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|KCRA News! |

|kcra- |

| | Summer 2014 |

|This newsletter is brought to you by the KCRA Executive Committee and is meant to give you the latest news and information happening in our |

|state organization as well as Nationally. |

|Contents |

|Section 1: From The President 1 |

|Section 2: Cardiac News 2 |

|Section 3: Pulmonary News 3 |

|Section 4: Program and Patient Spotlight 4 |

|Section 5: Upcoming Events 6 |

|Additional Information 7 |

| |

|Section 1: From The President |

|Beth Cundiff, MS, CSCS |

|President KCRA, Program Supervisor, UK Healthcare Gill Heart Cardiopulmonary Rehab, Lexington, KY |

|Hit Your Reset Button! |

|Our spring KCRA conference this year offered a great lineup of speakers. Among them was Certified Health Coach, Melinda Hardin. She reminded |

|us that life should be lived with intention and purpose. She emphasized the importance of mindfulness with everything we do and continual |

|focus on our goals. Instead of just going through the motions, we need to take time to pause, re-focus and “hit the reset button.” |

|I frequently find myself “hitting the reset button.” Recently, as I worked with one of our Exercise Specialists on a complicated billing |

|issue, I laughed and said “I got into this because I wanted to teach people how to exercise.” He smiled and said “Yeah, me too.” Do you find |

|there are days where the ancillary duties of your work become more prevalent than the very thing you went to school for? Sometimes our best |

|clinical skills sit dormant in our minds collecting dust. |

|I am so appreciative of organizations like the KCRA and AACVPR that help us stay current in our field. As many of you know, AACVPR is now |

|offering a Professional Certification for Cardiac Rehab. The first exam will be offered at the national conference this fall. I encourage |

|anyone working in cardiac rehab to explore this opportunity. What a great way to hit your reset button. For more information, refer to the |

|Cardiac News section in this letter. Future plans include development of a Pulmonary Rehab Professional Certification as well. |

|This summer I will hit my reset button and attend an AACVPR Affiliate Leadership forum. This meeting is designed to help leaders of state |

|affiliates learn more about best practice, legislation and tools to grow and develop your organization. I look forward to sharing and |

|implementing what I learn with our Executive Committee and members. |

|In closing, I am so thankful for the KCRA committee volunteers who made the conference happen in March. I am equally grateful for those that |

|chose to continue serving and the new folks that have stepped up to serve. I would like to recognize the generous members that will |

|participate in our Planning and/or Executive Committee this year: Past President, Peggy Cox; Newsletter Editor, Tammy McDill; |

|Secretary/Treasurer, Dana Wills; Website development, Cathy Lewis and Greg Brislin; Conference Planning, Stephane Tucker, Sherri Bradley, |

|Rodney Wills, and all names listed above. |

|If we can be of assistance to you, please feel free to contact me through email or phone: beth.cundiff@uky.edu 852-323-5424. |

|“The jump is so frightening between where I am and where I want to be…because of all I may become I will close my eyes and leap!” - Mary Anne |

|Radmacher |

|Section 2: Cardiac News |

|New professional certification offered |

|Tammy Tyillian McDill, MS, CES, RCEP, FAACVPR |

|Clinical Supervisor, KentuckyOne Healthy Lifestyle Centers, Louisville, KY |

|2014 marks the year that AACVPR will hold the first sitting for a new professional certification. The Certified Cardiac Rehabilitation |

|Professional (CCRP), exclusively for cardiac rehabilitation (CR) professionals, is the only certification aligned with the published CR |

|competencies. AACVPR’s exam assesses proficiency via exam questions that evaluate knowledge of facts, concepts and processes required to |

|complete tasks in the |

|following areas: |

|Patient Assessment |

|Nutrition Management |

|Weight Management |

|Blood Pressure Management |

|Blood Lipid Management |

|Diabetes Management |

|Tobacco Cessation |

|Psychosocial Management |

|Physical Activity Counseling |

|Exercise Training |

|The CCRP certification is awarded by the AACVPR Professional Certification Commission upon achievement of a passing score on the exam. A |

|candidate handbook is currently available on the AACVPR website which offers more detail about the exam and testing information. A study guide|

|has not yet been released but AACVPR states that they are attempting to have a guide by Mid-July. Professionals wishing to sit for the CCRP |

|exam must meet the following criteria: |

|1,200 clinical hours in CR/secondary prevention |

|Minimum of a Bachelor’s degree or higher in a health-related field from an accredited college or university OR current RN licensure. |

|Current RN licensure does not necessitate minimum academic requirement. |

|AACVPR is working on a similar certification specific to pulmonary rehabilitation so keep watch for that in the future. If you are attending |

|the 2014 National AACVPR conference in Denver, CO, you should consider sitting for the inaugural exam on September 3. More details are |

|available at . |

|Something to consider in “selling” your program… |

|Focus on Evidence-Based Services for Optimal Outcomes |

|According to the Centers for Disease Control, 80% of all chronic diseases are preventable with proper nutrition and activity. The combination |

|of inactivity and eating the wrong foods is the second most common preventable cause of death in the United States (smoking is the first). |

|Research studies demonstrate the strength of the relationship between physical activity and eight specific health outcomes: |

|• Premature all-cause mortality (33% reduction) |

|• Cardiovascular Disease (35% reduction) |

|• Stroke (19% reduction) |

|• Hypertension (35-50% reduction) |

|• Breast Cancer (30% reduction) |

|• Colon Cancer (50% reduction) |

|• Type 2 Diabetes (31% reduction) |

|• Osteoporosis (Reduces risk of hip fracture by |

|30%) |

|Source: University of Maryland Medical Center |

| |

|Cardiorespiratory Fitness (CRF), defined by estimated METs or CPX/gas exchange, may be the strongest cardiovascular risk factor. Low CRF or low|

|estimated METs increase all-cause mortality 1.7-fold. For every 1 MET change, mortality and CVD/CHD events are affected by13% and 15%, |

|respectively. And although lean and fit may be ideal, in the fit vs. fat debate, fitness seems more important than fatness. Carl J Lavie MD, |

|FACC,FACP,FCCP, Ochsner Clinical School-TheUniversity of Queensland School of Medicine, New Orleansand Pennington Biomedical Research Center, |

|Baton Rouge,Oct 2013 |

|Cardiac rehab produces a 20-30% reduction in all-cause mortality, better than aspirin and comparable to the efficacy of antiplatelets and beta |

|blockers. ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction,December, 2008 |

|Section 3: Pulmonary News |

|PEGGY COX, RN, RRT |

|Immediate Past President KCRA, Clinical Supervisor, Pulmonary Rehab, Frazier Rehab Institute, KentuckyOne Health, Louisville, KY |

|In case you did not hear the Complex Review for Pulmonary Rehab in KY was discontinued at the end of March. This was only for patients who |

|were being billed with the COPD CPT code G0424. That means we are no longer being looked at quite as closely. Thank goodness!!! |

|Over the last few months I have had several programs call me about PFT time table in regards to the evaluation date. CMS has made it quite |

|difficult to keep on top of all the guidelines. There was a bulletin that came out stating that PFT which determine the type and amount of lung|

|disease should be within three months of the evaluation date. However, AACVPR fought this, and the three month rule changed. Pulmonary Rehab |

|programs can continue to use the rule of thumb that PFT should be within one year of the evaluation date. |

|One last item I want to mention is the importance of each program using the AACVPR Pulmonary Rehab Toolkit to accurately determine the charge |

|billed for code G0424. I know my program found we needed to increase charges after using the kit. The information below is specifically on |

|the toolkit and how it can help all of us. Contact Peggy Cox with any follow up questions/comments at peggycox@. |

|Understanding the Pulmonary Rehab Toolkit |

|Pulmonary rehab programs have been feeling the effects of substantially reduced reimbursement (approx. $63/session to $37/session) that took |

|effect in 2012. This reduction happened as a result of pulmonary rehab programs across the country submitting charges for the G0424 code that |

|averaged about $150/session. In a review by the Centers for Medicare and Medicaid Services (CMS) in 2011, the average charge submission was |

|significantly less than [CMS] estimated based on labor, equipment, time, etc. As a result, CMS decided to lower reimbursement from $63 to $37.|

|AACVPR created the Pulmonary Rehab Toolkit to assist programs in working with hospital billing staff to accurately report charges associated |

|with G0424. If you have not looked at the toolkit and adjusted your charges, it is imperative to do this. Accurate reporting of charges for |

|G0424 will not only help your program survive, but will also help pulmonary rehab programs all over the country survive. Go to |

|for more information. |

|Section 4: Program and Patient Spotlight |

|KentuckyOne Health launches new “Healthy Lifestyle Centers” |

|Tammy Tyillian McDill, MS, CES, RCEP, FAACVPR |

|Clinical Supervisor, KentuckyOne Healthy Lifestyle Centers, Louisville, KY |

|In mid-May, KentuckyOne Health opened its first Healthy Lifestyle Center at 2401 Terra Crossing Blvd in Medical Center Jewish Northeast. |

|KentuckyOne’s Healthy Lifestyle Centers use a broad range of exercise, nutrition, stress management and other interventions to promote optimal |

|well-being in body, mind and spirit. Through medically-supervised lifestyle interventions, the staff prevent and treat chronic conditions, such|

|as cardiovascular disease, diabetes, cancer, and obesity. The multi-disciplinary team of wellness experts—all nationally certified in their |

|areas of specialty—offers a broad range of services to support patients on a sustainable path to healthy living. |

|The Lifestyle Center offers Phase II Cardiac Rehab (Pulmonary Rehab will be offered at Sts. Mary & Elizabeth Hospital opening August 2014), |

|Integrative Medicine (including acupuncture services, tai chi, therapeutic yoga, massage, mindful meditation, spiritual counseling, |

|The KentuckyOne Difference |

|Unlike other “health clubs”, the Healthy Lifestyle Centers are grounded in evidence-based medicine. The team works under the supervision of |

|KentuckyOne physicians including Dr. Deborah Ballard who is one of 3 physicians in the state board certified in Integrative Medicine. The team|

|also includes registered nurses, masters-prepared exercise physiologists, a registered dietitian, respiratory therapist, and licensed clinical |

|social worker. They serve as health coaches, identifying services within KentuckyOne and the community that could benefit the patient, and |

|navigate them to ensure easy access. Given the daunting challenge of making lifestyle changes, the program uses a technique called |

|Motivational Interviewing. Unlike traditional clinician-centered plans, MI engages patients in identifying their intrinsic motivation to |

|commit to change. Finally, the Healthy Lifestyle Centers’ approach is truly holistic, addressing patients’ needs in a comprehensive way that |

|integrates the physical, emotional, psychosocial, and spiritual dimensions. |

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|If you have an article or story to share about your program or a stand-out patient, we would love to hear it. For details, please email Tammy |

|McDill at tammymcdill@. |

|Section 5: Upcoming Events |

|Cardiac & Pulmonary Rehabilitation Week Gear still available! Visit to order items. |

|[pic] |

|Upcoming AACVPR Webcast [pic] |

|Thursday, July 17, 2014 12pm CT, 1pm EST : Meeting Patients Where They Are: COPD Education for Lasting Change |

|Cardiac Rehab Week: TBD (Vote for the theme on the aacvpr website) |

|Pulmonary Rehab Week: TBD (Vote for the theme on the aacvpr website) |

|Visit for more information |

|Not a member of AACVPR, visit the website for membership information. |

| |

|Not a member of KCRA, visit our website for membership information. |

|kcra- |

|KCRA 2015 Annual Meeting – Tentative Dates and Location |

|Four Points Sheraton in Lexington, KY |

|Pre-conference, Wednesday, March 4th |

|Conference Thursday, March 5th |

|Registration to open in 2015. More information to come! |

| |

|Preventive Cardiovascular Nurses Association |

|[pic] |

|Annual Symposium: Anaheim, CA April 9-11, 2015 |

|additional Information |

|Do you have something interesting to contribute? Please let us know! We welcome articles and letters in good taste on any topic! |

|To unsubscribe, make a comment, ask questions, or report a new email address, contact Tammy McDill at 502-409-2129 or |

|tammymcdill@. |

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