Introducing NC NOVA: New Organizational Vision Award

1. Introducing NC NOVA:New Organizational Vision Award A Voluntary Special Licensing Award for Home Care Agencies, Adult Care Homes & Nursing Facilities Part of the Better Jobs Better Care initiative funded by The Robert Wood Johnson Foundation and The Atlantic Philanthropies

2. NC NOVA: Overview and objectives • Link state policy and practice through licensure • Systematic, sustainable culture change • Voluntary, incentive-based model • Special license awarded independently of regulatory survey process • Ultimate goal is financial reward for NC NOVA designation

3. NC NOVA’s focus is the workplace • Help providers “raise the bar” to foster meaningful workplace culture change • Flexibility in how the criteria are implemented • Organizations with an operating license in good standing are eligible to apply • Providers meeting the challenge are rewarded with special NC NOVA license

4. NC NOVA: Legal basis • Established, in law, as a statewide program effective January 1, 2007 • Broad-based Partner Team spent more than three years developing NC NOVA • Piloted in 60 organizations

5. NC NOVA:Creating workplace culture change Orientation Peer Mentoring Coaching Supervision Management Support Rewards & Recognition Worker Empowerment

6. NC NOVA Designees • As of 6/12/08 – Total of 5 NC NOVA designees 3 nursing facilities 2 home care • Had pilot sites that serve almost all Medicaid eligible residents –still working toward Only publish names of those that attain designation

7. NC NOVA:Application and review • The provider obtains an application from www.thecarolinascenter.org (CCME) or www.ncnova.org • The provider submits the completed application and supporting documentation to CCME • CCME first verifies with DHSR that the provider’s license is in good standing

8. NC NOVA:Application and review, continued • CCME conducts a desk review of the application • If the application is in order, the reviewer schedules a site visit • If not, CCME notifies the applicant • During a site visit, CCME conducts separate interviews with direct care workers and supervisors • CCME then determines whether the applicant has successfully met the criteria for NC NOVA

9. NC NOVA:Application and review, continued • If the applicant HAS met the criteria • CCME notifies DHSR to reaffirm that the applicant’s license remains in good standing • If so, DHSR issues the special NC NOVA license • If the applicant has NOT met the criteria • CCME gives applicant general information about areas needing additional work • Eligible for 1 time re-review no sooner than 90 days –nor later than 12 months from notification letter

10. NC NOVA:Term and conditions of designation • NC NOVA designation is good for two years • Provider must go through full process again • If ownership change before two years up, the new owner may request an expedited review • NC NOVA designation may be terminated early if action is taken against the provider’s license

12. Turnover Data • 2007 Turnover Data: • NH- Overall state aggregate data = 109.7% • NC NOVA NH designees – 35% • HC – about same as state ave. & why • Administrator & Tenure data • NH – Occupancy – 94% vs. 86%

13. Our experiences • Developed under a grant • Working to ensure on-going Review Costs • Integrated all functions into existing operations • Have worked to integrate NC NOVA into other QI initiatives • State Statute- included: reviews, reviewer, partner Team (vs. admin. Rules), protect data

14. What’s Next • Now – help providers “Get There” • DVD and Getting Started document • Self-Assessment – Readiness Tool • Will develop “how to” guide for other states • Beginning work on financial reimbursement differential • Systems integrated • Structure for Partner Team to meet - tweak

15. NC NOVA: Website www.ncnova.org

16. Acknowledgements NC NOVA Partner Team thanks the following for the technical assistance they provided Paraprofessional Healthcare Institute (PHInational) Institute for the Future of Aging Services Barbara Bowers, Ph.D., University of Wisconsin