1. Home and Community-Based Services: Strategies for Diversification Stephen P. Fleming President and CEO WellSpring Services, Inc.

2. Among people turning 65 today, 70 percent will need some form of long-term care, whether in their own home (community) or in a residential care facility. * 2014 Medicare and You

3. Number of Older Americans 65+ 1900-2060

4. MISSION STATEMENT “WellSpring Services is committed to exceeding the needs of a diverse and evolving population of older adults through innovative and supportive aging services.”

5. WellSpring Services Member Organizations

6. STRATEGIC PLANNING Revenue Analysis Re-affirmation of Not-For-Profit Status Commitment to: –Broaden Customer/Client Base –Increase Maximum Number of Clients Served –Diversify Revenue –Increase and Diversify Market Penetration –Mitigate Risk –Explore Partnerships/JVs

7. WellSpring Retirement Community, Inc.

8. DEVELOPMENT OF CORPORATE STRUCTURE

10. DIVERSIFICATION OF REVENUE SOURCES AND GROWTH OPPORTUNITIES FOR BRAND PACE Adult Day Services Home Care and Medication Management Senior Housing Meal Delivery

11. RISK MITIGATION AND STRATEGIC PARTNERING PACE of The Triad PACE of The Southern Piedmont Partners Cone Health Advanced Home Care HOSPICE and Palliative Care of Greensboro HOSPICE and Palliative Care of Charlotte

12. 12 Alternative model of long-term care delivery targeted to nursing home eligible seniors Provides medical and support services that allow “aging in place. ” –Cost effective –Improves health outcomes –Improved quality of life WHAT IS PACE?

13. Adult day care that offers nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work and personal care Medical care provided by a PACE physician familiar with the history, needs and preferences of each participant Home health care and personal care All necessary prescription drugs Social services Medical specialists such as audiology, dentistry, optometry, podiatry, and speech therapy Respite care Hospital and nursing home care when necessary 13 PACE: SERVICES PROVIDED

14. Eligibility – Resident of approved service area (exclusive) – Certified by FL2 as needing skilled nursing home care – Able to live safely in the community with the services of the PACE program at the time of enrollment Characteristics – Ninety percent plus are dually eligible for Medicare and Medicaid – Almost ½ have dementia as a significant diagnosis 14 ELIGIBILITY & CHARACTERISTICS

15. FOR PARTIPANTS & CAREGIVERS: Comprehensive Stay in the community as long as possible Good care outcomes, high enrollee satisfaction and low disenrollment rates Caregiver respite and reduced burnout FOR PACE PROVIDERS: Freedom from traditional FFS restrictions Focus on the entire range of needs of individual Tightly controlled care management and utilization systems 15 SUMMARY OF BENEFITS

16. INTEGRATION WITH FLAGSHIP CCRC Operations – Dining (1.0 FTE) – Facility Services (.2 FTE) – Security and Transportation (Consulting) Population/Programming – Negligible

17. Adult Center for Enrichment Core Services Adult Day Center Group Respite Caregiver Education 414 served and 800+ through caregiver education

18. WellSpring Home Care Home Care –CCRC to Community Based 98 Caregivers 10,000+ Hours/Month = 124 clients Medication Management 16 clients

19. Home Meals by WellSpring Warm, freshly prepared, ready-to-eat meals. Designed for older adults living at home Partnering with K&W Cafeterias Meals delivered at lunchtime Daily menus provide variety

20. COSTS PACE – Partners Equity – Up to $7 Million L.O.C. Home Care – 1 FTE (RN) – Software – Marketing Materials

21. COSTS ACE - $300,000 equity - Debt obligation with new loan Home Meals - Use of Retirement Community automobiles - Part-time driver

22. LESSONS LEARNED Strong Partners make Good Partners Elongated Timeframe Complexity –Billing –Regulations –Survey Process Staffing Models (Timing) Don’t discount your Brand Location, Location, Location

23. THANK YOU! Stephen P. Fleming President and CEO sfleming@well-spring.org