Discount for MembersHCAM is pleased to offer our members the following

promotional pricing for this program:

“Buy One, Save $100 on a Second Registration From the Same Facility.”

The discount applies to HCAM members only.Note: To receive this discount, both registrants must be from the same facility address and

must be submitted on the same registration form. This discount does not apply to corporate entities as it is a facility based discount. This discount does not apply to non-members.

IntroductionHCAM is proud to announce that Vickie Burlew RN, has become the exclusive HCAM INTERACT III trainer and will bring the national, standardized care practices and tools to HCAM members. This training is essential to members as hospitals are now financially penalized for Medicare patients being re-admitted within thirty (30) days. Hospitals are likely to send more patients for short-term post hospital stay as opposed to home without proper support. However, the basis for referrals no longer is the physicians or the relationship with the hospital discharge planners. The basis is driven by the nursing home rates of rehospitalization. HCAM proudly supports our members in caring for these residents without rehospitalization.

INTERACT is a quality improvement program designed by CMS under a contract to establish standards of care and tools for the early identification, assessment, documentation, and communication about changes in the status of residents in skilled nursing facilities reducing costly rehospitalization.

This training is not how to complete the tools and add to your growing burden of paperwork. This is how to integrate the INTERACT III process into what you already do as a process improvement project, develop a plan, and learn strategies for implementation. In Part A of this series, you will learn the process, evaluate your own systems, and design the improved process for your home integrating the elements of INTERACT III. You will leave with an implementation plan and strategy. In Part B, you will come back to review the data you and your colleagues have collected, share stories of success, work through further opportunities for improvement, and learn strategies for continuous monitoring and improvement further reducing rehospitalization.

PurposeThe purpose of this training is to enable the learner to integrate the INTERACT III process into their current process improvement strategies, develop a plan and learn strategies for implementation in order to reduce re-hospitalization rates.

Target AudienceSkilled nursing facility owners, corporate level leadership, administrators, directors of nursing and nurse managers and interdisciplinary personnel with quality assurance, planning or operational responsibilities.

CONTINUING EDUCATIONThis program will provide participants the opportunity to earn up to 12 nurse contact hours.

HCAM is an approved provider of continuing nursing education by the Wisconsin Nurse 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.

AGENDA AT A GLANCE:Part A & B

9:30-10:00 AM Registration10:00 AM Program Begins 11:30-12:30 PM Provided Luncheon5:00 PM Program Ends

Interact IIIHealth Care Association of Michigan Proudly Presents:

AN INTENSIVE TWO-PART REGIONAL TRAINING

LOCATIONSThis program will be held regionally. You must attend both Part A and Part B, however you may choose whichever date/location you prefer for each part.

LCC West Campus Conference Center: (517) 483-93005708 Cornerstone Drive, Lansing, MI 48917

Motor City Hotel: (313) 237-77112901 Grand River Ave., Detroit, MI 48201

Courtyard by Marriott Grand Rapids Downtown: (616) 242-600011 Monroe Ave. NW, Grand Rapids, MI 49503

Holiday Inn of Marquette: (906) 225-02551951 US 41 West, Marquette, MI 49855

Interact IIIHCAM Proudly Presents:

AN INTENSIVE TWO-PART REGIONAL TRAINING

Select Your Registration Fee: ____________ Member Rate: $399 for first individual

____________ Member Rate: $299 for second individual

____________ Non-Member Rate: $599 per person

$___________ Total Due

PRINT CLEARLY / REGISTRANT 1

Name:____________________________________________________________________________ Title:_________________________________________________________________________

Facility/Company:_______________________________________________________________________________________________________________________________________________

Address:_________________________________________________________________________________________________________________________________________________________

City:___________________________________________________________________________________________ State:____________________________ Zip: ________________________

Phone:_______________________________________________ Fax: _________________________________________

E-mail (required):___________________________________________________________________ (NEW! Confirmation of registration and important program info. will be sent to you by e-mail, if provided)

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

Credit Card Number:________________________________________________________________________ Expiration Date (month/year):__________________________________

Three-digit Security Code on Back of Card:_____________________________________ Billing Zip Code for Credit Card:__________________________________________

Cardholder Name (print):_______________________________________________________________________________________________________________________________________

Cardholder Signature:_______________________________________________________________________ Today’s Date:_____________________________________________________

Registration

Please utilize this form to register for the 2013 HCAM Interact III Training. Please mail or fax

completed registration forms.

Event ConfirmationAfter your registration form has been processed, an event confirmation will be emailed to your

attention. Please be sure to include a current email address on the form. If you do not receive a

confirmation within 14 business days of submitting your registration form to our office, please

contact HCAM via e-mail at eventconfirmation@hcam.org.

Payment & Applicable RateAll registration fees are due at the time of registration. We accept Visa, MasterCard, American

Express or Discover. We will also accept a check or money order payable to HCAM. Incorrect

rates will be adjusted to reflect the correct applicable rate and automatically charged

accordingly. Should you have questions in regards to your applicable rate, please contact

Meggen Galbreath, Finance Specialist, by phone at (517) 622-6188 prior to submission.

Cancellation & Refund PolicyAll refund requests must be made in writing by e-mail to the attention of Mary Campbell at

MaryCampbell@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 Mar.

15. Cancellations received after Mar. 15 and no-show registrants, will not receive a refund

nor a credit to a future program.

SubstitutionsIndividuals registered to attend this conference, but unable to attend, may send an alternate in

their place. Please contact HCAM via e-mail at eventconfirmation@hcam.org with the first and

last name, title, facility/company and e-mail addresses of both you and your substitute to process

this request.

Dietary Restrictions and/or Special AccommodationsIndividuals with special dietary restrictions, or those who require special accommodations

to fully participate in this conference, should contact HCAM in writing by e-mail to

MaryCampbell@hcam.org no later than Mar. 15, detailing their request or restriction. It is the

responsibility of each participant to notify banquet staff of their dietary request at each meal

on-site.

Consent to Use of Photographic ImagesRegistration and attendance at, or participating in, HCAM and MCAL events and/or activities

constitutes an agreement by the registrant to HCAM and MCAL’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.

QuestionsPlease contact Mary Campbell by phone at (517) 622-6194.

2013 HCAM REGISTRATION POLICIES: MUST REVIEW

REGISTRANT 2 - MUST BE FROM THE SAME FACILITY (Note: This does not apply to corporations or non-members)

Name:____________________________________________________________________________ Title:_________________________________________________________________________

E-mail (required):___________________________________________________________________ (NEW! Confirmation of registration and important program info. will be sent to you by e-mail, if provided)

Select Your Part A Session: ____ April 15 (Lansing) ____ April 29 (Grand Rapids)

____ April 22 (Detroit) ____ May 2 (Marquette)

Select Your Part B Session: ____ October 14 (Lansing) ____ October 28 (Grand Rapids)

____ October 21 (Detroit) ____ October 7 (Marquette)

NOTE: There is no discount if you choose to only attend Part I. Part I is a pre-requisite for Part II.

To register, submit this completed form by fax to (517) 627-3016 or by mail to:

HCAM 7413 Westshire Dr., Lansing, MI 48917