102 $504,854
Liabilities and net assets Current Liabilities Accounts payable Accrued paid annual leave Deferred revenue Total current liabilities Net Assets Unrestricted Temporarily restricted Total net assets
$25,804 20,993 21,193
$17,141 18,797 82,710
67,990
118,648
335,916 272,536 111,196 113,670 447,112
386,206
I cannot say enough about just how much our agency values the partnership we have with TCC. I am new to compliance, and the assistance I have received has been incredible. I have attended many webinars and workshops offered by TCC and found them all to be highly beneficial and cost effective. Tamara Kavanaugh Director of Regulatory Affairs Lower Cape Fear Hospice & LifeCare Center
Total Liabilities and Net Assets
$515,102 $504,854
back cover, left to right: Members engage with exhibitors at the TCC Annual Conference; Big-screen presentation brings a TCC conference to its close; The Carolinas Center is the only two-state association in the Carolinas dedicated exclusively to hospice and palliative care.ai
Voice • Leadership • Impact • Innovation — 13
The Carolinas Center is the only two-state association in the Carolinas dedicated exclusively to hospice and palliative care.
Voice • Leadership • Impact • Innovation share in our mission If you are already a member, get more involved in some aspect of our work that benefits your work … If you are interested in being an integral part of an active membership of hospice and palliative care providers …
Contact the carolinas center
North Carolina Office South Carolina Office 1230 SE Maynard Road, Suite 203 1350 Browning Road Cary, NC 27511 Columbia, SC 29210 919.459.5380 803.509.1021
CCHospice @tcchospice
800.6 62.8859
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