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
Section 2: Cardiac News
Section 3: Pulmonary News
Section 4: Program and Patient Spotlight
Section 5: Upcoming Events
Additional Information
Section 1:From The President
Beth Cundiff, MS, CSCSPresident 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: 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 offeredTammy 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
- 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 universityOR current RN licensure.
- Current RN licensure does not necessitate minimum academic requirement.
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, RRTImmediate 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 PFTwhich 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 .
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 staffprevent 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 LifestyleCenters are grounded in evidence-based medicine. The team works under thesupervision 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-preparedexercise physiologists, a registered dietitian,respiratory therapist, and licensed clinicalsocial worker. They serve as health coaches,identifying services within KentuckyOneand the community that could benefit thepatient, and navigate them to ensure easyaccess. Given the daunting challenge of makinglifestyle changes, the program uses atechnique called Motivational Interviewing. Unlike traditional clinician-centered plans,MI engages patients in identifying theirintrinsic motivation to commit to change. Finally, the Healthy Lifestyle Centers’ approach is truly holistic, addressingpatients’ needs in a comprehensive waythat integrates the physical, emotional,psychosocial, and spiritual dimensions.
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 .
Section 5: Upcoming Events
Cardiac & Pulmonary Rehabilitation Week Gear still available! Visit to order items.Upcoming AACVPR Webcast
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 2015Annual 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
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 .