KNOCKING DOWN CLINICAL BARRIERS IN LTC

2016 MI-NADONA/LTC Annual Convocation & ExpoNovember 16-18, 2016Grand Traverse Resort & SpaAcme, MI

MiNADONA

www.MINADONA.org

MiNADONAHealth Care Association of MichiganPromoting Excellence in Senior Care

PurposeParticipation in this year’s MI-NADONA/LTC Annual Convocation will result in enhanced implementation of clinical standards of nursing practice and care performance excellence in the post-acute care environment.

Target AudienceThis convocation is appropriate for directors of nursing, assistant directors of nursing, nurse managers and other clinical partners with intermediate to advanced levels of nursing expertise in post-acute care. Corporate consultants, clinical directors, nursing home administrators and other health care partners with direct resident care responsibilities are encouraged to participate as well.

Joint Provided EventThe 2016 MI-NADONA/LTC Annual Convocation & Expo is co-provided by the Health Care Association of Michigan and Michigan Chapter National Association of Directors of Nursing in Long-Term Care.

Continuing EducationThis year’s MI-NADONA/LTC Convocation & Expo will provide participants the opportunity to earn up to 12 nurse contact hours and up to 1 contact hour of "pain" and "human trafficking" education.

HCAM is an approved provider of continuing nursing education by the Wisconsin Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Participants may also earn up to 12 licensed nursing home administrator contact hours.

NADONA MembershipIf you are not already a member of NADONA/LTC, please be sure to visit:

www.NADONA.org to sign-up for membership now to receive the discounted NADONA member registration rate and many other benefits or complete page 18 and fax to NADONA at (513) 791-3699.

HCAM is proud to be the exclusive event manager for the Michigan Chapter of NADONA/LTC.

2

K N O C K I N G D O W N C L I N I C A L B A R R I E R S I N LT C

Networking Highlights Awards & Recognition Luncheon to honor the best of nursing in post-acute care

Annual Vendor Expo featuring up to 76 exhibitors dedicated to providing exceptional products and services

PARTY NORTH Celebration! See page 14 for more information on the NURSE ADMINISTRATOR PARTY OF THE YEAR

Chance to win many scholarship prizes, expo prizes and many other grand prize nurse-giveaways this year

Massage therapists will be present on Wednesday & Thursday to provide complimentary scalp, neck, shoulder and/or back massages to nurse participants throughout both days

Take advantage of the 20% discount for all nurses & participants at the Spa Grand Traverse

Education HighlightsOpportunity to earn up to 12 nurse continuing education contact hours including up to 1 “pain” and 1 "human trafficking" contact hour over the course of 3 days

Opening keynote by organizational development expert Stacey Starling, who will kick off this year’s Convocation with “Human Data Point” and a dicey panel discussion on “Morality, the Law, and Nursing Leadership”

Keynote & concurrent breakout session by forensic nursing expert Dr. Dan Sheridan on "When Injuries Speak: Forensic Investigation & Documentation of Possible Abuse, Neglect & Falls of Vulnerable Persons."

Closing keynote by Fran Vian with a fun and engaging look at “How to Work with Generations Y & Z

24 quality, nurse-focused educational sessions designed for long-term care nurses with intermediate to advanced levels of nursing experience

Table of Contents

2-3 Education Highlights4-5 Agenda at a Glance6-7 Wednesday Education8-9 Thursday Education9 Friday Education 10 Annual Vendor Expo11 PARTY NORTH11 Lodging Information12 Convocation Sponsors 13 Board of Directors14 NADONA Membership15 Registration Policies15 Save the Dates16 Registration Form

RECOGNIZE

NETWORK

PARTY

WIN

RELAX

INDULGE

3

Scholarship Prize Drawings

On-site at Convocation, the MI-NADONA/LTC Board of Directors will be selling Scholarship Prize Drawing raffle tickets to support the Margaret Godfrey Scholarship Fund and Jim Bebb Certification Scholarship Fund to help promote the professional development of Michigan nurses and CNAs who are pursuing their nursing license. All proceeds will directly benefit these scholarship funds. Tickets can be purchased at the following rates (cash or check only):

5 for $1010 for $1515 for $20

Wednesday, November 169:00 am REGISTRATION OPENS & PROVIDED BREAKFAST

9:30 - 9:45 am WELCOME & OPENING REMARKS

9:45 - 10:45 am OPENING KEYNOTE PRESENTATION:K1: Human Data Point

11:05 am - 12:05 pm CONCURRENT BREAKOUT SESSIONS:

W1: Diagnostics: Step Outside the Box, Instead of Just Checking it Off!

W2: Life is a Zoo

W3: Complementary Alternative Medicine: Nonpharmacological Approaches to Pain (PAIN CE)

12:05 - 1:25 pm AWARDS & RECOGNITION LUNCHEON

1:25 - 2:25 pm CONCURRENT SESSIONS:

W4: Finding Truth in the Failed Theories of Heart Disease

W5: Morality, the Law, and Nursing Leadership: A Panel Discussion

W6: REPEATED: Complementary Alternative Medicine: Nonpharmacological Approaches to Pain (PAIN CE)

2:45 - 3:45 pm CONCURRENT SESSIONS:

W7: New State TB Testing Requirements for Skilled Nursing Facilities

W8: What Makes An Attractive Post-Acute Partner

W9: The Nurse’s Personal Risk in Claims & Litigation: Protecting YOUR License

4:05 - 5:05 pmGENERAL SESSION:W10: What LTC Professionals Need to Know About Human Trafficking and Why!

5:05 pm EVENING ON YOUR OWN

4

Thursday, November 178:00 am REGISTRATION OPENS & NETWORKING BREAKFAST8:30 - 8:50 am AREA BREAKFAST MEETING / MEET & GREET

8:50 - 9:50 am K2: When Injuries Speak: Forensic Investigation & Doc. of Possible Abuse, Neglect & Falls of Vulnerable Persons

10:10 - 11:10 am CONCURRENT BREAKOUT SESSIONS:T1: Assessing for Possible Abuse & Neglect of Vulnerable Residents: From the Top Down and Bottom UpT2: Active Shooter: Part 1 of 2T3: Navigating the Mental Health Complexities of a Progressively Younger Long Term Care Population

11:30 am - 12:30 pm CONCURRENT BREAKOUT SESSIONS:T4: The Role of Nutrition in Preventing Infections & Promoting Wound HealingT5: Active Shooter: Part 2 of 2T6: How to Start a Wellness Program on a Budget for Beginners

12:30 - 1:30 pm ATTENDEE & EXHIBITOR "NATIVE AMERICAN" LUNCHEON1:45 - 2:45 pm CONCURRENT BREAKOUT SESSIONS:

T7: Delirium: A Final Common Pathway DisorderT8: Caring for Transgender PeopleT9: Employer vs. Employee Side of Social Media Policy

2:45 - 5:00 pm ANNUAL VENDOR EXPO SHOW5:00 - 7:30 pm DINNER ON YOUR OWN7:30 - 10:30 pm PARTY NORTH CELEBRATION

Friday, November 188:00 am REGISTRATION OPENS & NETWORKING BREAKFAST

8:30 - 9:00 am CLOSING REMARKS, GENERAL ASSEMBLY MEETING & SCHOLARSHIP PRIZE DRAWINGS

9:00 - 10:00 am CLOSING KEYNOTE PRESENTATION:K3: How to Work with Generations Y & Z: #HELP!

10:15 - 11:15 am GENERAL SESSION: F1: Regulatory & CMS Update Part 1

11:30 am - 12:30 pm GENERAL SESSION: F2: Regulatory & CMS Update Part 2

12:30 pm CONVOCATION CONCLUDES

5

K1 The Human Data PointSTACEY STARLING | STARLING CENTER FOR

ORGANIZATIONAL DEVELOPMENT2016 emerges as a critical time in the post acute care industry with a number of CMS initiatives mandating greater accountability for enhancing the patient experience and producing better outcomes, while reducing the overall expenditure for the care of patients. Alongside the advancing policy remains the moral imperative to infuse person-centered philosophy and practice into post-acute care. Nurse leaders have an extraordinary responsibility to balance these often competing interests. Contributing to this complex dilemma is a multi-generational workforce with diverse expectations related to workplace factors that influence employee commitment to the organization. Join Dr. Starling as she maps the path to navigate the Tridge of these seemingly unrelated yet present challenges for nurse leaders today.

W1 Diagnostics: Step Outside the Box,Instead of Just Checking it Off!

LORELEI SCHMIDT | TRIDENTUSA HEALTHSERVICES, LLC

With post-acute healthcare initiatives focused on reducing avoidable acute transfers, avoidable hospital admissions/readmissions, and implementing Antibiotic Stewardship Programs, there is an increasing need for all healthcare providers and suppliers to work more collaboratively to meet the expanded expectations. Open and accurate communication is vital and an area that always needs improvement. Improved collaboration and communication between diagnostic service post-acute providers and suppliers can lead to a deeper understanding of diagnostics, including their capabilities, limitations, and factors affecting results. This information is vital, as diagnostic results often play a role in resident treatment and transfer decisions. Join the discussion and learn how a better understanding of diagnostics may lead to improved clinical, financial, and resident satisfaction results.

W2 Life is a ZooJOE IAQUINTO | SEASONS HOSPICE AND

PALLIATIVE CAREThis presentation will enhance the nurse’s knowledge regarding personality types in order to facilitate successful communication with residents, their families and coworkers. As a result of this educational activity, nurse participants will be able to: Identify their own personality type, understand characteristics of each of the four different personality types and realize how their personal traits can influence communication success or failure.

W3&W6 Complementary Alternative Medicine: NonPharmacological Approaches to Pain• HENRY BOUTROS | NEXCARE HEALTH

SYSTEMS• SANDY PLACE | JACKSON COUNTY

MEDICAL CARE FACILITY• DIANE ROTHMAN | HAND TO HEART

HOLISTIC HEALING• VICKIE BURLEW | LEBENBOM & ROTHMANCMS will be requiring skilled nursing facilities to investigate and utilize potential non-pharmacological interventions for the management of pain. This presentation will provide evidenced based modalities for use in the nursing home setting, demonstrate hands on experiential training and practical management of these modalities in the skilled nursing environment. Nurse participants will highly benefit from this overview of complimentary & alternative approaches to pain management. This session will be offered 2 times during this year’s Convocation to promote the participation of all nurse participants in this “pain” education overview. (This session will be offered twice to promote full

nurse participation.)

W4 Finding Truth in the FailedTheories of Heart Disease

JIM PAINTER | UNIVERSITY OF TEXAS -HOUSTON, SCHOOL OF PUBLIC HEALTH

Dietary advice on fat, saturated fat and cholesterol seems to change daily and this can be disconcerting and confusing for dietitians and healthcare providers. This presentation will provide the scientific, evidence-based truth about these nutrients. Current research findings suggest that cholesterol, total fat, and salt are not a risk factor of heart disease – although the Dietary Guidelines were created to help Americans decrease their intake of these nutrients. Instead, elderly individuals should focus on consuming heart-healthy foods to reduce the risk of developing heart diseases.

Wednesday, Nov. 16 Education

6

MiNADONA

W5 Morality, the Law, and NursingLeadership: A Panel Discussion

MODERATOR: STACEY STARLING | STARLING CENTER

FOR ORGANIZATIONAL DEVELOPMENTPANELISTS: • KRISTEN COOK | THE KITCH FIRM• SARAH THURSTON | GREAT LAKES

CARING• LAURA JENNINGS | WELLBRIDGE-

GENESEE CARE CENTER• KATHLEEN LATOSCH | SAGE METRO

DETROIT• MELISSA SLUSS | METRON INTEGRATED

HEALTH SYSTEMSJoin our moderator Dr. Stacey Starling for a highly interactive panel discussion exploring the most controversial nursing and employee relations topics that nurse leaders currently face in post-acute care. Our panel of experts will represent legal, moral, and human rights perspectives in the disciplines of Social Services, Nursing, and Human Resources. No subject is taboo. Bring your questions and your experience. Be prepared to share your wisdom.

W7 New State TB Testing Requirements for Skilled Nursing Facilities

• LARRY HORVATH | STATE OF MI - LARA• THOMAS BISSONNETTE | STATE OF MI -

LARA• TERI DYKE | STATE OF MI - LARAScreening for Tuberculosis (TB) historically has included the provision of an annual TB skin test and a chest x-ray in long term care facilities. With the advent of newer testing methods to distinguish between TB infection and TB disease and the reduced case rate of TB in Michigan, the need for routine chest x-rays has been eliminated. This rule change is undergoing the legislative approval process for the State of Michigan.

W8 What Makes an Attractive Post-Acute Partner

• HOLLI BENTHUSEN | ENCORE REHABILITATION

• JENNIFER CALLAHAN | ENCORE REHABILITATION

This presentation will provide an up to date national overview of ACO development including healthcare reform initiatives and bundling models. In addition, the program provides a practical approach for identifying and assessing the Skilled Nursing Facility’s (SNF) key quality programs, objective measures and systems; Case reports and

examples of application of successful strategies will further provide support for utilization of these tools for building and enhancing relationships within the local healthcare community. Highlighting facility strengths and how they can positively impact healthcare community partners is critical for determining most successful marketing strategies.

W9 The Nurse’s Personal Riskin Claims & Litigation: Protecting YOUR License

DAVID WIEGEL | THE KITCH FIRMAs a long-term care nurse, you give “everything you’ve got,” every day to your beloved residents and facility. However, when push comes to shove and the facility is involved in a claim and/or litigation, how does this affect the integrity of your own nursing license? You want to continue to give your residents the best of care, be the most optimal partner to your facility and continue to provide your maximum effort but risking or forfeiting your own nursing license is not what you had in mind… This informative presentation will provide you with critical information on how to minimize your own personal risk and protect the integrity of your nursing license when your facility is involved in a claim and/or litigation.

W10 What LTC Professionals Need toKnow About Human Trafficking and Why!

BETH BACON | HEALTH CARE ASSOCIATIONOF MICHIGAN

Human trafficking is a form of modern day slavery and is the fastest-growing international crime industry in the world. Human trafficking is not a crime that just happens “someplace else;” it happens here in Michigan. The magnitude of this horrific human rights violation is appalling and inconceivable and yet, health care professionals and systems are uniformed and ill-prepared to address this issue. This informative presentation will provide an overview on human trafficking, examine the history and importance behind recent initiatives in the health care sector and provide nurse participants with resources in which they can utilize to fulfill their continuing education requirement for human trafficking.

7

Wednesday, Nov. 16 Education

Thursday, Nov. 17 Education K2 When Injuries Speak: Forensic

Investigation & Documentation of Possible Abuse, Neglect & Falls of Vulnerable Persons

DR. DAN SHERIDAN | TEXAS A & M UNIVERSITY Participants will learn techniques for improving their forensic assessment and documentation, both written and photographic, of client/patients with possible abuse and neglect related injuries. An overview of contributors to falls will be presented as well as techniques to differentiate and document witnessed falls from being found down. Basic forensics terminology will be presented in a format immediately useful to professionals from multiple disciplines. A series of instructive injury slides will be shown to demonstrate patterned injuries and injuries in various stages of healing. Participants will be asked to review a series of injury photographs from one to two cases and correctly identify the injuries and describe how they should be documented in medical records.

T1 Assessing for Possible Abuse &Neglect of Vulnerable Residents: From the Top Down and Bottom Up

DR. DAN SHERIDAN | TEXAS A & M UNIVERSITY In this session, participants will learn the elements needed to conduct a thorough, competent, fact-based and unbiased internal investigation of known or suspected abuse and neglect. These same elements are crucial when investigating unexplained injuries. In addition, participants will learn strategies to develop forensically trained registered nurses from within an agency’s personnel pool. The presentation will highlight the importance of timely investigations that include written, injury map and photographic documentation within a client/patient’s medical record. Tips on easily performed basic evidence collection and preservation by a facility will be presented.

T2&T5 Active Shooter: Parts 1 & 2MARILYN KNIGHT | INCIDENT MANAGEMENT

TEAMThis 2 part session will describe behavioral indicators of potential violence and types of situations that may result in violent behavior in healthcare settings. OSHA Healthcare Violence Prevention Guidelines, risk factors, types of perpetrators, “approach behaviors” and "triggers" which may precipitate violence against caregivers, will be discussed. Active Shooter Survival choices will be outlined. Policies, systems, and structures of a Comprehensive Workplace Violence Prevention and Threat Assessment System will be described. Actual video tape case histories will be used as illustrative case examples. Participants will not want to miss this engaging discussion!

T3 Navigating the Mental HealthComplexities of a Progressively Younger LTC Population

MICHAEL GOLDSMITH | BEHAVIORAL CARESOLUTIONS LLC

Individuals between the ages of 31-65 years of age are the fastest growing demographic in long-term care to date. This younger and more viable demographic has presented with its own complexities and difficulties for long-term care facilities and staff. This presentation will examine the shift in resident population, related mental health complexities, as well as specific approach tactics to best address this population of younger residents.

T4 The Role of Nutrition in PreventingInfections & Promoting Wound Healing

EVELYN PHILLIPS | MAGEE REHABILITATIONHOSPITAL

This presentation will discuss the link between illness related inflammation and the associated hyperglycemia with malnutrition and hospital acquired conditions such as infection, aspiration and pressure ulcers. Nutrition recommendations for prevention and strategies for intervention will be reviewed along with case study examples.

T6 How to Start a Workplace Wellness Program on a Budget for Beginners

MARIA HICKS | CAMBRIDGE CONSULTINGGROUP

In this presentation, we will look at WELCOA's (Wellness Council of America) "8 C's" for starting, promoting and implementing a workplace wellness program. Wellness programs are becoming a trend in the workplace and companies are looking for ways to engage employee's, improve morale and lower healthcare costs. Participants will learn why wellness is important, simple ways to implement a workplace wellness program and low/no cost wellness ideas to start implementing right away.

T7 Delirium: A Final Common PathwayDisorder

MICHAEL GOLDSMITH | BEHAVIORAL CARESOLUTIONS LLC

Delirium as a disorder is transient in nature, acute in presentation and may last days, weeks or months. A number of studies have found that delirium accounts for 10-20% of acute medical admissions for older adults and 18% for those initially admitting to a long term care/SNF setting. Age and pre-existing dementia have been found

8

Thursday, Nov. 17 Education to be the primary predisposing factors for delirium. We’ll review clinical criteria for diagnosis, epidemiology/aetiology of delirium, and methods of differential diagnosis including assessment tools to be utilized by your interdisciplinary team to promote optimal resident outcomes.

T8 Caring for Transgender PeopleKATHLEEN LATOSCH | SAGE METRO DETROITThis interactive discussion will provide an introduction to caring for transgender people in the long-term care setting. It will include a review of appropriate language, cultural norms, critical policies to have in place and updates on the latest legal issues affecting this unique population in Michigan. Resources and links will be provided for additional learning. Nurse participants will also have an opportunity to hear personal experience from a transgender older adult and ask questions.

T9 Employer vs. Employee Side ofSocial Media Policy

DEBORAH BROUWER | NEMETH LAW, P.C.The advent of social media has resulted in formerly private matters, from family member complaints to employee on employee harassment, to all out public matters. This presentation will provide legal perspective on what can you legally do and what you can’t do to protect your facility’s on-line reputation and the integrity of your residents and staff.

9

Friday, Nov. 18 Education K3 How to Work with Generations

Y& Z: #HELP!FRAN VIAN | FORTIS MANAGEMENT GROUPOur workplaces are multigenerational – a simple statement with complex implications. Our multigenerational workforce requires us to be aware and understand the differences in employee engagement to facilitate efficiency and effectiveness in resident care. In this closing keynote presentation, nurse participants will explore the differences and similarities of the generations within their facility’s workforce and review employee engagement strategies to best meet the needs of their residents.

F1 Regulatory & CMS Update Part 1VICKIE BURLEW | LEBENBOM & ROTHMANWe are facing the largest shift in the paradigm of long term care in decades. Compliance with minimal standards is not sufficient. Reimbursement tied only to costs is fading away. Quality outcomes are driving overall operations. In Part 1 of this presentation we review how the state and CMS are making the shift with us. We discuss changes at the state, changes to the survey process, and what resident-centered survey trends are emerging in Immediate Jeopardy citations.

F2 Regulatory and CMS Update Part 2• VICKIE BURLEW | LEBENBOM & ROTHMAN• BETH BACON | HEALTH CARE

ASSOCIATION OF MICHIGANWe are facing the largest shift in the paradigm of long term care in decades. Compliance with minimal standards is not sufficient. Reimbursement tied only to costs is fading away. Quality outcomes are driving overall operations. In Part 2 of this presentation we provide an overview of the new regulations, the timeline to implement, and strategies to operationalize these.

MiNADONA

360care 3MAdvaCare SystemsAdvanced TissueAll Med Medical SupplyAllergan PLCAmerican Medical TechnologiesAtrium CentersAvanir PharmaceuticalsBehavioral Care SolutionsBiocodexBMI Mobile ImagingCareLinc Medical Equipment & SupplyCiena HealthcareClorox / ApexCollegium PharmaceuticalCompass Communications Group, LLCFitzsimmons Hospital ServicesGenemarkersGreat Lakes Caring Home Health and

HospiceHealthcare AcademyHomeTown PharmacyHPSI Purchasing ServicesIn Touch PharmaceuticalsJanssen

McKesson Medical SurgicalMedlineMobile Care GroupMobilex USA - US LABSMoblie Medical SupportNovo NordiskNutricia Advance MedicalOmnicarePCA PharmacyPharMerica CorporationPine Rest Christian Mental Health

ServicesQA ReaderQCI HealthcareRemedi SeniorCareResidential Home Health & HospiceSanofiSeasons Hospice & Palliative CareSenior Psychiatric Services of MI, PLLCService Care, Inc.Symmetry Hand HygieneTherapy Management Inc.Wound Kair Management

Annual Vendor Expo ShowProudly Featuring:list as of August 30, 2016

10

MiNADONA

Nurses: Be sure to bring your business cards to distribute to exhibitors for your chance to win one of many great prizes!

This year’s MI-NADONA/LTC Annual Convocation & Expo will be held at the Grand Traverse Resort & Spa located at 100 Grand Traverse Village Blvd, Acme, MI 49610.

Should you need overnight lodging, please secure your hotel reservation directly with Grand Traverse Resort & Spa by calling (800) 968-7352 by Friday, October 14, 2016.

Please be sure to reference “NADONA” at the time of reservation to receive the discounted room rates of $109 & $139 per night plus applicable taxes and a $14.95 daily resort fee per room per night.

Please make your reservation now, as rooms are limited and not guaranteed.

Self-parking at Grand Traverse Resort & Spa is complimentary.

HOTEL ACCOMMODATIONS Secure by Oct. 14!

11

Join us Thursday evening from 7:30 - 10:30 pm for the NURSE ADMINISTRATOR PARTY OF THE YEAR featuring:

• LIVE COUNTRY BAND, REBOOTED• LINE DANCERS / INSTRUCTORS• SHOOTING GALLERY• LOG SAWING

• WOOD CARVING• 2 HOURS OF HOSTED BAR AND 1 HOUR OF CASH BAR• HEAVY APPETIZERS AND SNACKS

PARTY NORTH Celebration

12

Please Thank our Generous Convocation Sponsors!

As of: August 31, 2016

AREA I: Etta Brown lbrown@fairlanescr.com Macomb, Oakland & Wayne counties

AREA II: Lynae Carsonlcarson@saginawscr.comBay, Gratiot, Isabella, Midland & Saginaw counties

AREA III: Judi Christensenjachristensen93@gmail.comIonia, Kent, Mecosta, Montcalm, Muskegon, Newago, Oceana & Ottawa counties

AREA IV: Beth Beamrebeam@frontier.comAllegan, Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph & Van Buren counties

AREA V: Renee Cunninghamrcunningham@mhc.netAlcona, Alpena, Arenac, Crawford, Gladwin, Iosco, Montmorency, Ogemaw, Oscoda, Otsego & Roscommon counties

AREA VI: *VacantBaraga, Gogebic, Houghton, Iron, Keweenaw & Ontonagon counties

AREA VII: Brenda Palmer1bpalmer62@gmail.comClinton, Eaton, Ingham, Livingston & Shiawassee counties

AREA VIII: Kim Shaughnessykim.shaughnessy330@comcast.netHillsdale, Jackson, Lenawee, Monroe & Washtenaw counties

AREA IX: *VacantAlger, Delta, Dickinson, Marquette, Menominee & Schoolcraft counties

AREA X: Patty McCleesclipstitch@msn.comCharlevoix, Cheboygan, Chippewa, Emmet, Luce, Mackinac & Presque Isle counties

AREA XI: Patricia Leonardpleonard@thevillagerehab.comHuron, Lapeer, Sanilac, St. Clair & Tuscola counties

AREA XII: Cheryl Pattoncheryl@meadowbrookmcf.comAntrim, Benzie, Clare, Grand Traverse, Kalkaska, Lake, Leelanau, Manistee, Mason, Missaukee, Osceola & Wexford counties

AREA XIII: Laura Jenningsljennings@wellbridgegroup.comGenesee county

FOUNDER: Peggy Godfreypgodfrey1@aol.com

PRESIDENTBonnie Beullabbeulla@marwoodmanor.org

VICE PRESIDENTCheryl Pattoncheryl@meadowbrookmcf.com

PAST PRESIDENT/PROGRAM CHAIRShari Carsonshari.carson@metronihs.com

TREASURERMonica Brennanmbrennan@laurelhealth.com

SECRETARYKim Desmetkdesmet@wellspringluthern.com

BYLAWS/MEDIALinda Mondouxstratltc@gmail.com

MEMBERSHIPEllie Posterekposter@aol.com

NOMINATINGJulie Pudvayjpudvay@ingham-mcf.org

SCHOLARSHIPDonna Beebegerald.beebe@yahoo.com

EXECUTIVE BOARD:

AREA COORDINATORS:

*If you would be interested in serving on the Board as the Area VI or IX Coordinator, please see a MI-NADONA board member or contact MI-NADONA President, Bonnie Beulla.

2016 MI-NADONA/LTC Board of Directors

13

Form #03092016

MEMBERSHIP APPLICATION A Membership Organization dedicated to Nurses in the Long Term Care Continuum

Make check or money order payable to: NADONA/LTC, 1329 E. Kemper Road * Suite 4100A * Cincinnati, OH 45246 FOR Credit Cards only - fax request to (513) 791-3699

Apply for membership on our website with Visa/Mastercard/American Express/Discover @ www.nadona.org Membership question? Call NADONA/LTC toll free 800-222-0539 or Email us at membership@nadona.org

□ New □ Renew Please print clearly (use one form per applicant or update renewal notice information) Tell Us About You Select all that apply: CDONA FACDONA CALN CLPN GDCN First Name Last Name

Home Address City State Zip

Home Phone Home Email

Tell Us About Your Career □ Skilled Nursing □ Assisted Living □ Retired

Corporation Facility/Community Name

Facility/Community Address City State Zip County

Facility Phone (please include extension) Work Email

Title License# and State Issued Type of license (RN, LPN, LVN)

Membership Dues PLEASE SUBMIT FEES FOR DUES AS LISTED BELOW (circle one)

STATE 1 YR 2 YR STATE 1 YR 2 YR STATE 1 YR 2 YR STATE 1 YR 2 YR

Alabama $110 $195 Indiana $115 $200 Nebraska $110 $200 South Carolina $115 $210

Alaska $110 $200 Iowa $110 $200 Nevada $130 $235 South Dakota $110 $200

Arizona $115 $200 Kansas $115 $200 New Hampshire $115 $200 Tennessee $115 $210

Arkansas $110 $190 Kentucky $115 $210 New Jersey $130 $235 Texas $125 $225

California $110 $200 Louisiana $110 $200 New Mexico $115 $215 Utah $110 $200

Colorado $110 $200 Maine $110 $200 New York $120 $215 Vermont $110 $200

Connecticut $115 $210 Maryland $120 $220 North Carolina $115 $210 Virginia $115 $200

Delaware $110 $200 Massachusetts $125 $215 North Dakota $125 $230 Washington $115 $210

Florida $125 $230 Michigan $120 $220 Ohio $130 $235 Wash D.C. $110 $200

Georgia $115 $205 Minnesota $115 $210 Oklahoma $115 $210 West Virginia $110 $200

Hawaii $120 $220 Mississippi $110 $195 Oregon $110 $200 Wisconsin $110 $200

Idaho $110 $195 Missouri $120 $210 Pennsylvania $115 $205 Wyoming $110 $195

Illinois $115 $210 Montana $110 $195 Rhode Island $110 $200 How Would You Like to Pay? □ Check Enclosed □ Visa □ MasterCard □ American Express □ Discover

Name as it appears on card: ___________________________________________________________________

Billing Address (if different from above) __________________________________________________________

Card#: ______________________________________________________ Expiration Date: ____/____

Signature: _______________________________ Contributions or gifts to the National Association of Directors of Nursing Administration in Long Term Care, Inc. are not tax deductible as charitable contributions.

However, they may be deductible as ordinary and necessary business expenses.

Submit directly to NADONA by fax to 513-791-3699

14

Early Registration DeadlineThe discounted early registration rate is available to current NADONA members only, whose registration is received by HCAM by Friday, October 7, 2016.

Registration ConfirmationAfter your registration form has been processed, an event confirmation will be emailed to your attention from KistiBoatright@hcam.org. Please be sure to include a current email address on this form.

Payment & Applicable RateMembership will be verified for all registrations indicating NADONA membership status. All registration fees are due at the time of registration.

Cancellation & Refund PolicyAll refund requests must be made in writing by e-mail to KistiBoatright@hcam.org. Telephone cancellations will NOT be accepted. Individual registration fees, less a 25% processing fee, will be refunded for cancellations received in writing prior to Oct. 7. Cancellations received after Oct. 7 and “no-show registrants,” will NOT receive a refund nor a credit to a future program.

SubstitutionsIndividuals registered to attend this program, but unable to participate, may send an alternate in their place. Please contact HCAM by email to KistiBoatright@hcam.org with the first and last name, title and facility/company of both you and your substitute to process this request.

Dietary RestrictionsShould you have a dietary restriction, please contact HCAM by email to KistiBoatright@hcam.org no later than Oct. 7 detailing your need.

Consent to Use of Photographic ImagesRegistration and attendance at, or participating in, MI-NADONA/LTC’s and/or HCAM's events and/or activities constitutes an agreement by the registrant to MI-NADONA/LTC’s and/or HCAM's use and distribution (both now and in the future) of the registrant or attendee’s image or voice in photographs, videotapes, electronic reproductions and audiotapes of such events and activities unless specified in writing prior to event.

QuestionsShould you have questions, please contact Kisti Boatright by phone at (517) 622-6194 or by e-mail at KistiBoatright@hcam.org.

2016 Registration Policies

MI-NADONA/LTC RN Boot Camp

Part 1: March 28-29Part 2: April 25-26

Lansing, MI

MI-NADONA/LTC Alzheimer’s Disease &

Dementia Care Seminar: Preparation for CDP

CertificationJune 22

Lansing, MI

MI-NADONA/LTC Annual Webinar: Topic TBD

July 12

MI-NADONA/LTC Annual Convocation & Expo

October 18-20Mt. Pleasant, MI

2017 SAVE THE DATES

15

MiNADONA

Package & Inclusions: Please circle the applicable package rate to the right and indicate the total abount due.

Early Bird NADONA Member

Rate Prior to Oct. 7

NADONA Member

Rate After Oct. 7

Non-Member

Rate

A) Full Package: Includes all education, contact hours, breakfasts, luncheons, breaks, expo and the PARTY NORTH Celebration from Nov. 16-18. $425 $500 $600

B) Nov. 16 Only: Includes education, contact hours, breakfast and luncheon on Nov. 16 only. $325 $400 $450

C) Nov. 17 Only: Includes education, contact hours, breakfast, luncheon, expo and PARTY NORTH Celebration on Nov. 17 only. $350 $425 $475

D) Nov. 18 Only: Includes education, contact hours and breakfast on Nov. 18 only. $250 $325 $375 - AVAILABLE TO 2016 PARTICIPATING EXHIBITORS & SPONSORS ONLY -

E) Annual Vendor Expo & Party North Only: Includes a ticket for lunch, the expo and PARTY NORTH Celebration on Nov. 17 for 2016 participating exhibitors/sponsors only. Any vendor who is NOT exhibiting or sponsoring will need to register for Package C.

$200

2016 registration rates are based on membership to NADONA/LTC. Please note that NADONA membership is separate from HCAM membership, and is based on an individual, not a facility. To sign-up for NADONA/LTC membership now, please be sure to complete

and submit the NADONA/LTC Membership Application included on page 18 to NADONA/LTC by fax to (513)791-3699.

TOTAL DUE $

Name:_____________________________________________________ Title:____________________________________________________________

Facility/Company:_____________________________________________________________________________________________________________

Address:_____________________________________________________________________________________________________________________

City:______________________________________________________________________ State:___________________ Zip: ____________________

Business Phone:_______________________________ Cell Phone: _______________________________ Fax: _______________________________

E-mail (REQUIRED):____________________________________________________________________________________________________________

Your confirmation of registration & other important conference information will be sent by to you by email from KistiBoatright@hcam.org.

PAYMENT INFORMATION

Check One: ____Check/Money Order made payable to “HCAM” ____Visa ____MasterCard ____American Express ____Discover

Credit Card Number:__________________________________________________________________________________________________________

Expiration Date (month/year):__________________ 3-digit Security Code:______________ Billing Zip Code for Credit Card:_____________________

Cardholder Name (print):______________________________________________________________________________________________________

Cardholder Signature:_________________________________________________________________________ Today’s Date:____________________

To register now, complete this form & submit with payment to: Fax: (517) 627-3016 | Mail: HCAM at 7413 Westshire Dr., Lansing, MI 48917

PRINT CLEARLY / ONE REGISTRATION FORM PER PERSON

Submitted registrations will NOT be accepted by email to promote the safety & security of your payment information. Thank you for your understanding.

Check this box ONLY if you have a dietary allergy &/or restriction such as “vegetarian” or “nut allergy.” You will be contacted directly if you check this box to discuss further.

NURSE PARTICIPANTS ONLY: REQUIRED

Please indicate the COUNTY that the facility in which you work at is located:_______________________________________________________________

Check this box ONLY if you will be traveling from the south east side of Michigan (metro Detroit area) and are interested in taking advantage of complimentary &/or low cost group transportation to & from Convocation & Expo. You will be contacted via email with additional information should you wish to consider this option.

PLEASE REVIEW BELOW & CHECK THE BOX(ES) IF APPLICABLE:

2016 MI-NADONA/LTC Annual Convocation & ExpoNovember 16-18, 2016Grand Traverse Resort & Spa | Acme, MI