full conference brochure leading

FULL CONFERENCE BROCHURE

Aging Services Annual Meeting and Leadership ForumSeptember 20 - 23, 2011 • Madden’s Resort, Brainerd

Networking

Leading change

C o n n e c t t o W h a t ’ s N e x t

Education

Innovation

Empowerment Recognition

Public Policy

Solutions

Health Care Reform Future Trends

Opportunities

Vision Leadership

Partnerships

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Annual Meeting is the premier leadership conference for aging services providers.

In these days of smart phones and iPads, it seems there is an “app” for just about anything you need. Not true.

The only way to get educational programming that delivers true business intelligence for older adult service leaders AND

opportunities to connect and share ideas with peers face to face is by attending this year’s Annual Meeting.

Programming has been carefully designed to help you connect to what’s next – those issues on the horizon that

will help inform your business strategies and day-to-day decisions.

Welcome to the 2011 Aging Services of Minnesota

Annual Meeting and Leadership Forum

Leading change

C o n n e c t t o W h a t ’ s N e x t

Registration brochure sponsored by 3

Here’s a snapshot of programming designed to inform you on what’s next:

New Business Models, Shifting Operations

Ian Morrison Opening Keynote: Leading Change in Aging and Healthcare

(Wednesday)

#1 – New Demographics and What They Mean, Courtesy of the 2010 Census

#2 – Successful Grant Writing to Support Your Organization’s Strategic

Objectives

#4 – Through the Looking Glass: What Might Be In Store for Minnesota’s

Elderly Waiver Program

#8 – What’s Next? Changing Your Senior Housing Business Model in Response

to the New Realities

Health Care Reform

#3 – Partnering to Avoid Hospital Re-admissions

News and Views from Inside Minnesota’s Beltway: Partnerships, Innovation

and Preparing Jointly for Health Care Reform (Thursday)

#5 – A Refresher on Partnership Opportunities Under Health Care Reform

#6 – Preparing for Value Based Reimbursement

#7 – Health Care Reform: The Advanced Course

#9 – The Affordable Care Act, QAPI and Your Skilled Nursing Facility:

What You Need to Know

#10 – HIPAA: A HITECH Update

Policies and Politics

News and Views on Aging Services Public Policy Issues from Inside the

Beltway (Thursday)

News and Views from Inside Minnesota’s Beltway: Partnerships, Innovation

and Preparing Jointly for Health Care Reform (Thursday)

Legislative Panel General Session (Friday)

Robert Gibbs General Session: Inside Washington: What’s Next (Friday)

Lee Woodruff Endnote: Life Changes in an Instant (Friday)

Future Trends

Health Care Reform

Networking

Education

VisionLeadership

Partnerships

Innovation Solutions Opportunities Empowerment Recognition

Public Policy

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SeSSionSTUESDAY, SEPTEMBER 20Noon – 12:45 p.m. – Golf Registration and Lunch sponsored by Alliance Purchasing/Aging Services Group

1 p.m. – Seventh Annual Aging Services Golf Tournament

5 – 7:30 p.m. – 19th Hole Golf Awards and Meet & Greet Reception sponsored by Merwin LTC Pharmacy and hosted by District E

WEDNESDAY, SEPTEMBER 21

7 – 8:45 a.m. – Hot Breakfast Buffet

7:30 – 8:30 a.m. – New Faces BreakfastJust added for 2011 – here’s your opportunity to meet new people and learn some helpful tips for making the most of your first (or second) Annual Meeting. We invite you to gather with other newer members over breakfast for an informal overview of the sessions, activities and networking opportunities available throughout the week. Facilitator: Adam Suomala, Director of Member Relations, Aging Services of Minnesota, St. Paul

8:45 a.m. – Opening Welcome, Awards and Keynote sponsored by LarsonAllen LLPLeading Change in Aging and HealthcareConnect to what’s next for health care delivery in aging services in this engaging and provocative session with internationally acclaimed futurist, author and consultant Ian Morrison.

We are well aware of the statistics, trends and economic forces that will shape the future, but what does it all mean for how we care for our older adults and operate our aging services organizations? Morrison is a master at making sense of seemingly disparate factors. This morning he takes a broad look at the mega trends impacting our field and weaves them together to illustrate a changing business

environment in which aging services organiza-tions can emerge stronger and more vibrant than ever.

Drawing on his new book Leading Change in Healthcare: Building a Viable System for Today and Tomorrow, Morrison outlines the drivers of change and how aging services leaders can respond to the challenges and opportunities through innovative strategies and programs.

Ian Morrison, PhD is an internationally known author, consultant and futurist specializing in long-term forecasting and planning with parti-cular emphasis on healthcare and the changing business environment. He combines research and consulting skills with an incisive Scottish wit to help public and private organizations plan their longer-term future. He is the author of several books and is founding partner of Strategic Health Perspectives, a forecasting service for clients in the healthcare industry. He is also President Emeritus of the Institute for the Future (IFTF).

Mr. Morrison will be signing copies of his book immediately following his presentation.

11:15 a.m. – Break sponsored by Welsh Construction/Genesis Architecture

11:30 a.m. – Aging Services Business MeetingAll members in attendance are requested to at-tend the association's annual business meeting. The business meeting is an essential function of association governance and as a member, you play an important role. During this meeting, members will receive important information on the financial condition of the association, elect honorary members and vote on key governance changes. All members are welcome; however only voting members are eligible to vote. Lunch is served immediately following the meeting (day guests must purchase a lunch ticket).

1:15 p.m. – CONCURRENT SESSIONS #1 – New Demographics and What They Mean, Courtesy of the 2010 Census (All)• Review 2010 Census data relevant to the interests of aging services organizations in Min-nesota like yours. • Understand how your business may be impacted by various demographic trends such


as population shifts by geographic area, changes in types of households, potential customers and potential workforce.• Gain important insights on what the state of Minnesota is doing or has done to prepare for the change in state-wide demographics.• Explore how to better prepare to serve older adults and their families in the future using Census data.Daniel Lindh, President and Chief Executive Officer, Presbyterian Homes and Services, Roseville; and staff from the state demographer’s office to be announced

#2 – Successful Grant Writing to Support Your Organization’s Strategic Objectives (All) • Identify potential sources of grants that will help support your strategic initiatives and learn how to evaluate which ones will be worth your time and resources to pursue.• Switch it up: Understand why developing a program first, then applying for a grant (rather than vice versa) is a more sustainable and successful model.• Learn how to boost your grant seeking success by linking your overall and programmatic strategies and aligning them to your grant writing objectives.• Gain tips and techniques to make your grant application more competitive and increase the odds of winning it through case study examples. Cyndi Anderson, CEO, Mosaic Consulting, Detroit Lakes

2:45 p.m. – Break sponsored by Omnicare Minnesota

3 p.m. – CONCURRENT SESSIONS

#3 – Partnering to Avoid Hospital Re-admissions (All)• Refresh your understanding of reducing re-hospitalizations as a hallmark goal under the Affordable Care Act.• Identify some of the stakeholder groups that are coming together to tackle this challenge in Minnesota, what they have accomplished and what is still to be done. • Hear specific strategies implemented by a Minnesota-based aging services provider cooperative to collaborate with health systems/hospitals to reduce readmissions and improve outcomes.• Learn from a case study example of an aging services provider partnership with a hospital in Greater Minnesota designed to reduce

re-admissions related to congestive heart failure and what has been accomplished to date. Kathy Cummings, Clinical Systems Improvement Facilitator, Institute for Clinical Systems Improve-ment, Bloomington; Bob Dahl, President and Chief Executive Officer; and Callie Larson, Director of Quality Assurance, Elim Care Inc., Eden Prairie; Nellie Johnson, Chief Executive Officer, CareChoice Cooperative, St. Paul; and Mark Sonneborn, Vice President, Information Services, Minnesota Hospital Association, St. Paul

#4 – Through the Looking Glass: What Might Be In Store for Minnesota’s Elderly Waiver Program (Housing)• Recognize how the potential doubling in the number of Elderly Waiver recipients between now and 2020, and the likelihood that most will be running out of private resources to pay for their necessary services, will have a huge impact on the aging services system.• Explore current state and federal policy and funding responses that address this anticipated explosive growth trend.• Take an active role in looking ahead so you can prepare your organization. Barbara J. Blumer, Attorney, Barb Blumer Law PA, Eagan; and guest speaker to be announced

4:30 p.m. – Adjourn for the day

5 p.m. – Dine Around on Gull LakeDrink tickets, appetizers and transportation generously sponsored by Piper Jaffray & CompanyConsider it an Annual Meeting Progressive Dinner – join friends and colleagues for a fun and unique dining experience at some of the finer establish-ments on Gull Lake. Just $50 per person covers your entire evening including a four course dinner, four drinks and transportation. (A $108 value!) Destinations include Madden’s Wilson Bay, Lost Lake Lodge, Quarterdeck Resort and Iven’s on the Bay. Don’t miss this unforgettable event! Space is limited to 55 and pre-registration is required, so secure your spot early. Motorcoach departs promptly at 5:30 p.m. and returns you to Madden’s at 9:30 p.m.

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THURSDAY, SEPTEMBER 22


8:30 a.m. – General Session sponsored by Wipfli LLP

News and Views on Aging Services Public Policy Issues from Inside the Beltway • Explore the funding and regulatory issues before Congress that will impact aging services providers across the continuum. • Delve into health care reform initiatives and how that’s playing out across the country and over time. • Take home the latest information on public policy trends for your organization to follow and incorporate into your strategic planning efforts. Vin Weber, Managing Partner, Clark and Weinstock, Washington D.C.; and former U.S. Representative from Minnesota (invited) News and Views from Inside Minnesota’s Beltway: Partnerships, Innovation and Preparing Jointly for Health Care Reform• Learn about Minnesota’s efforts in moving toward implementation of health care reform in the state.• Understand and evaluate the role you and other aging services providers can play to help shape initiatives by partnering with key stake-holder groups.• Describe how the various reform initiatives are likely to impact aging services providers in Minnesota and what you can do to prepare for them. Lauren Gilchrist, Assistant Commissioner for Health Policy and Reform, Minnesota Department of Human Services, St. Paul

10:30 a.m. – Break sponsored by Wipfli LLP

10:45 a.m. – CONCURRENT SESSIONS

#5 – A Refresher on Partnership Opportunities Under Health Care Reform (All)Brought to you by Health Dimensions Group • Receive an update on the health care reform initiatives that are now being experienced by both institutional and home and community based providers of aging services.• Learn how integrated health systems and accountable care organizations are selecting and negotiating payment with post acute providers.• Understand how primary care and aging services providers are creating chronic care management and prevention programs to

improve the health of seniors and how the payment stream is working for these initiatives. Kathleen Griffin, National Managing Director of Consulting, Health Dimensions Group, Scottsdale, Ariz.

#6 – Preparing for Value Based Reimbursement (Care Centers)• Briefly review Value Based Reimbursement (VBR), a key component of health care reform designed to reduce costs and achieve desired outcomes.• Compare the old and new quality metrics and consider what your organization will need to do differently to meet the expectations of hospitals and health care systems.• Learn how key metrics are calculated so you can establish them in your organization to tell your performance story.• Take home practical ideas and resources to help your organization prepare for VBR. Nancy Rehkamp, Principal, LarsonAllen LLP, Minneapolis

Noon – Lunch

1:30 p.m. – CONCURRENT SESSIONS

#7 – Health Care Reform: The Advanced Course (All)Brought to you by Health Dimensions Group • Get a brief update on recent developments from the Center for Medicare and Medicaid Services (CMS) to implement health care reform mandates. • Participate in a facilitated discussion about strategies used by providers and LeadingAge organizations to create value-based partnerships with payers, health systems and other not-for-profit providers.• Take home case studies and tools to establish not-for-profit clusters that can effectively serve the post acute needs within an entire market. Kathleen Griffin, National Managing Director of Consulting, Health Dimensions Group, Scottsdale, Ariz.

#8 – What’s Next? Changing Your Senior Housing Business Model in Response to the New Realities (Housing)• Briefly review the key factors driving the changes in current senior housing business models including, but not limited to changes in funding, demographics and consumer preference. • Explore service delivery options that other Aging Services of Minnesota organizations have employed to better meet the needs of their customers and communities.


• Examine the critical financial considerations for the various business models to help your organization evaluate which are viable options.• Review how to cost out your services so you can capture appropriate levels of funding. Andy Edeburn, Consultant Manager, Health Care and Cory R. Rutledge, Principal, Health Care, LarsonAllen LLP, Minneapolis; Kyle Nordine, President and CEO; and Shelley Holden, Vice President of Residential Housing-Property Management, Northfield Retirement Community, Northfield

3 p.m. – Break sponsored by Elim Preferred Services Inc.

3:15 p.m. – CONCURRENT SESSIONS

#9 – The Affordable Care Act, QAPI and Your Skilled Nursing Facility: What You Need to Know (Care Centers)• Refresh your knowledge about the CMS initiative for nursing homes directed specifically at implementing the Quality Assurance and Performance Improvement (QAPI) program mandated by the Affordable Care Act. • Learn about the QAPI requirements for nursing homes to further develop and start a program to identify potential and existing problems.• Understand why your organization will need to address these problems with more rigorous and systematic strategies than what has been done in the past. • Hear about the demonstration project involving Minnesota providers and how its outcomes are likely to influence the final CMS QAPI requirements. Nancy Rehkamp, Principal, LarsonAllen LLP, Minneapolis; Rosalie Kane, Professor, University of Minnesota - School of Public Health, Minneapolis; and Jennifer Lundblad, President & CEO, Stratis Health, Bloomington (invited)

#10 – HIPAA: A HITECH Update (All)• Take home the latest information on the HITECH Act – including the pending final rule. • Enhance your understanding of what your organization needs to do to comply with HIPPA under the HITECH Act – including, but not limited to business associate accountability, breach requirements and enforcement provisions. • Gain insights from aging services providers’ experiences with HIPAA HITECH to date using case study examples.• Review Minnesota’s E-Health Initiative and meaningful HITECH considerations. Marnie S. Moore, Attorney and Associate, Larkin Hoffman Daly & Lindgren Ltd., Minneapolis; and Jim Stumpf, Director of Home Services and Compliance, Walker Methodist, Minneapolis

4:15 p.m. – Adjourn for the day

5 – 6:30 p.m. – What Ales Ya? sponsored by PointClickCareBenjamin Franklin famously said, “Beer is proof that God loves us and wants us to be happy.” Join us for what will no doubt be the most amazing evening for craft beers ever to grace the shores of Gull Lake. Learn about some of the finest craft beers available today while enjoying a fun evening with your friends. A brew master will talk about the selections and answer your questions while you sample. Just $10 per person (a $31 value!) includes 10 generous six-ounce pours. Beer menu includes a selection of ale, lager, porter and stout. This event will accommodate as many people as pos-sible, but pre-registration is required.

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FRIDAY, SEPTEMBER 23


8:30 a.m. – General Session and Awards: Legislative PanelThis facilitated panel discussion with key state legislators is designed to explore how the Legisla-ture has and will likely approach public policy is-sues impacting aging services providers. Recog-nize how the provider community’s interests and needs may or may not mesh with the mandates the legislators believe they have received from those who elected them and what this may mean for public policy-making in the future. Facilitator and panel members to be announced

9:30 a.m. – Break sponsored by Elim Preferred Services Inc.

9:55 a.m. – General SessionInside Washington: What’s Next (co-sponsored with Minnesota Hospital Association)Robert Gibbs, former White House Press Secretary, Advisor – Obama Administration, Washington, D.C.

As former White House Press Secretary and close Presidential advisor, Robert Gibbs has traveled a long road with President Barack Obama. His rapport and access to the President provides intimate and insightful commentaries on issues ranging from domestic, social and inter-national relations to healthcare, taxes and more, all of which will impact the upcoming 2012 election. Blending his Washington acumen with his trademark quick wit and straight talk, Gibbs will provide updates on the policy debates of the day that help shape our collective work across the spectrum of health care delivery.

Robert Gibbs has been an advisor and strate-gist to President Obama from the early days of Obama’s 2004 Senate race to his sweep to the White House. Most recently, he served as President Obama’s Press Secretary, presiding over daily press briefings. He is one of President Obama’s masterminds and speaks with great authority and accuracy from a White House insider’s perspective on any of the issues that have crossed the President’s desk.

10:55 a.m. – Break

11:15 a.m. – Endnote: Life Changes in an Instant (co-sponsored with Minnesota Hospital Association)

Whether it’s a child in a car accident, a serious health diagnosis or a terrorist attack on a warm day in Septem-ber – life can change in an instant for any of us.

Co-author of In An Instant, the #1 New York Times best seller, and author of her newest book, Perfectly Imperfect: A Life In Progress, Lee Woodruff recounts her story of a marriage, a family, a crisis and a healing. When her husband, ABC’s newly appointed co-anchor Bob Woodruff, was hit by a roadside bomb while covering the war in Iraq, Woodruff’s life changed in an instant. She had to learn to put her own grief aside to care for her children, as well as her husband who was gravely injured and close to death. In the words of Bishop Desmond Tutu, “Suffering is not optional. It seems to be part and parcel of the human condition, but suffering can embitter or ennoble.”

Woodruff speaks with grace and humor about her own family’s experience and how they chose to attack the crisis that befell them, resulting in a life-changing journey of love, healing and miracles for her whole family.

Lee Woodruff, speaker, contributing editor for ABC’s Good Morning America, New York, N.Y.

12:15 p.m. – Adjourn


4 2011 Institute Celebrate Age

2011 Annual Sponsors Special Thanks...Aging Services of Minnesota would

like to thank the following 2011

Annual Sponsors for helping advance

our mission and for supporting

important programs and initiatives.

DIAMOND

GOLD

SILVER

BRONZE

(list as of Nov. 8, 2010)

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How to RegisterOnline at www.agingservicesannualmeeting.org • Fax to 651.645.0002Mail to: Aging Services of Minnesota, Attn: Annual Meeting Registration #6011 2550 University Avenue West, Suite 350 So., St. Paul MN 55114-1900

Conference Registration Fees – Early Bird registration deadline is Friday, Aug. 19, 2011. Full Conference Registration Fees – Sept. 20-23 (lodging and meals not included):Member Provider: Early Bird: $300/After Aug. 19: $350Non-member Provider: Early Bird: $565/After Aug. 19: $615Business Partner: Early Bird: $410/After Aug. 19: $460Prospective Business Partner: Early Bird: $600/After Aug. 19: $650One-day Conference Registration Fees (lodging and meals not included):Member Provider: Early Bird: $160/After Aug. 19: $185Non-member Provider: Early Bird: $315/After Aug. 19: $340Business Partner: Early Bird: $230/After Aug. 19: $255Prospective Business Partner: Early Bird: $335/After Aug. 19: $360

Joint PROVIDER members of Aging Services and MHA may attend both association’s meetings and social events for $405. To register for this special rate use the MHA registration form online at www.mnhospitals.org, click on Events and then click on MHA Annual Meeting.

Lodging and MealsSeparate registration is required for the conference and for lodging and meals. Register for lodging packages and separate meals directly with Madden’s at www.agingservices.maddens.com or visit www.agingservicesannualmeeting.org to print registration forms.Madden’s lodging packages are more affordable when you pay only for what you use. Meals: Lodging packages include a hot breakfast buffet and lunch. Evening dinners are no longer automatically included.Golf: Unlimited golf is not included in lodging packages but may be purchased onsite for a reduced fee. Lodging: All rooms are priced equally; no up charge for Sunrise Villas and Golf Villas. Room requests are granted on a first come first served basis. Lodging deadline is Aug. 23.

Golf Tournament RegistrationComplete separate registration form online to participate in Aging Services’ Golf Tournament. Registration fee $75. Provider members only. Business Partners interested in golfing should contact Jenny Prosser for sponsor rates.

Special Evening Events RegistrationIf you would like to participate in Wednesday’s Dine Around on Gull Lake ($50) or Thursday’s What Ales Ya? ($10) please make sure to indicate this on your registration form. Advanced registration is required. Fees apply.

Continuing Education CreditsAnnual Meeting programming has been designed to meet continuing education requirements for licensed nursing home administrators and nursing professionals. Final approval information will be available onsite. Questions: Contact Heidi Simpson at Aging Services.

Cancellation PolicyConference Registration: Registration fees (less a $25 processing fee) are refundable if written notice is received in the Aging Services office no later than Friday, Sept. 9, 2011. No refunds for cancellations made after Sept. 9 or for no-shows. Lodging Fee: Lodging fees (less a $25 processing fee) are refundable if Madden’s receives cancellation notice no later than Tuesday, Aug. 23, 2011. No refunds after Aug. 23 but replacements are gladly accepted.

Aging Services of Minnesota reserves the right to cancel this event.

General Info For full conference details and registration forms visit www.agingservicesannualmeeting.org


SCHOLARSHIPS AVAILABLE

Seven full conference scholarships are available to cover Annual Meeting registration fees for those facing financial hardship, thanks to these generous sponsors:

• Alliance Purchasing/Aging Services Group (3 scholarships)• Elim Preferred Services Inc. • Evercare• McKesson Medical Surgical• Kraus-Anderson Construction Company• Merwin LTC Pharmacy

Application deadline is Friday, August 19. For more information about scholarships or to apply, go to http://survey.minnesotacca.com/TakeSurvey.aspx?SurveyID=8l4M9ml.

We guarantee your satisfaction or wewill refund your registration fee!

Times are tough and we know you spend your dollars wisely. We guaran-tee you will walk away from Annual Meeting with at least three strategies,

ideas or contacts to help lead your organization or we will refund your registration. See any Aging Services staff member for details!

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2011 Aging Services Annual Meeting and Leadership ForumProgram Registration Form

Early Bird Registration Deadline: Friday, Aug. 19, 2011

One form per person, please.

Name____________________________________________________________ Title_______________________________________________________________

Organization__________________________________________________________________________________________________________________________

Address_____________________________________________________________________________________________________________________________

City______________________________________________________________________ State__________________________ Zip_________________________

Phone___________________________________________________________ Fax _______________________________________________________________

E-mail_______________________________________________________________________________________________________________________________

Are you attending Annual Meeting for the first time? r Yes r No

Indicate the concurrent sessions you will attend: (Required to ensure adequate seating and educational materials.)Wednesday, Sept. 21 ~ 1:15 – 2:45 p.m. r #1 r #2 r I don’t plan to attend a session during this timeWednesday, Sept. 21 ~ 3 – 4:30 p.m. r #3 r #4 r I don’t plan to attend a session during this timeThursday, Sept. 22 ~ 10:45 a.m. – Noon r #5 r #6 r I don’t plan to attend a session during this timeThursday, Sept. 22 ~ 1:30 – 3 p.m. r #7 r #8 r I don’t plan to attend a session during this timeThursday, Sept. 22 ~ 3:15 – 4:15 p.m. r #9 r #10 r I don’t plan to attend a session during this time

Section A – Full Conference Registration FeesFull conference registration fees are per person and include admittance and course materials for all educational programs offered during the three days, networking breaks and social events.

Member Provider: Early Bird: $300 Regular Rate: $350Non-member Provider: Early Bird: $565 Regular Rate: $615Business Partner: Early Bird: $410 Regular Rate: $460Prospective Business Partner: Early Bird: $600 Regular Rate: $650

For joint PROVIDER members of Aging Services and MHA: Attend both associations’ meetings and social events for $405. To register for this special rate please use the MHA registration form, available online at www.mnhospitals.org, click on Events and then click on MHA Annual Meeting.

Total Section A: $_________________

r Check here if you will need lodging at Madden’s. See online form to make your lodging reservations directly with Madden’s.

Section B – One-day Conference Registration FeesOne-day conference registration fees are for those who are unable to attend the full conference. Fees are per person, for one day only. Please indicate which day you will be attending.

Member Provider: Early Bird: $160 Regular Rate: $185Non-member Provider: Early Bird: $315 Regular Rate: $340Business Partner: Early Bird: $230 Regular Rate: $255Prospective Business Partner: Early Bird: $335 Regular Rate: $360

r Wednesday, Sept. 21 r Thursday, Sept. 22 r Friday, Sept. 23

Total Section B: $_________________


Section C – Golf Tournament RegistrationComplete separate registration form online to participate in Aging Services’ Golf Tournament. Please include the $75 fee on this form online. Business Partners interested in golfing should contact Jenny Prosser for sponsor rates.

r Check here if you plan to participate in the Golf Tournament ($75 – rate for provider members only)

Section D – Dine Around on Gull Lake5 – 9:30 p.m. on Wednesday, Sept. 21. $50 per person (a $108 value) ~ includes transportation via motorcoach, four drink tickets, four courses and gratuities. Limited to 55 people ~ first come, first served. Advanced registration required.

r Check here if you plan to participate in the Dine Around ($50)

Section E – What Ales Ya?5 – 6:30 p.m. on Thursday, Sept. 22. $10 per person (a $31 value) ~ includes ten – 6 ounce pours, pretzels and brew master to talk about the craft brews. Advanced registration required.

r Check here if you plan to participate in What Ales Ya? ($10)

Section F – Lodging and Meal ReservationsSee separate form online to make lodging reservations. Lodging preference is on a first-come, first-served basis with reservation and payment made directly to Madden’s. Reservation deadline is Tuesday, Aug. 23, 2011.

Section G – No Lodging, Day Meeting Package Reservations OnlySee separate form online if you are staying off-site and you would like to purchase meals from Madden’s. Payment should be made directly to Madden’s. Deadline is Wednesday, Sept. 7, 2011.

**********************************************************************************************************************************Amount Due*Section A Total $___________ (full conference fee)

Section B Total $___________ (one-day conference fee)

Section C Total $___________ (golf tournament fee - $75 – provider members only)

Section D Total $___________ (dine around - $50)

Section E Total $___________ (what ales ya? - $10)

Total Due $___________

Annual Meeting Payment Information

r Invoice me (Aging Services members only)

r Enclosed is my check made payable to: Aging Services of Minnesota Attn: Annual Meeting Registration #6011 2550 University Avenue West, Suite 350 South St. Paul MN 55114-1900

r Charge to credit card r MasterCard r Visa r American Express

Name on Card_________________________________________________Cardholder’s Signature ______________________________________

Card Number ________________________________________________________________ Exp. Date__________________________________

How to Register:Online at www.agingservicesannualmeeting.orgFAX to 651.645.0002Mail to: Aging Services of Minnesota Attn: Annual Meeting Registration #6011 2550 University Avenue West Suite 350 South St. Paul MN 55114-1900

AGING SERVICES ACCOUNTING USE ONLY:

Date Received _______________________ Check # ______________________ Amount $ _________________

#6011

14

Name ____________________________________________________________________________________________

Organization ______________________________________________________________________________________

Please have Aging Services staff pair me with a fun team! OR

I prefer to golf with the following members (list your desired team, provider names only, no vendors unless

Golf Tournament Registration Form (Please print or type clearly.)

GO

LF

Indicate payment on Aging Services’ conference registration form or online registration page.

When: Tuesday, Sept. 20 Where: Pine Beach East Madden’s on Gull Lake, Brainerd Provider Member Entry fee: $75 Noon-12:45 p.m. Registration & Lunch sponsored by Alliance Purchasing/ Aging Services Group 1 p.m. Shotgun Start 5 -7:30 p.m. 19th Hole Golf Awards and Meet & Greet Reception sponsored by Merwin LTC Pharmacy and hosted by District E

Aging Services of Minnesota

SEVENTH ANNUAL GOLF TOURNAMENT

Preliminary Details:

1. Check-in at Madden Inn starting at Noon on Tuesday, Sept 20. Lunch will be provided. Groups must be at their carts

for a shotgun start at 1 p.m. ALL SKILL LEVELS welcome for this scramble tournament.

2. Registration is limited to Aging Services of Minnesota active PROVIDER members. (Business Partners interested in

golfing should contact Aging Services for sponsor rates.)

3. Teams will consist of up to four participants, possibly including a sponsor. Aging Services reserves the right to

change and complete all team pairings.

4. To register as a group, list all names on one form. Please make sure all group members are aware of the registration

and include payment on their Aging Services conference registration form (see section C) or on Aging Services online

registration page.

5. To ease congestion, golf carts will be assigned to each team. Complimentary refreshments and snacks will be

provided throughout play.

6. Participants who do not have lodging at Madden’s on Tuesday night must pay a $45 greens fee at the pro shop prior

to play. This is in addition to the $75 tourney fee.

Entry fee should be paid by each individual on Aging Services of Minnesota’s conference registration form (see Section

C) or on Aging Services online registration page. Send this form with your conference registration form.

No refunds will be granted for cancellations received after Friday, Sept. 9, 2011. Contact Adam Suomala in the Aging Services office with questions. We look forward to seeing you for a fantastic day of golf!

they are sponsors that have selected and paid for this option separately with Aging Services staff):

Name ___________________________________________ Organization ___________________________________




GO

LF

Indicate payment on Aging Services’ conference registration form or online registration page.

These package rates include lodging, meals (listed above), use of meeting rooms, tennis, croquet, non-motorized boats, use of most resort facilities (except golf unless noted above) service charge and Minnesota sales tax. Rooms are run of the house and assigned on a first come, first served basis. Breakfast buffets will be served in the Madden Inn dining room.

ONLINE RESERVATIONS Go to www.agingservices.maddens.com.

PLEASE INDICIATE AREA YOU PREFER TO STAY: __No preference __Madden's Inn __Wilson Bay __Madden Lodge __Golf Villa __Sunrise Villas

RATES & ROOMMATES: All rates are per person; the double rate requires two adults sharing a room. For your safety and security,

Madden’s does not assign roommates. If the second occupant is not indicated, we will assign a single room with a single occupancy rate. Any reservation requests received after August 23, 2011 will be accepted on a space available basis only.

Special Requests: (i.e. room accessibility, dietary needs, etc.)

Explain: _________________________________________________________________________________________________________________

OCCUPANT 1 Single Occupancy ____or Share?____ OCCUPANT 2- Register me now__ OR will register separately?__

Name Mr/Ms______________________________________________ Name Mr/Ms______________________________________________ Company _______________________________________________ Company________________________________________________ Address ________________________________________________ Address_________________________________________________

_______________________________________________________ ________________________________________________________ City ________________________ State_______Zip_____________ City____________________________ State_____Zip____________ Daytime phone___________________________________________ Daytime phone___________________________________________ Email:__________________________________________________ Email:__________________________________________________

Credit card number: VISA MASTERCARD Credit card number: VISA MASTERCARD ____________________________________________Exp________ ____________________________________________Exp_________ Amount to be debited (full package payment) $__________________ Amount to be debited (full package payment) $___________________

PAYMENT INFORMATION: CREDIT CARDS ARE DEBITED UPON RECEIPT The full package payment is required at time of reservation request. When a credit card is used for payment, it must be valid and will be charged the required amount when the reservation is processed. We accept VISA or MASTERCARD. Checks made out to MADDEN'S ON GULL LAKE are acceptable and must accompany the reservation request form. Vouchers and purchase orders are not accepted for payment. All guests must present a credit card at check-in.

MAIL THIS FORM TO: MADDEN'S ON GULL LAKE, 11266 Pine Beach Peninsula, Brainerd, MN 56401. Call reservations at 800.642.5363 or FAX to 218.829.7698. A credit card is required for payment on all phone and fax requests.

CANCELLATION POLICY: You are responsible for your entire stay, early departures or reservation reductions are not

refundable. Package payments are refundable minus a $25 cancellation fee if you cancel by August 23, 2011. Any cancellations made after August 23, 2011 will not receive a refund. (Replacements are glady accepted.) Reservations made after the deadline are non-refundable.

Reservation made by _____________________________________________Phone ____________________________Date ___________________

MADDEN’S RESERVATION REQUEST DEADLINE: August 23, 2011 Check in time: 4 p.m. Check out time: 11 a.m.

Aging Services of Minnesota #8005 Arrival: Tuesday, September 20, 2011 Departure: Friday, Sepetember 23, 2011

OPTION 2 – 2 nights - Wednesday & Thursday nights lodging Package includes: 2 nights lodging, 2 breakfast buffets & 2 lunches

_____ $277.78 per adult DOUBLE _____ $481.78 per adult SINGLE

OPTION 1 – 3 nights - Tuesday, Wednesday and Thursday nights lodging Package includes: 3 nights lodging, waived greens fee for association golf tournament on Tuesday (must pay tourney fee to ASM), 3 breakfast buffets & 2 lunches


Option 3 – ONE Night - Tuesday night lodging Package includes: 1 nights lodging, waived greens fee for association golf tournament on Tuesday (must pay tourney fee to ASM)


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2011 Aging Services Annual Meeting & Leadership Forum

Madden’s Day Meeting Package The Day Meeting Package provides for your participation in Aging Service of Minnesota meetings as a DAY VISITOR at Madden’s on Gull Lake. Send this form with payment directly to Madden’s.

Parking and general access to Madden’s Conference Center is included. Please complete this form to reserve your space and for any additional meals. (Check all days you will be attending.)

Lunch ~ $21.32 per day (Includes state sales tax)r Wednesday, Sept. 21 (plated)r Thursday, Sept. 22 (buffet) Lunch Charge $____________

Breakfast Buffet ~ $12.77 per day (Includes state sales tax)r Wednesday, Sept. 21r Thursday, Sept. 22r Friday, Sept. 23 Breakfast Buffet Charge $____________

TOTAL CHARGE $____________

IMPORTANT: Dinner on Tuesday, Wednesday and Thursday are NOT included in the conference package. Dining will be available at The Restaurant at Madden Inn (reservations are strongly recommended for the Restaurant at Madden Inn). Additional dining options include19th Hole Lounge, Parfecto Pizza and The Classic Grill. Due to limited seating in these outlets, reservations are not accepted. Visit www.maddens.com for more information on menus and restaurant hours. To make your dining reservations for The Restaurant at Madden Inn call 800.247.1040.

MAKE CHECK FOR TOTAL AMOUNT PAYABLE TO MADDEN'S ON GULL LAKE OR CHARGE TO VISA OR MASTERCARD.

Card#________________________________________________________________ Exp. Date: ____________________

Signature: __________________________________________________________________________________________

Name (please print):___________________________________________________________________________________

Company:___________________________________________________________________________________________

Address:____________________________________________________________________________________________

City: _____________________________________________ State: _________ Zip: _______________________________

Email confirmation to: _______________________________ Daytime Phone: ____________________________________

DEADLINE for DAY MEETING PACKAGE is Wednesday, Sept. 7, 2011.

Send this form with payment directly to: Madden’s on Gull Lake, 11266 Pine Beach Peninsula, Brainerd, MN 56401. Questions call 800.247.1040.

FAX credit card purchases to 218.829.7698.Pick up meal tickets at MADDEN INN. Tickets are for meals only.

Green fees and other recreation are not included.

full conference brochure leading

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