NARHC News

Winter Quarter 2012

ICD-10: So, what’s the BIG deal?

By Patty Harper, RHIA An AHIMA‐Approved ICD‐10‐CM/PCS Trainer

Buzz. Buzz. So, what’s the big deal about ICD‐10 & what will it mean to your Rural Health Clinic? First of all, it’s important to understand that the new codes sets, effective October 1, 2013, will be a major departure from codes used in the United States for the past three decades. The code structure is completely different. The specificity of the codes is greatly expanded. The number of diagnosis codes will increase five‐fold from 13,000 codes to approximately 68,000. Although this increased granularity is great in the world of epidemiology, it will be a challenge for providers and billers alike. RHCs will need to identify which diseases they most often treat and then customize clinical notes, encounter forms, internal documents, and EHR templates to make sure the new data elements required for code assignment can be correctly captured. One example is the code assignment for acute suppurlative otitis media. Two codes in ICD‐9 become 16 codes in ICD‐10‐CM. The provider will now need to document lat‐erality, the episode/history of infection, and exposure to tobacco & smoke. Specialties, such as Obstetrics, will see dynamic differences in code assignments, too. The code structure introduces diagnosis codes that will be 3 to 7 characters in length and in‐clude both alpha and numeric values. Providers and office staff will find little use for the codes we have all committed to memory. An example is DM, Type 2, not uncontrolled: In ICD‐9, you would expect the code to be 250.00. In ICD‐10, the appropriate code would be E11.9. There will be a learning curve for everyone.

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ICD‐10 Continued from Pg. 1...

ICD‐10 will bring many more changes than the routine updates we have all come to expect each October. The primary reason for the 5010 conversion now is to make sure that EDI will be seamless for ICD‐10 implementation. Fortunately, CPT codes will continue to prevail in am‐bulatory settings, so RHCs will not be required to adopt the new ICD‐10‐PCS procedure codes that will be mandatory for hospitals. (That’s another article altogether, folks!). ©2011 Patty Harper CEO, InQuiseek, LLC

NARHC Announces Pharmacy Benefit Program The National Association of Rural Health Clinics and US Pharmacy Card are pleased to an‐nounce a new benefit to help patients and staff of NARHC member clinics obtain reduced cost prescription drugs. Under the agreement, U.S. Pharmacy will initially send up to 500 discount pharmacy cards to any NARHC member clinic that requests them. The cards can be given to RHC patients or staff who the clinic believes could benefit from this program. The discount cards should be of particular help to the following patients:

Uninsured patients Underinsured patients Patients with high deductible health plans Patients with health insurance with limited or no pharmacy benefits

The card can be used anytime a prescription is not covered by health insurance. The card also covers many pet medications. In 2011, the average savings with the card was approximately 55% off the retail price of drugs. One card covers an entire family. Patients will appreciate receiving the cards and know that the clinic cares about helping them save money on their prescription medications. For more information about the free discount prescription card program, please visit www.uspharmacycard.com/narhc or to order additional cards visit www.uspharmacycard.com/narhc1. You can also place your card order by contacting Steve Rohm at 724‐772‐9762 or emailing steve@financialmarketingconcepts.com In the event that there are any questions about the program, please contact the US Pharmacy Card at 1‐800‐931‐8872.

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Selecting an EHR by Jim Estes, NARHC Secretary/Treasurer

Selection of both the EMR and Billing/Management software for the Rural Health Clinic is a daunting and confusing task. RHC Administrative and Clinical staff should consider the spe‐cific needs of the RHC when evaluating EMR/Billing/Practice Management software, regard‐less of whether you are looking for your first software, or you want to replace an existing EMR/Practice Management system. This list should not be viewed as inclusive of every topic that you should consider but it does provide information on many of the most critical areas to consider when purchasing a sys‐tem. It is suggested that the RHC staff charged with evaluating and selecting an EMR/Practice Management system give this list to all prospective software vendors and require them to go thru each item and give proof that their system will perform each function to the staff’s satis‐faction. This list has been edited down from the longer one that includes areas that non‐RHC clinics find useful. This list has been pared to areas specific to the needs of Rural Health Clinic staff and patients. As you go through the evaluation/selection process, you may identify questions you would want added to the list. You should feel free to add to this list and if the topic(s) should be included in future lists, feel free to share them with me at the email address in‐cluded with this article. The revised list will be made available at the NARHC meeting in San Antonio on March 19‐21, 2012. Choosing Rural Health Clinic “friendly” software is important to improving the quality of care available in your RHC and maximizing the profitability of the clinic. If the billing and manage‐ment software will not bundle charges on the UB‐04, will not generate a Medicare Bad Debt log, will not generate a flu and pneumonia log, will not allow for documentation of MSP infor‐mation on a per‐visit basis, does not accurately count encounters (which means the system must recognize what an encounter is based on CPT codes), and more…..well, you’ve got a mess in your billing department that will result in slow claims submission, frequent turn‐over in the billing staff, lowered reimbursements and cost report settlements, etc.

RHC Billing and Management:

1) Monthly encounter report (by type: Medicare, Medicaid, dual‐eligible (crossovers), insur‐ance, self‐pay and all other, per Provider)

2) Bill electronically on UB04 AND HCFA1500, plus ANSI‐837/835 electronic format (HIPAA compliant)

3) Ability to recognize the payer type & CPT code for the service rendered and automatically generate the correct claim to the correct destination (Part A, Part B, Split charge, etc.). ]

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Selecting an RHC continued from pg. 4...

4) Ability to split charge and split bill, with the correct portion of the claim going to Medicare Part A and the other portion going to Medicare Part B. Must also keep account of patient co‐insurance calculated on 20% of Part A charges (for charges billed to Part A on the UB04) and 20% of Part B allowable (for charges billed to Part B on the 1500).

5) The billing system MUST recognize the payer class of the Medicare patient, and based on that payer class and the CPT code entered (only those recognized as billable PA or Cert. Nurse Midwife, Clinical Psychologist, LCSW, DPM or Chiropractor) AUTOMATICALLY bun‐dle ALL charges entered, not just the E & M code/charge. This means the system will add together all charges entered and put them on ONE line on the UB‐04 claim form, with the 521 revenue code & description” Rural Health Clinic Encounter” or similar wording. Fail‐ure of the system to do this results in SIGNIFICANT revenue loss to the clinic. If the clinic billing staff has to manually over‐ride the software and force this bundling, the additional time required to do so is prohibitive and adds greatly to the cost of operations and billing.

6) Ability to bill directly to the CMS‐MAC. Software company MUST Provide at least one RHC that is currently using their software and is currently billing to the same MAC and the State Medicaid entity as your clinic.

7) Medicare Bad Debt report (log in Excel or similar format) for cost report purposes must include name, Medicare number, Medicaid number (if appropriate) and date first bill sent, date of service, and date of write‐off, amount paid by Medicare, Medicaid, Patient, Sup‐plemental Ins. and the amount of the write‐off. A separate log with the same information should be available for all dual eligible patients (having Medicare & Medicaid). These re‐ports will need to be submitted electronically, so it is important to be able to save them to a disc in a format that is compatible (i.e. Excel or similar spread sheet). Failure to have these logs means the billing staff has to invest considerable time in manually entering this information. If the clinic has significant Medicare Bad Debt and the system does not pro‐vide this report or allow for collection of this data without increased time investment of staff, the clinic can lose considerable amounts of revenue on the cost report settlement every year. Failure to have ALL the information required on the log will result in the clinic’s annual Medicare Cost Report being denied and returned as incomplete, resulting in cessation of Medicare reimbursements until the corrected report is submitted to CMS. The Clinic should give the vendor a copy of the Bad Debt Log they use on their Cost Report to assure collection of the correct data.

8) Flu and Pneumonia injection log includes print out of total number of injections AND a separate report for Medicare patients that includes the patient name, Medicare number, date of injection, etc. as per cost report requirements.

Medical Records Specific 9) Will the system allow for a space to document Medicare Secondary Payer (MSP) ques‐

tions asked and verified, with this space retaining the response for past encounter dates, yet having the same field available for new verification on each new encounter.

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Selecting an EHR continued from pg. 5… 10) In the RX section of the SOAP note, is it possible to have a REPORTABLE field whereby the

provider can enter the LOT NUMBER of a sample medication given to the patient under RHC regs—no 99211 or services provided by someone other than the MD, DO, NP, while at the clinic. It is also required in most states to be able to run a report showing all sam‐ple medications provided to patients, by patient name, date, dosage, drug name and lot number ( a type of continual inventory).

11) Can patient sign‐in be done electronically with a signature “pad” at the reception desk, with this sign‐in method to include the patient “writing” in their name, complete address, phone number and possibly answering the three Medicare MSP questions: A) Has your insurance, Medicare or Medicaid coverage changed since your last visit at this clinic? B) Is today’s visit the result of an accident or injury? C) Will today’s visit result in the filing of a Workman’s Compensation claim? (unless the system has the ability to meet this compli‐ance requirement via another method).

12) There MUST be a way to communicate ANY and ALL changes to a patient’s insurance status (including MSP changes) TO THE BILLING DEPARTMENT. There should be some kind of “flag” or alert that the biller can easily see, so that they will correct the billing process to reflect the change in patient payer status.

Jim Estes, President Healthcare Horizons hlthcarehorizons@mindspring.com

Join Us in San Antonio, TX!

NARHC 2012 Spring Institute March 19-21, 2012

Mon.-Wed. at the Hyatt Regency Located on the Riverwalk, by the Alamo

See agenda on pg. 7...

National Association of Rural Health Clinics2 East Main StreetFremont, MI 49412

2012 SPRING INSTITUTE

N A T I O N A L A S S O C I A T I O N O F

N A T I O N A L A S S O C I A T I O N O F

March 19-21, 2012 | San Antonio, Texas

Room reservations can be made at https://resweb.passkey.com/go/NARHC2012If assistance is needed, call 888-421-1442 & reference group code “NARH”. The discount room rate is $169/ night plus tax.The reservation deadline is February 23, 2012.Please make reservations early before NARHC’s room block is full!

Save on Postage and Register Online!Online registration is available at www.narhc.org under the Events tab.Also, check the Events tab for a final agenda and updated conference information.

Draft agenda and registration form are included.

Questions? Email: meetings@narhc.org or call 866-306-1961

Hyatt Regency123 Losoya Street

San Antonio, Texas 78205

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MONDAY, MARCH 19, 2012Breakfast (on your own)

7:30 – 8:30 am Registration

8:00 – 5:00 pm CONFERENCE VENDORS (Monday and Tuesday Only)

8:30 – 9:00 am Welcome and Conference Overview

9:00 – 10:00 am Legislative Update

10:00 – 10:30 am Networking Break

10:30 – 11:30 am Compliance 101 and Medical Practice Programs

11:30 – 12:30 pm RHC Regulations and Compliance

12:30 – 1:30 pm Lunch (on your own)

1:30 – 3:00 pm Cost Reporting 101

3:00 – 3:30 pm Networking Break

3:30 – 4:30 pm Gaining Access to State, Federal and Other Resources by Working with your SORH

TUESDAY, MARCH 20, 2012Breakfast (on your own)

8:00 – 8:30 am Registration (For those who didn’t register Monday)

8:00 – 5:00 pm CONFERENCE VENDORS (Monday and Tuesday Only)

8:30 – 10:00 am Complete RHC Billing

10:00 – 10:30 am Networking Break

10:30 – 11:30 am Advanced Cost Reporting Topics

11:30 – 12:00 pm Prescription Cards

12:00 – 1:00 pm Lunch (Provided)

1:00 – 2:00 pm Preparing your Practice for ICD-10 by 2013

2:00 – 3:00 pm Hot Topics/Emerging Issues

3:00 – 3:30 pm Networking Break

3:30 – 4:45 pm MAC Discussion Panel

WEDNESDAY, MARCH 21, 2012Breakfast (on your own)

8:30 – 9:00 am HPSA/MUP Negotiated Rulemaking Update

9:00 – 9:30 am Rural Assistance Center at Your Service

9:30 – 10:00 am Networking Break

10:00 – 11:00 am Meaningful Use — What You Need to Know

11:00 – 12:00 pm Texas Break Out Session

2012 NARHC Spring Institute RegistrationLocated at Hyatt Regency, 123 Losoya Street, San Antonio, TX 78205

March 19-21, 2012 (Monday — Wednesday)

Method of Payment: (Check one): Check Visa Master Card (sorry, no Discover or American Express)

Credit Card Number: Exp. Date Security code:(3 digit)

Name on Card:

Credit Card Billing Address:

Signature: Amount:

Payment is requested in advance for conference.

Return completed form to: National Association of Rural Health Clinics OR By faxing to 866-331-9606 (If paying by Visa/MC) 2 East Main Street Phone 1-866-306-1961 Fremont, MI 49412

Submit Conference & Room Registration Early! The Hyatt Deadline is February 27th (or when full).

Name: Title:

Phone: Email:

Facility Name:

Provider-Based RHC Independent RHC Other

Address:

City: State: Zip Code:

Additional Attendees: Email: Title:

NARHC MEMBERS: 1st NARHC Member Additional Member (each)

NON-MEMBERS: 1st Non-Member Additional Non-Members (each)

$400$325

$500$450

Early DiscountedConf. Registration

BY FEBRUARY 19TH*

$450$375

$550$500

Conf. RegistrationFEBRUARY 20TH - MARCH 5TH*

$500$425

$600$550

Late Conf. RegistrationAFTER MARCH 5TH*

*REGISTRATION FEE BASED ON DATE PAYMENT RECEIVED.Conference is 2 ½ Days Long. Sorry, there is not discount for attending fewer days.

TOTAL

Quantity Fee

For a complete agenda and learning objectives, check our website, www.narhc.org, under the Events tab.CANCELLATION POLICY: 30+ days prior to conference, NARHC will refund 100%.

Cancellation 14-29 days prior to conference, NARHC will refund 50%.Cancellation 0-13 days prior to conference, there will be no refund.

You may, however, send a substitute in your place. Please inform us 10+ days before conference!

NARHC 2012 Spring Institute Agenda

Ron L. Nelson Award Nomination Form

The Ron L. Nelson Award stands for Outstanding Leadership & Commitment to Rural Health Clinics in the United States. This award is a fitting tribute to the life of Ron Nelson who passed away on June 11, 2011. Born in the rural community of Grant, Michigan, he was deeply concerned about underserved areas and their ability to recruit and retain quality medical personnel to the community. He was equally troubled by the limited access that rural communities had to both funding and medical services. Recognizing the need to promote healthcare at the national level, Ron Nelson, P.A., co-founded and served as the first president of the National Association of Rural Health Clinics. Ron served two terms as President of the American Academy of Physician Assistants (AAPA), and was appointed by President George W. Bush to serve on the National Advisory Committee on Rural Health & Human Services. Ron was President of Health Services Associates and a recognized expert in the area of reimbursement and physician payment related to rural health clinics and federally qualified health centers. He also worked as a Physician Assistant for Spectrum Health Gerber Memorial and was on faculty for Central Michigan University’s PA program.

Ron served on the National Advisory Committee on Rural Health & Human Services in the hope of developing programs that might heighten medical exposure to rural health settings. It is in this spirit that the Ron L. Nelson Award is given.

Ron L. Nelson Award Winners: 2011: Bill Finerfrock Please submit the following nomination information at or before the Spring Meeting (March 19-21, 2012). You may

fax or email to: the National Association of Rural Health Clinics at 866-311-9606 (fax) or e-mail meetings@narhc.org. The

award winner will be announced during the NARHC Annual Meeting held at the Fall Conference in October.

NOMINEE INFO: Nominee Name____________________________________________ Phone__________________________________

Email____________________________________________ Current Position___________________________________

Organization______________________________________________________________________________________

Address__________________________________________________________________________________________

Educational background_____________________________________________________________________________

Nominee’s work experience__________________________________________________________________________

________________________________________________________________________________________________

Summarize why the nominee should receive the award: (rural areas impacted, work experience, key highlights, etc.):

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

NOMINATOR INFO: Your Name________________________________________________ Phone_________________________________

Email_____________________________________________

Address_________________________________________________________________________________________

Relationship to nominee____________________________________________________________________________

Overview of The Compliance Team’s Accreditation Program

The Compliance Team’s quality standards are “patient‐focused, operations‐driven, and written in plain language.” The standards are crafted to be fully integrated with the CMS RHC Conditions of Participation ensuring your facility is compliant to current standards. In addition, The Compliance Team also offers an optional module for becoming a Patient Centered Medical Home.

RHCs seeking accreditation by The Compliance Team will be provided a phone advisor who con‐ducts a series of hour‐long phone conference calls walking you through the standards, explaining what each standard means, the policies and other documentation that’s required and the actions needed to be compliant. Soon after the calls are completed, The Compliance Team will schedule an on‐site visit (survey) when the clinic is ready for inspection. Once a clinic is accredited, elec‐tronic benchmarking of your patients’ experience begins.

The Compliance Team’s Exemplary Provider™ quality standards and accreditation process estab‐lishes Safety, Honesty and Caring™ as core patient relationship values. During the phone confer‐ence phase of their program, TCT identifies potential areas of concern resulting in improved pa‐tient care with better outcomes. Provider organizations are therefore guided to healthcare excel‐lence by going through a process that focuses on the RHCs everyday patient care practices and business operations.

Once The Compliance Team’s RHC Accreditation program is approved by CMS, RHCs accredited by TCT will no longer need to conduct routine state inspections.

The Compliance Team, Inc. was founded in 1994 and has been accrediting health care providers since 1998. TCT has accredited over 5000 locations in all 50 states, including 1000 in designated rural areas. TCT is currently an approved certifying agency by CMS for DMEPOS (Durable Medical Equipment Suppliers), and they have accreditation programs for Infusion/Specialty & LTC Phar‐macy, Diagnostic Sleep Centers, Private Duty Homecare and Ocularist/Anaplastogist. The Compli‐ance Team is also conducting a demonstration project for Critical Access Hospitals with plans to become an approved certifying organization for these facilities. RHCs interested in being accredited by The Compliance Team or learning more about their initia‐tive, are encouraged to contact Bill Dowdall—bdowdall@thecomplianceteam.org or phone 1‐215‐654‐9110.

Rural Health Clinic Accreditation Demonstration The Compliance Team, Inc (TCT) is now accepting applications from Rural Health Clinics to participate in its RHC Accreditation Demonstration Project. Once the demonstration has been completed, The Compliance Team will submit an application to CMS to become an approved RHC certifying/recertifying organization.

National Association of Rural Health Clinics

2012 MEMBERSHIP SALE

“Coming together is a beginning; keeping together is progress;

working together is success.” ‐ Henry Ford Despite these difficult times, we are grateful that NARHC’s membership has sustained itself over the past few years. However, we need our membership to grow so that RHCs can have more weight in the health care world. The strength of RHC advocacy depends a great deal on NARHC’s membership numbers and activities. It is members that allow associations to accomplish what needs to be done. Member dues provide necessary funding and member volunteers provide guidance and expertise to continue to move the association and what it represents into the future. Members truly make the difference – for NARHC and for the health care of our nation. Thank you to all for joining and for renewing your memberships! So far, about 15% of the RHCs in this country belong to NARHC, and we do want to increase membership in order to enhance our abil‐ity to influence change. NARHC advocates on behalf of all RHCs, and each one of us should support its activities. The association serves a vital role in maintaining the viability and success of clinics throughout the United States. NARHC works to help develop policies, set standards, advocate in gov‐ernment and private settings, provide needed education, maintain the original vision of the RHC rule, and shape the rules of the future to assure the program continues to exist. NARHC is the only national organization dedicated exclusively to improving the delivery of quality, cost‐effective health care in rural underserved areas through the RHC Program. NARHC works with Congress, federal agencies, & rural health allies to promote, expand, & protect the interests of RHCs. Rural Health Clinics face difficult challenges every day. We work hard to improve the lives of our pa‐tients by providing quality, affordable health care. This requires access to cutting edge ideas, current information, quality resources and legislative updates, which NARHC offers. We are also working to provide more “members only” benefits, which currently include reduced fees for semi‐annual con‐ferences, connection with RHC experts, and the option to join group purchasing and pay less for many supplies and services. We have recently added some new benefits ‐ free as well as reduced‐price online education for staff through Essential Learning (http://narhc.cequick.com) and free dis‐count prescription cards for patients (www.uspharmacycard.com/narhc1). There are also discounts available for recruiting new members. Please spread the word, and renew your membership. You are a very important part of NARHC!

Gail Nickerson Vice‐President NARHC

2012 Membership Application

Why join? Joining the NARHC is an investment in the future of the RHC program. NARHC advocates at the federal and state level for policies, grant

opportunities, and legislation that benefit Rural Health Clinics and the patients they serve. Through conferences, educational workshops,

teleconferences, list serve forum, web site, legislative updates, and quarterly newsletters NARHC gets you the most up-to-date information.

SECTION A: GENERAL INFORMATION Application Date:______________

1. Contact Person’s Name:

2. Organization/Hospital

Name:

3. Clinic Name (if applicable): CMS Clinic ID #:

__ __ __ __ __ __

4. Mailing/Billing Address:

5. Phone:

FAX:

6. Contact’s E-mail Address:

7. Membership Status: Renewal New Member

8. Dues: Mail your application & payment to: NARHC, 2 East Main Street, Fremont, MI 49412

Membership Type:

$200.00 New RHC Clinic – less than two years

$450.00 Independent RHC

$450.00 Provider-based RHC

$115.00 For Each Additional Clinic

$400.00 Governmental or Association (circle which) – non-voting*

$550.00 Corporate or Consultant (circle which) – non-voting*

* Only RHC Membership Types may vote.”

Method of Payment:

Check

Credit Card (Visa or MasterCard Only!)

Credit Card:

Credit Card Number: __________________________________________

Expiration Date: _______________Three digit security code: __________

Name on Card: _______________________________________________

Card Billing Address:___________________________________________

Total Amount Paid: $ ___________________

The following Clinic Information is important! It allows NARHC to accurately represent its membership on key policy and legislative issues. All information will be kept confidential and no clinic specific information will be released. If your clinic is part of an Affiliation Network, please copy these pages and complete a Section B for each rural health clinic affiliate member.

NARHC 2 East Main Street Fremont, MI 49412 Toll Free: 866.306.1961 Fax: 866.311.9606

Website: www.narhc.org

SECTION B: CLINIC INFORMATION

1. Clinic Name:

CMS Clinic

ID #: __ __ __ __ __ __

2. Clinic Address:

3. Clinic Contact No.: Tele: Fax: E-mail:

4. Clinic Specialty: Sub-Specialty:

5. Date of Initial RHC Certification:

6. Current Medicare all-inclusive rate: $ /encounter

7. Annual Encounters (total patient encounters from most recent cost-report

No. of Medicare encounters: No. of Medicaid encounters:

8. How many days per week is your RHC open for patient care?

9.

Please indicate the type of providers by health profession and full time/part time status providing care at the RHC:

Professional Type Specialty (if applicable) Number of Full Time Equivalents (FTEs)

Physician

Physician Assistant

Nurse Practitioner

Certified Nurse

Midwife

Clinical Psychologist

Social Worker

Chiropractor

10. What is the population (round to the nearest 1,000) of the town where the RHC is located?

11. What is your best estimate of the population of the RHC’s service area?

12. Do you participate with a Medicare HMO or PPO plan? Yes No

13. Do you participate with a State sponsored Medicaid HMO plan? Yes No

14. Does your clinic accept new patients? Yes No

15. What percentage of the RHC’s patient population is uninsured?

Release of Information:

NARHC’s mailing list has been requested for purchase by third parties. Our mailing list consists of members, listserve requests, purchased CMS list and participants from conferences. NARHC has the right to refuse the sale of this list upon their discretion. NARHC does not share email addresses. Because we value your opinion as a member, please indicate below your desire.

Yes, I would like my contact information passed along to valuable third parties. No, I do not want my contact information passed along. Note: If no box is checked, NARHC will assume it is fine to release your information.

ADVERTISING OPPORTUNITIES NARHC NEWS (Newsletter) Spring issue: (Deadline: Feb. 15) Mid‐March distribution Summer issue: (Deadline: June 15) Mid‐July distribution Fall issue: (Deadline: Aug. 15) Mid‐September distribution Winter issue: (Deadline Dec. 15) Mid‐January distribution Ad Rates: Quarter page ad (6‐1/2 x 2”) $250 per issue (this is banner shaped) or $750 per year (3‐4 issues)

WEBSITE (www.narhc.org) Logo linked to consultant or vendor’s homepage with two‐line description of services. Additional lines may be purchased. There are approximately 3,000 visitors to this site monthly. These numbers are growing as the web‐site gains more dynamic content, a key goal for NARHC. Quarterly Rates: Logo & description (two lines) ‐ $250 per quarter (3 months), Additional lines ‐ $100/line Annual Rates: Logo and description (two lines) ‐ $900 annually Additional lines ‐ $200 per line

CONFERENCE SPONSORSHIPS OR EXHIBITORS: NARHC hosts two conferences per year throughout the United States. Conferences are 2½ days in length and participants can earn CEU/CME credits. Exhibitors exhibit just the first 2 days. SPONSORSHIPS: Gold $1500. Silver $1250. Bronze $1000 Sponsors depending on level receive: Conference Registration, Food & Beverages, Advertisement, Partici‐pants List, Poster & Banner Marketing, and a 6’ Draped & Skirted Table. EXHIBITORS: Conference Exhibitor $825

UPCOMING CONFERENCES: SPRING 2012 Institute… Hyatt Regency 123 Losoya Street San Antonio, TX 78205 March 19‐21, 2012 (Mon.‐Wed.) FALL 2012 Institute… Atlantis Casino Resort Spa 3800 S. Virginia St. Reno, NV 89502 Oct. 24‐26, 2012 (Wed.‐Fri.)

Contact NARHC at 866‐306‐1961 or email meetings@narhc.org for more information.

2012 NARHC Board of Directors

Barbara Berg, Board Member Elsie Crawford, RN, BSN, MST, Board Member Lake Chelan Clinic Wilkens Medical Group PO Box 368, 219 E. Johnson PO Box 447 Chelan, WA 98816 Jellico, TN 37762 Phone: 509‐682‐2511 Phone: (423) 784‐7269 ext. 3104 Email: barbara@lcclinic.org Email: ejecrawford@aol.com Term: January 2011 – December 2014 Term: January 2010 – December 2013

Gail Nickerson, Vice President Jim Estes, Secretary/Treasurer Adventist Health Healthcare Horizons 2130 Professional Drive, Ste 190 2308 County Rd 3007 Roseville, CA 95661 Bartlesville, OK 74003 Phone: (916) 774‐7308 Phone: (800) 399‐0874 Email: nickergw@ah.org Email: hlthcarehorizons@mindspring.com Term: January 2011 – December 2014 Term: January 2012 – December 2015

Wm. John Gill, President Ramsey Longbotham, Board Member Pioneer Medical Center Texas Association of RHCs 515 Carlton Street 1104 N. Terrell Wauchula, FL 33873 Cuero, Texas 77954 Phone: (863) 832‐0001 Phone: (361) 576‐2940 Email: William.Gill@AHSS.org Email: ramsey@tarhc.org Term: January 2010 – December 2013 Term: January 2012 – December 2015

Charles A. James, Board Member Sylvia Weise, Board Member N. American Healthcare Management Services Wipfli, LLC 100A Kenrick Plaza 3703 Oakwood Hills Parkway Saint Louis, MO 63119 Eau Claire, WI 54702 Phone: (314) 968‐0076 Phone: (715) 858‐6631 Email: cjamesjr@narhsinc.com Email: sweise@wipfli.com Term: January 2012 – December 2015 Term: August 2011 – December 2013

Cathy Rybicki, Board Member Angie Charlet, RN, BSN, MHA, Board Member Spectrum Health Reed City Hospital Illinois Critical Access Hospital Network 300 North Patterson Dr., PO Box 75 245 Backbone Road E Reed City, MI 49677 Princeton, Il 61356 Phone: (231) 832‐7133 Phone: (815) 875‐2999 Email: Catherine.Rybicki@spectrumhealth.org Email: acharlet@icahn.org Term: January 2010 – December 2013 Term: November 2011 – December 2014

STAFF

Bill Finerfrock NARHC OFFICE: Executive Director 2 E. Main St., Fremont, MI 49412 426 C St., NE, Washington, DC 20002 Phone: (866) 306‐1961 Phone: (202) 543‐0348, Fax: (202) 543‐2565 Fax: (866) 311‐9606 Email: bf@capitolassociates.com Web site: www.narhc.org Email: info@narhc.org Chris Christoffersen Rhondi Davis Director of Finance Director of Meeting Planning/Office Operations Email: christoffersen@hsagroup.net Email: rdavis@hsagroup.net Email: meetings@narhc.org