Other Educational Opportunities from our sister organizations

If you aren’t able to join us in Chapel Hill on March 22-23, 2018 – perhaps you can attend the symposiums around us.

South Carolina 2018 Cardio Brochure SCACVPR

Virginia  2018 VACVPR Conference Brochure

Proposed Readoption/Amendment of Certification of Cardiac Rehabilitation Programs – NC DHHS

Attached is the NC Department of Health and Human Services – Proposed Readoption/Amendment of Certification of Cardiac Rehabilitation Programs –  Rules – 10A NCAC 14F

The period of public comment is from December 15, 2017 – February 13, 2018 with a public hearing scheduled for January 2nd at 11:00am in Raleigh.


Rather than having each program respond with comments, we would suggest you forward suggestions/comments to Connie Paladenech –  cpaladen@wfubmc.edu


Connie has agreed to “gather” all comments/suggestions to take to the public hearing on January 2nd.  In this way we can bring comments/suggestions from our affiliate membership of approximately 70+ programs.  


You may send your comments/suggestions individually, but we would ask that you cc them to Connie as well, so she can see what is being suggested.  

InterestedParties Readopt14F w Rule

CMS finalizes the cancellation of the Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model

Today, the Centers for Medicare & Medicaid Services (CMS) finalized the cancellation of the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center and implemented changes to the Comprehensive Care for Joint Replacement (CJR) Model. These changes will offer greater flexibility and choice for hospitals in providing care to Medicare patients.

“While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care. We anticipate announcing new voluntary payment bundles soon,” said CMS Administrator Seema Verma.

In the final rule, CMS is reducing the number of mandatory geographic areas participating in CJR from 67 areas to 34 areas. As part of the agency’s ongoing commitment to addressing the unique needs of rural providers, CMS is also making participation voluntary for all low volume and rural hospitals participating in the model in all 67 geographic areas. This regulation also includes an Interim Final Rule with Comment Period, in which CMS is establishing and seeking comment on a final policy to provide flexibility in determining episode costs for participant hospitals located in areas impacted by extreme and uncontrollable circumstances, such as the major hurricanes of 2017.

CMS is also finalizing the cancelation of the hip fracture and cardiac bundled payment and incentive payment models – the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model – that were scheduled to begin on January 1, 2018. Not pursuing these models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the in-patient and post-acute care spectrum.

Moving forward, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled payment models. The changes in the final rule will help position the agency to engage in future voluntary efforts.

For a technical fact sheet on the changes in this final rule and interim final rule with comment period, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-30.html.

Recordings from the Piedmont Regional Meeting

Connie Paladenech

Jeff Soukup

Michelle Ray

Mike Dunlap

Taylor Stroud

Slides from Recent Regional Meetings

The Piedmont and Mountain regional meetings occurred last month and we are pleased to share some of the great content from those meetings.

Nutrition for rehab patients – MRay
Keeping science in the exercise Soukup J
Lung Function
Emotional Health (Cardiopulmonary) Recovered
6MWT Mistakes (10-19-17)

We appreciate our Vice Presidents and how they hard they work to create these informative meetings!  The next regional meeting will be the Coastal Regional Meeting which will be held on Dec 5th from 8-1 at Cape Fear Valley Hospital in Fayetteville, NC.  For more information please contact our regional Vice President (candace.e.langston@gmail.com).



Message from our New Exercise Discipline Chair

As the newly appointed Exercise Discipline chair, I encourage you all to attend your regional meetings this month.  It is always beneficial to meet, network and receive up to date information within our specific discipline and region.  If topics should arise during the regional sessions that you feel may need more discussion, please email me and I will get the conversation started.

In addition, if you have questions or comments throughout the year pertaining to our exercise discipline or Cardiopulmonary Rehab  please feel free to email and I will do my best to help answer your questions or get others involved who may know more about the specific topic.

Thank-you for you time and your continued dedication to our field of study and Cardiopulmonary Rehabilitation.

Angela Lanier, MS ACSM-CEP

Clinical Exercise Physiologist, Cardiopulmonary Rehabilitation
Iredell Health System
557 Brookdale Drive
Statesville, N.C.  28677
704-878-4558 ext 3442
704-878-4951 (Fax)|

Resources available through American Heart Association

A Letter from our NCCRA President

NCCRA members,

For those of you who attended the 32nd AACVPR annual meeting in Charleston, SC, wouldn’t you agree that it was one of the best ever?!  With 1102 attendees the meeting was the biggest ever. For those of you who didn’t or couldn’t attend, start planning for next year’s meeting in Louisville, KY on September 12-15, 2018.  The theme of this year’s AACVPR conference was “Leading Change”.  As we are all aware, change is constant and our hospital administrators, referring physicians, co-workers and patients expect us to “keep up” with all the changes in rules/regulations, new and evolving therapies, diverse patient populations (PAD patients), etc..  Attending conferences and joining your state affiliate – nccraonline.org and/or our national organization – aacvpr.org is a must. I’ve attached the 2017 NCCRA regional meeting information. Hopefully, you already are planning to attend a regional meeting to help you connect and become more informed about our profession (http://nccraonline.org/upcoming-events/).  Contact the regional VP listed for any additional information.

Coastal Regional Meeting

December 5th from 8-1

The location: 3418 Village Drive – Fayetteville, NC

For more information please contact Candace Langston 



Mountain Regional Meeting

October 19, 2017

Iredell Memorial Hospital’s Cardiopulmonary Rehabilitation

739 Hartness Road Statesville, NC

Registration will begin at 8am and the meeting will end at 1pm

For more information please contact Jennifer Simmons (704) 878-4558 or Jennifer.Simmons@iredellhealth.org


Piedmont Regional Meeting

October 26, 2017

Presbyterian Hospital

200 Hawthorne Ln, Charlotte, NC 28204

Registration will begin at 8am and the meeting will end at 1pm.

For more information please contact Hannah Wofford h.crawford@novanthealth.org or 704-384-9616

The NCCRA Board of Directors is working on the NCCRA Spring symposium in Chapel Hill, NC on March 22-23, 2018. Please put that date on your calendars and make plans to attend. We are also asking for nominations for Coastal Region Vice President.  Our current Coastal VP, Candace Langston, will move into the president elect role in 2018. The application is on line (http://nccraonline.org/about/application-for-nccra-vice-presidents/).  Nominations need to be submitted by January 1st, 2018. Duties of the Regional VP are included in the NCCRA bylaws that are also published on the website (http://nccraonline.org/about/nccra-bylaws/). Please, consider volunteering to help our organization.  Contact myself or any board member – yep, they are listed on the website – if you have any questions about the process.


Lastly, please review a new award the NCCRA Board of Directors approved – the Carl King Award.   If you are not familiar with who Carl King is and what service he has performed for the profession of cardiovascular and pulmonary rehabilitation, take the time to review his bio. His biography, the award guidelines and nomination form are posted on the NCCRA website (http://nccraonline.org/about/carl-king-award/).   We all know a cardiopulmonary rehabilitation professional who deserves to be recognized for the work and dedication to our profession. This is your opportunity to do that. 

I hope to see you at one of the NCCRA regional meetings and at the Spring symposium March 22-23, 2018.


Mike Dunlap MS FAACVPR

President NCCRA

Manager Cardiopulmonary Rehabilitation

CarolinaEast Medical Center

New Bern, NC 28560



Content from today’s AHA and Get With The Guidelines Webinar – Best Practices for Cardiac Rehab

In this webinar event, we  heard from Dr. Ileana L. Piña MD, MPH, FAHA, FACC, Professor of Medicine & Epidemiology and Population Health. Albert Einstein College of Medicine and Associate Chief for Academic Affairs, Division of Cardiology Staff Heart Failure/Transplant, Montefiore Medical Center. Dr. Piña highlighted the importance of referral to cardiac rehab for patients with Heart Failure as well as best practices and the latest science. Click on the link below to view the powerpoint presentation.


Letter from our NCCRA President

NCCRA membership,

The NCCRA and AACVPR leadership recognize that our profession is in a constant state of change. With advances in clinical practices, changes in regulatory/administrative policies and patient’s increasing individual needs we are challenged, more than ever, to accept our ever changing responsibilities. The NCCRA leadership took on the strategic plan in 2016 with three goals: to promote increased membership, member engagement and promotion of future leaders in our state. The NCCRA strategic plan can be found on the NEWS link on the NCCRA website (nccraonline.org) – posted 3/24/17.  These goals are critical to increase our ability to support each other. We are stronger and more efficient as individuals when we have the knowledge and support of our colleagues in developing new strategies to meet new challenges.

As president of the NCCRA I was honored to represent our state at the recent AACVPR Leadership forum in Chicago, IL June 10-11, 2017. I was one of approximately 30 affiliate leaders from around the United States who attended the forum.  Candace Langston, NCCRA Coastal Vice President, helped to facilitate the forum, as she serves on the AACVPR Membership and Affiliate Relations Committee as Vice-Chair.

The theme of the forum was to challenge us all as leaders to review our “way of doing business” both on a clinical and affiliate level. We heard from the AACVPR leadership the need for affiliate leader to engage you, our colleagues, on a local level to review and adapt our practices to meet the challenges of changing payment models (bundle payments/incentive payments, value based care) new diagnosis codes – I73.9 PAD (see NCCRA website NEWS – May 30, 2017 and My NCCRA link for PAD Exercise Training Kit) and the ever increasing need to provide high quality cost effective treatment.

I would refer you to the NCCRA website to learn more about the Road to Reform (R2R).  There is a video from AACVPR president, Tom Draper posted on NEWS – May 11th, 2017. If you have not seen it, I highly recommend you take the time (http://nccraonline.org/news/featured-news/aacvpr-r2r-cardiac-rehab-bundles-incentive-payment-video/).  Even if you are not involved in the upcoming Cardiac Bundle/Incentive Payment model, this is the wave of the future and now is the future. There is also a listing of the hospitals in North Carolina that are part of the Cardiac Bundle Payment model and/or the Cardiac Rehabilitation Incentive payment model and an article on Value Based Care posted below.

I challenge each of you to take time to sit down with your staff and discuss how you might adapt to better meet your patients, physicians, administrators and your needs. Our program staff recently took three hours away from our program for a mini “retreat”. We had a list of topics to review in advance, so staff had time to formulate ideas.  Our program is part of the upcoming Cardiac Bundle/Cardiac Rehab Incentive Payment model. We discussed and agreed on several major changes on how we plan to “stream-line” referrals into our program. This change will involve our referring physicians and hospital staff and we are working with both groups. We also are making several clinical programming changes to provide high value yet efficient care. We are reducing the number of sessions that will be telemetry monitored, blood glucose tests and blood pressure checks performed.  We will perform these procedures as individually indicated instead of a “blanket” policy that has us performing low value, time consuming work. We want to have the flexibility to provide high value service to those who require it, in an efficient manner.

I plan to send out a “letter from the president” every few months to keep you informed on the work of the NCCRA and AACVPR. I also recommend you check the NCCRA Website regularly for the latest updates and information. The NCCRA Facebook site typically announces when new information is available, so be sure to “friend” us.

I also want you to review a new award the NCCRA Board of Directors approved beginning in 2018- the Carl King Award.   If you are not familiar with who Carl King is and what service he has performed for the profession of cardiovascular and pulmonary rehabilitation, take the time to review his bio. His biography, the award guidelines and nomination form are posted on the NCCRA website.

Finally, please review the 21 Distinguishing Qualities of Great Leader Volunteers. Are you a LEADER or a PLACEHOLDER?

Please feel free to contact me or any member of the board with any questions or concerns that we might be of assistance to you with.

Hope you all have a great summer.

Mike Dunlap MS FAACVPR

President NCCRA

Manager Cardiopulmonary Rehabilitation

CarolinaEast Medical Center

New Bern, NC 28560


Supporting documents:
AMI – CAB Episode Payment Model
EPM & CR algorithm schematic
The Road to Value-Based Care
Qualities of Great Leader Volunteers