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We are celebrating Care Providers of Minnesota’s 75th anniversary this year, a perfect opportunity to reflect on the past and set our sights on the future as an organization leading collaboration and innovation to improve health. Check back soon for the first blog entry from Care Providers of Minnesota President/CEO Patti Cullen!


75th anniversary reflections on key initiatives

June 3, 2022

During the course of 2022, we have been sharing memories, photos, and pearls of wisdom from members new—and not so new. We sent a series of questions to former Board members/Association leaders, and we will be sharing some of their thoughts with you over the course of this year, culminating with a summer party with the St. Paul Saints on August 18 and a big dance celebration for all members at our annual convention in November. This is the fifth article in our series of questions and answers from leaders—the others can be found here: 75th Anniversary—CEO Blog. This week, we feature responses from Julie Ditzler who was involved in Association committees and events since starting in this profession in 1976 as a director of nursing. Julie was an active DON, administrator, educator, and Association committee chair over the years until her retirement in 2003. She still reaches out for opportunities to volunteer! 

Reflecting on key initiatives led by the Association during your tenure, what are you most proud of as a legacy initiative?
Julie Ditzler: As a young director of nurses in April 1976 I was introduced to Minnesota Association of Health Care Facilities (MAHCF), (the precursor to Care Providers of Minnesota) by my employer Merle Nugent, who owned Cedar Pines Health Care Facility at that time. I had never been in nursing administration, done any work in long term care, or taken any specific courses in gerontology. One of the most meaningful. Important programs that MAHCF had at the time was called Peer Review. A team of department mangers representing administration, nursing, dietary, and maintenance from one facility would visit another member facility for a mock health department survey. We would stay most of the day and look at their systems, policies, procedures, etc. and share ideas. This was a most educational program that both introduced me to the business of skilled nursing facilities and helped me to meet other professionals heading up nursing departments in those facilities. In retrospect, I am not certain I would have survived without it. Even though the program is no longer in place, the great legacy of Care Providers has always continued to be one of EDUCATION.

Secondly, the Association was my go-to site to clarify federal, state, and local regulations, the separation of each and the accuracy of policies reflecting those regulations. I am certain many people practicing in those days recall that much of the survey, was simply the surveyors sitting in an office on site and reviewing everything you had written out in policy and procedure manuals! After a short time of recognizing how closely tied we were to the Department of Human Services (DHS), the Medical Assistance program, Rule 49, and setting our payment rates I was stunned and angered. The Association again led the way to not only argue for greater funding, but to educate the legislators themselves who had a most difficult time understanding the complex system of reimbursement in place at that time! 

Thirdly, the creation of regional sections of the state and annual conventions is something that again stands out as the way to share new ideas, learn about new programs in aging, and most importantly meet colleagues with whom you could develop strong relationships. I served on many of the committees over the years, meeting fantastic professionals all of whom were interested in improving the quality of care for our dear residents and families.

Minnesota has frequently been referred to as a leader in aging services over the decades—why do you think that is? Why have we been more successful than other states?
Julie Ditzler: Minnesota has had a long-standing history, I believe, for high standards of quality health care. One could say that it all began with the Mayo Brothers in southern Minnesota, but it also stems from the cultures that settled in this State mid-nineteenth century. Our ancestors all seemed to have a strong work ethic and continually made attempts at improving methods of farming and other industries. The University of Minnesota has always been a leader in research and Medicine was often at the forefront of that. At the University, Dr. Robert Kane and his wife Rosalie were the first to set up an endowed long-term care chair to lead quality of life research and best practices initiatives. To my knowledge that had not been done elsewhere back then. Many health care businesses got their start here—such as Medtronic, 3M, and others! We have attracted bright professionals in all areas of practice. Many of these successful companies then created foundations, to help fund much of the progress. We have literally millions of dollars invested in improved health care in Minnesota. 

In addition, many professional organizations were started in Minnesota, led by creative professionals who moved us forward in developing a full array of options for seniors such as the Minnesota Gerontological Society, AAA ( Area Agency on Aging), the Veterans Administration, Senior Federation and Nursing Home Advocacy groups. Many of these organizations worked on collaborations—something Minnesota is known for. For example, the Veterans Administration worked with Aging experts from the University of Minnesota including Vernon Weckworth in the healthcare master’s program, and Ken and Ruth Gordon who developing the long-term care administrators program. The Senior Federation and Nursing Home Residents Advocacy groups helped to define resident/senior needs and desires for change. It was a busy, exciting time and the cooperation and communication from each party and discipline helped improve our quality of care immeasurably.  

 


Continued reflections for our 75th anniversary—Advice for emerging leaders

April 29, 2022

During the course of 2022, we have been sharing memories, photos, and pearls of wisdom from members new—and not so new. We sent a series of questions to former Board members/Association leaders, and we will be sharing some of their thoughts with you over the course of this year, culminating with a summer party in August and a big dance celebration for all members in November. This is the fourth article in our series of questions and answers from leaders—the others can be found here: 75th Anniversary—CEO Blog.

What advice would you give to the emerging leaders today who will likely be very resilient given all they have experienced these past two years?

Loren Colman: Be bold. The past will not always guide the future or even repeat but must be considered. The boomers have changed every institution for 70 years and will continue. “Hell no, we won’t go” is the Vietnam mantra that will apply to nursing homes for this generation of 78,000,000 strong!  Be bold and do not settle for incremental change to the workforce challenge. There isn’t enough time for 2-3% annual colas. Don’t be afraid to challenge government or the legislature! 

Dennis Kamstra: The more time you put into the job the more rewarding it will be. I think the members expect their leaders to work at the capital and be their voice on legislative and regulatory issues and listen to their concerns. The years go by very fast and so if you want to leave your mark you have to have an agenda and focus on it!  

Steve Chies: 
  • The senior care sector needs to be on the side of the residents and their families as we have allowed the consumer advocates to wedge between our customers and public policy. This would include a focus on understanding and meeting the expectations for staffing, physical plants (HVAC handling systems), private rooms, technology access, culinary service, etc.
  • Focus on enhancing the workplace and workforce.  Don’t oppose changes to minimum wage, other enhancements to benefits, working conditions, and the need for standards on hours. Create career options and mobility so that a CNA can easily move to a licensed position and others can upgrade as well. This includes removing barriers at the licensure board level and signing the Nurse Compact Act. 
  • Move the sector from having quality being determined by governmental regulations and the subjective opinions of surveyors to control how quality is determined by taking steps to lead the quality agenda. Quality is determined by the client or customer based on their needs AND expectations. Quality metrics should be determined by research and be evidence-based that the metric actually improves outcomes.  
  • Focus on rewarding operational performance. Operators should benefit from their financial/quality performance in the payment systems and not only pay interest to banks or bondholders or dividends to equity investors and REITs.  
  • The Minnesota Medicaid payment model has demonstrated it cannot quickly respond to changes in the marketplace based on the response to the COVID pandemic and changes in both costs and occupancy.  It needs to be focused on how to be proactive in setting payment levels.
  • Be leery of financial payment models disguised as “value-based purchasing”.  Is it really a budget-neutral proposal or giving the funding to non-operators?
  • Many nursing facilities are 50 and 60 years old and need updating.  Assisted living operations may not have anticipated the needs of infection control management. A revised financing model should focus on recognizing upgrading and updating physical plants. The demand for private rooms is a clear client expectation but the payment model creates penalties for downsizing and occupancy decline. Consider a major legislative effort to enhance the physical plants of skilled nursing and assisted facilities.  

Susan Voigt: Do the next right thing.* Educate yourself on the financial side of providing services, but never forget that long term care is a human service being delivered by humans to humans. The better the care and service, the better the financial and not the other way around. Care and service includes care and service of your employees as well as by your employees. Know the regulations and if the regulations conflict with what you and your team consider the next right thing—do the next right thing. It will pay off. Every. Single. Time.  

*And as your legal counsel would advise,  keep notes of “why” you did the next right thing so you can explain why it was right. 

Rick Carter: The success of Care Providers over the years has always been to be proactive in all matters! Don’t wait until others map out a direction, instead be out front in taking a stand and proposing a solution. It is not easy, of course, to be a leader BUT leaders solve problems and those who follow are just that…followers! Be bold in all that you do! Stand for something don’t just stand against things! Always have a positive program in mind whether that be in the Legislative arena or in other areas. Propose, develop, and dispose of annual, and longer goals. Nothing is too big or audacious!  So, my advice to everyone involved in the Association and in the Long-Term Care profession is…to leave a legacy!

About the leaders:
Loren Colman:  Currently private consultant; Provider leader with Extendicare; Board Chair for Care Providers of Minnesota 1996-1997, Assistant Commissioner at the Department of Human Services from 2003 through 2017

Dennis Kamstra:  Currently CEO of Living Services Foundation; Board Chair for Care Providers of Minnesota 1993-1995

Steve Chies:  Currently Program Director, LTC Administration, St. Joseph’s College and Independent Consultant; Board Chair, American Health Care Association 2003-2005; Master Examiner, AHCA/NCAL Quality Program; Board Chair for Care Providers of Minnesota 1981-1982

Rick E. Carter: Associate Director of the Minnesota Health Care Facilities (former name of Care Providers of Minnesota) 1973; became Executive Vice President (title changed to President/CEO) in 1983 until his retirement in 2007.

Susan Voigt:  Dietary aid at Highland Chateau 1971-1973, Minnesota Legislative staff (House Research and Revisor of Statutes) 1980-1984, legal counsel and lobbyist Care Providers of Minnesota 1985-1989, Attorney representing long term care providers at Siegel Brill Law Firm 1989-2001 and Voigt Rode Boxeth Law Firm 2001-2021, CPM Foundation board trustee, Mn Elder Justice Center board 2014-2021; retired 2021. 



 

75th anniversary year—Continuation of thoughts from Association leaders

April 1, 2022

During the course of 2022, we have been sharing memories, photos, and pearls of wisdom from members new—and not so new. We sent a series of questions to former board members/Association leaders, and we will be sharing some of their thoughts with you over the course of this year, culminating with a summer party in August and a big dance celebration for all members in November. This is the third article in our series of questions and answers from leaders—the others can be found on the “75th Anniversary: CEO Blog” page. 

Q:  Reflecting on key initiatives led by the Association during your tenure, what are you most proud of as a legacy initiative?

Loren Colman: There are two initiatives that stand out in my mind. The first is the alternative payment system that demonstrated how responsive Care Providers of Minnesota (CPM) was to a crisis and an early willingness to take risks and be treated like a business not entirely dependent upon government regulations. The second is F.A.I.R. which was a very early initiative to take control of the discussion and recognize that the status quo was not going to serve the industry short- or long-term. (Anyone remember what the acronym stands for?) 

Dennis Kamstra: I would have to say the alternative payment system was a major accomplishment. It lasted longer than any other payment methodology including both versions of rule 50. Many people worked on it including members and staff and it was enjoyable to work on something pro-actively.

Steve Chies: Top legacy initiatives would be CARE-PAC (political campaign) being expanded to facility staff; prioritization of a proactive legislative agenda as a top strategy; and strong Association leadership and resources.

Susan Voigt: In the late 1980s and through the 1990s, many federal laws and regulations passed impacting nursing homes. Care Providers of Minnesota (CPM) staff and board leaders met the challenges that members faced under OBRA ‘87 and OBRA ‘91 with grace, depth of information, and sensitivity for long-term care professionals, residents, and families. OBRA ’87 significantly affected the standard of care in long-term care with heavy regulatory requirements and new scrutiny. Discharge and transfers were no longer an informal process, immediate jeopardy meant something much less severe than a pest infestation or no air conditioning in southern states. Restraints became a thing of the past, and abuse and neglect reporting and investigating became the Congressional and state legislative focus. The new regulations imposed by OBRA ‘87 and ‘91 were shockingly severe and included large fines for violations and resident deaths.

The MN state agency response to these new federal regulations was not to work together with long-term care providers, but to issue heavy handed penalties. Restraint usage was punished with immediate jeopardy (IJ) deficiencies, and a $1000.00 fine issued on a facility when a death occurred. Media published the $1000.00 fines and obtained only the MDH version of the death. CPM worked tirelessly with both MDH and DHS to educate agencies, providers, and resident families about the new regulations. In spite of the heavy fines and overreaching IJ F-Tags issued, CPM continued to meet with MDH and DHS to help slow their enforcement zeal so the agencies and providers could understand how to best implement the new regs to provide for the better care and safety of long-term care residents. CPM convinced MDH to stop publishing the $1000.00 fines in the media, and eventually MDH stopped issuing them. CPM brought members to meet with MDH and DHS to provide context for their implementation of the new laws. The heavy-handedness of the agencies was successfully slowed, and quality of care improved as everyone collaborated regarding a shared goal of good care.

CPM took the initiative to set up an appeal process with MDH on discharge and transfers allowing for both the provider and the resident to have a say about what was the best placement for that resident. That process, as well as a new and improved appeal process for providers who were unfairly cited under OBRA, allowed providers to have inappropriately cited deficiencies removed. CPM worked with DHS tirelessly to get its Medical Assistance division pay for residents who were not at fault for nonpayment due to financial exploitation or in need of emergency Medical Assistance. CPM lobbied the legislature to ensure that Minnesota law allowed for an appeal process of deficiencies under the new regulations, and then developed that process step-by-step with the Minnesota Office of Administrative Hearings (OAH). CPM staff trained and educated the OAH Judges who hear those appeals in order to help them to understand the complex regulations.

Rick Carter: The association sponsored numerous initiatives to measure and improve quality thus becoming a nationwide leader in quality care. Early initiatives focused on voluntary reviews of a facility (peer review) and its quality as well as adherence to regulations and providing resources to help a facility which asked for it or where a facility did not meet the Association’s standards. The effort required each new member to go through this process prior to becoming a member. Although this effort seems very basic at this juncture, it was, nonetheless, very creative and innovative. This program also demonstrated clearly that the association was committed to quality in the performance of its members. 
 
At the same time the association had a focus on quality and performance it also was committed to ensuring the business health of each and every member. In this regard the association was always deeply involved in regulations, regulatory process and, as well, the financing of long-term care which required deep involvement in the State Medicaid program. 

Several decades ago, there was a focus on revamping the Association’s political agenda and developing the tools necessary to provide excellent member services from a political/legislative standpoint. The association reestablished a strong political action committee and a program designed to raise substantial sums of money to fund this committee and its activities including becoming a major player in providing contributions to candidates who were sympathetic to long term care and association initiatives. Obviously, the outcomes from all this activity took years to come to fruition but it was necessary to begin to bring the infrastructure of lobbying inside of the association rather than rely on purchasing lobbying solely from an outside source. The association became a very strong and effective representative of long-term care and has been recognized not only within the State of Minnesota for this but also from others on a national level. 

Every legislative session since the mid-1970s has had major agendas impacting long-term care. I'm proud to say that both MAHCF and Care Providers of Minnesota has been a major player in each of those sessions in representing the membership of the association. One of the most difficult yet productive legislative sessions was one where, as always, finances were tight in Minnesota. It took a great deal of creativity to come through the session without major damage being done to Medicaid funded care. It was this session where the Association developed what is now known as the alternative payment system. This system which was legislated during that session was never intended to be a long-term answer to Minnesota’s budgetary problems but rather a transition to something new in the future. In spite of this, the alternative payment system was, in fact, a fantastic answer to what could have been a major legislative and financial loss to our members. This session demonstrated the creativity and focus of the association, it’s staff and members. Once members understood this new system and its benefit to facilities, most members embraced it and used it to enhance their financial situation. 

Loren Colman: Currently private consultant; Provider leader with Extendicare; Board Chair for Care Providers of Minnesota 1996-1997, Assistant Commissioner at the Department of Human Services from 2003 through 2017

Dennis Kamstra:  Currently CEO of Living Services Foundation; Board Chair for Care Providers of Minnesota 1993-1995

Steve Chies:  Currently Program Director, LTC Administration, St. Joseph’s College and Independent Consultant; Board Chair, American Health Care Association 2003-2005; Master Examiner, AHCA/NCAL Quality Program; Board Chair for Care Providers of Minnesota 1981-1982

Rick E. Carter: Associate Director of the Minnesota Health Care Facilities (former name of Care Providers of Minnesota) 1973; became Executive Vice President (title changed to President/CEO) in 1983 until his retirement in 2007.

Susan Voigt:  Dietary aid at Highland Chateau 1971-1973, Minnesota Legislative staff (House Research and Revisor of Statutes) 1980-1984, legal counsel and lobbyist Care Providers of Minnesota 1985-1989, Attorney representing long term care providers at Siegel Brill Law Firm 1989-2001 and Voigt Rode Boxeth Law Firm 2001-2021, CPM Foundation board trustee, Mn Elder Justice Center board 2014-2021; retired 2021. 


Continuation of thoughts from Association leaders

February 25, 2022

During the course of 2022, we will be sharing memories, photos, and pearls of wisdom from members new—and not so new. We sent a series of questions to former board members/Association leaders, and we will be sharing some of their thoughts with you over the course of this year, culminating with a summer party in August and a big dance celebration for all members in November.

Question: You encountered many innovative leaders during your career who likely influenced your work in long-term care—who were your top influencers and why? 

Loren Colman: Leo Goldberg. What a kind, knowledgeable man. You couldn’t figure out what his role was or what he did, but you knew he understood the bigger picture. I can still hear his words: “Federal regulations  92—was our future and how it would change the LTC world!”

Dennis Kamstra: I spent and a lot of time with Dale Thompson and Bob Sundberg and learned about the history of and workings of the association. Staff also helped a great deal in teaching me the mechanics of the job. I don’t think any chairperson could succeed without strong staff help. 

Steve Chies:  Jim Swanson, Dale Thompson, LaVonne Hagemeyer, Helen Frampton, Leo Goldberg, Rick Carter, Chip Roadman, Sister Claudia. Jim for his focus on care for the residents. Dale for his commitment to quality. LaVonne for the need for professionalism. Helen for the innovative buildings. Leo for creating the care planning process still in use today. Rick for his focus on politics and public policy. Chip for his efforts to move AHCA into the 21st Century. Sister Claudia who taught me the value of common sense when making challenging decisions.

Susan Voigt: Bill Hargis and Bob Piker influenced my work in long term care. They were the leaders of Good Neighbor, Inc., an organization who at one time owned and operated dozens of Minnesota nursing homes. As a team, Hargis and Piker emphasized quality service as one of the tenets of Good Neighbor. These two men were as different as night and day. However, they both fully appreciated their people who were providing the care and service, the administrators, nursing and social services, and the housekeeping and maintenance. They put a leadership program in place for staff that focused on customer (resident and family) service. They empowered all Good Neighbor employees and rewarded them for their good service. It worked. I was the recipient of that good service as a family member of a resident. Unsolicited, a Good Neighbor employee held an umbrella open and took my mother’s arm as she got out of her car to visit my dad. He introduced himself to her and walked her to the elevator. She never forgot that service or the employee. Neither will I. 

Rick Carter:   
  • Dave Meillier: David was President of the association when I met him during the very first convention that I attended as a staff person. He impressed me as a very even person who was very thoughtful about complex issues especially the issue of Medicaid reimbursement for long term care. David was instrumental in developing the very first Rule 49 which was quite favorable to long term care facilities. David was “in charge” as the association’s chief elected officer thus, he had to field many of the member complaints and mount an effort to make changes in this new payment rule. Throughout this time David was a real statesman both with his own members as well as legislators and state agency personnel. I learned a great deal from David about the appropriate role of an association in its dealings with governmental agencies and the state legislature.  
  • Dale Thompson: Dale Thompson has played an outsized role with both Care Providers of Minnesota as well as the American Healthcare Association as President and chief elected officer of both of these organizations, Dale Instilled confidence in the associations by members as well as staff.  
  • Steve Chies:  I still recall meeting Steve (early in my tenure) at a regional meeting during which there was much discussion about state politics and its impact on the association's ability to make legislative changes regarding various payment issues related to Medicaid and the new payment rule. Steven impressed me as a very savvy individual and one who was realistic about politics and how the association should position itself. Steve has always been extremely analytical and a person who does not act on emotion but rather on facts and analysis. Steve is another Minnesotan and prominent member of Care Providers of Minnesota who also distinguished himself, not only as President of Care Providers of Minnesota but also of the American Healthcare Association. 
  • Pete Madel: Pete came along as the association's chief elected officer after some turmoil within the membership ranks and some dissatisfaction with some of the elected leaders. Pete was very helpful in tempering the turmoil. Pete was a very straightforward individual who, was a self-made man from rural Minnesota.  Pete was well known in political, social, and business circles. Pete's constant mantra was communications and the need to be straightforward with members about issues which impacted their ability to provide services and conduct business.  
  • Jim Swanson: Jim was among the first people I met at the Association. Jim was a steady individual who also became one of the Association’s Board Chairs. Jim was always a “cheer leader” for the Association and the LTC profession. As I began working for the Association, I could not have hand picked a better person to guide me in my role of developing a credible program of educational offerings then Jim Swanson! Jim was a “real gentleman”. Jim had a critical role in helping the Association grow and develop in many  ways. Both he and his spouse ,Sally, were “super stars” in the Association.  
  • Gerry Sikorski: Although Gerry was not an Association member or leader, he was incredibly influential in my life! Gerry was a State Senator with whom I had formed a very strong relationship. During the first legislative session where the Legislature rather than DHS set limits on Medicaid rate increases, Gerry was helpful in making sure that long term care received a very favorable rate increase. I worked with Gerry hand in glove during that session and will never forget his willingness to constantly be in touch with me and members of our leadership. Without Gerry and his advocacy and assistance who knows how things would have ended up in this “cutting session” where The Governor had recommended cuts or very low rate increases at best.  

Check out the 75th anniversary site for previous blog posts, videos, photo albums & more!

Loren Colman:  Currently private consultant; Provider leader with Extendicare; Board Chair for Care Providers of Minnesota 1996-1997, Assistant Commissioner at the Department of Human Services from 2003 through 2017 

Dennis Kamstra:  Currently CEO of Living Services Foundation; Board Chair for Care Providers of Minnesota 1993-1995 

Steve Chies:  Currently Program Director, LTC Administration, St. Joseph’s College and Independent Consultant; Board Chair, American Health Care Association 2003-2005; Master Examiner, AHCA/NCAL Quality Program; Board Chair for Care Providers of Minnesota 1981-1982 

Rick E. Carter: Associate Director of the Minnesota Health Care Facilities (former name of Care Providers of Minnesota) 1973; became Executive Vice President (title changed to President/CEO) from 1983 until his retirement in 2007. 

Susan Voigt:  Dietary aid at Highland Chateau 1971-1973, Minnesota Legislative staff (House Research and Revisor of Statutes) 1980-1984, legal counsel and lobbyist Care Providers of Minnesota 1985-1989, Attorney representing long term care providers at Siegel Brill Law Firm 1989-2001 and Voigt Rode Boxeth Law Firm 2001-2021, CPM Foundation board trustee, Mn Elder Justice Center board 2014-2021; retired 2021.  


Sharing thoughts from leaders

February 4, 2022

During the course of 2022, we will be sharing memories, photos, and pearls of wisdom from members new—and not so new. We sent a series of questions to former Board members/Association leaders, and we will be sharing some of their thoughts with you over the course of this year, culminating with a summer party and a big celebration for all members in November.

Question: Minnesota has frequently been referred to as a leader in aging services over the decades--why do you think that is? Why have we been more successful than other states?

Loren Colman: Care Providers of Minnesota (CPM) recognized that collaboration was important. Partners included consumers, regulators, payers, government, workforce, etc. The future looked different and creating the care system of the future was a shared obligation that could not be left to government alone. We developed and participated in a variety of state initiatives including the Long Term Care Task Force, Transform 2010, Transform 2030, Transform 2050, Care Center of the Future, Housing with Services, The LTC Imperative, and consumer direction and choice!

Dennis Kamstra: I think we have had a stronger and more stable staff than any other state I am familiar with. We also had a broad base of membership from large corporations to independent operators, for-profit and non-profit and most of our administrators were very engaged in the association and its activities.  

Steve Chies: Our long-term care sector is not dominated by national multi-facility chains; we have many regional and local owners, both in the profit and non-profit sectors. Local control providers have better connections with and for the community. Engagement by the membership in the Association leadership and a willingness to engage in the public policy arenas has contributed to our success. Finally, the public policymakers in Minnesota have had a willingness to fund senior care services as they have been influenced by community-engaged providers.

Bethesda "old people" home circa 1948

Question: Reflecting on key initiatives led by the Association during your tenure, what are you most proud of as a legacy initiative?

Loren Colman: There are two initiatives that stand out in my mind. The first is the alternative payment system that demonstrated how responsive CPM was to a crisis and an early willingness to take risks and be treated like a business not entirely dependent upon government regulations. The second is FAIR, which was a very early initiative to take control of the discussion and recognize that the status quo was not going to serve the industry short or long term. Anyone remember what the acronym stands for?

Dennis Kamstra: I would have to say the alternative payment system was a major accomplishment. It lasted longer than any other payment methodology including both versions of rule 50. Many people worked on it including members and staff and it was enjoyable to work on something pro-actively.

Steve Chies: Several things come to mind—CARE-PAC being expanded to facility staff; prioritization of legislative agenda as a top strategy; and strong Association leadership and resources.

Loren Colman: Currently private consultant; Provider leader with Extendicare; Board Chair for Care Providers of Minnesota 1996-1997, Assistant Commissioner at the Department of Human Services from 2003 through 2017

Dennis Kamstra: Currently CEO of Living Services Foundation; Board Chair for Care Providers of Minnesota 1993-1995

Steve Chies: Currently Program Director, LTC Administration, St. Joseph’s College and Independent Consultant; Board Chair, American Health Care Association 2003-2005; Master Examiner, AHCA/NCAL Quality Program; Board Chair for Care Providers of Minnesota 1981-1982




Reflections on 75 years

January 7, 2022

Welcome to 2022! We are celebrating Care Providers of Minnesota’s 75th anniversary this year, a perfect opportunity to reflect on the past and set our sights on the future as an organization leading collaboration and innovation to improve health. Our organization was established as the Minnesota Nursing Home Association—subsequently there were two name changes: Minnesota Association of Health Care Facilities in 1972 and Care Providers of Minnesota, effective at the start of 1987.

Beginning 1946–1947, the Association had at its roots family-owned, -developed, and -operated facilities. It began as the Association of Nursing Homes; here are a few excerpts from the association meetings of 1947, reflecting the most pressing issues of the time (which could also be adapted to fit some of the issues for today!):  

February 4, 1947: “That patients should pay for a full day on the dates of admission and dismissal was agreed upon by members of the Association.  It was further decided that bills be computed on a thirty-day month basis for the entire year.”  

March 3, 1947: “Mrs. Pearson (President) was appointed to send a wire to Gov. Youngdahl in regards to our (the association) being required to keep bad seniles through April due to the fact there was no available room at Rochester for them.”  
 
75 years ago, family-owned nursing home operators gathered together to formalize what they had been doing in a rather informal fashion—joining together as a group to network together and share best practices. This was nearly two decades before the Medicare or Medicaid program were established so you can imagine that both the services provided, payment structures, regulatory oversight, and the clients being served were dramatically different from what we see today, 75 years later. As we take time in 2022 to celebrate 75 years for Care Providers of Minnesota as a membership association, we do so with the knowledge that this association has had remarkable volunteer leadership over the course of 75 years…from the small group establishing the Minnesota Nursing Home Association in 1947 to the diverse group of leaders representing services across the full spectrum of care in 2022. 

The change of our name to Care Providers of Minnesota over 35 years ago reflects the evolution of long-term care including an expansion of services provided by our members, from short-term post-acute care to longer term home health and hospice and a variety of services in between. With each passing year, we deepen our commitment to helping our members successfully provide care and services to seniors and persons with disabilities 

The results-driven culture at the Association for the past 75 years, combined with a deep commitment for quality service to the ultimate customers served by our members, sit solidly on the shoulders of those who have guided the organization for the past 75 years—our volunteer leaders and staff. We have a tradition of strong leadership on our Board of Directors and committees-devoted volunteers who have been the backbone of the Association’s longevity and success.   

We have deep gratitude for how wisely and generously our volunteer leaders have shared their time and expertise to establish public policy, lead significant change waves for this profession, and serve as stewards of Association resources. In addition to our volunteers, our staff members are-and always have been-an integral asset for this Association, starting with the hiring of the first “executive secretary” in 1962. The staff expertise, relationships, and commitment to our work have been extraordinary, with longevity of most staff positions indicative of their dedication to this profession.

It has been a privilege to serve as the President/CEO for the last 15 years—and to serve as a staff member for 20+ years before that. Watch for special messages about our anniversary year on our social media as well as in our newsletter and website beginning in mid-January, culminating in a great celebration at our November convention! 


Patti Cullen, CAE
Patti Cullen, CAE  |  President/CEO  |   pcullen@careproviders.org  |  952-851-2487