1. business and industrial
2. business operations
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PACAH
PO Box 60769
Harrisburg, PA 17106-0769
(717) 526-1010
Fax (717) 526-1020
2015 PACAH Spring Conference
The Woodlands Inn Wilkes-Barre, Pennsylvania
Conference Agenda
Monday, April 27, 2015
9:00 am to 6:00 pm
Registration
10:00 am to 12:15 pm
Executive Board Meeting
11:30 am – Executive Board Meeting Lunch
12:30 pm to 4:30 pm
“Embracing the ‘All Hazards’ Emergency Management Approach in Long Term Care Facilities”
General Session
SPONSORED BY PELICAN
Emergencies and large scale disasters can occur in a blink of an eye or with some advanced warning.
Whether it is a broken water pipe in the ceiling, fire in the laundry room, active shooting incident,
tornado touchdown, slow moving winter storm or other manmade or natural events, long-term
care facilities should be prepared to handle every emergency situation. A proposed rule change by
CMS will require LTC providers to increase and enhance their levels of emergency preparedness,
response and recovery. This program will present critical disaster planning and emergency
management concepts that every LTC facility needs to incorporate into their operations. Main
elements of this program will include a review of significant incidents that have impacted LTC
facilities, common barriers to effective response, the importance of Hazard Vulnerability
Assessment (HVA) and an “All Hazards” approach to emergency management. The essential
concepts of the Incident Command System (ICS) as it relates to nursing homes and other LTC
facilities will be one of the main focuses of this workshop. Additionally, the presenters will review
new OSHA-based requirements that will impact LTC providers in 2015.
Stan Szpytek
President, Fire and Life Safety, Inc.
Pendulum, LLC
4600 Montgomery Boulevard, Suite 204
Albuquerque, NM 87109
(505) 889-8262
Steve Wilder
President, Sorensen, Wilder & Associates
Pendulum, LLC
4600 Montgomery Boulevard, Suite 204
Albuquerque, NM 87109
(505) 889-8262
*There will be a 15 minute break during this session – 3.75 CEUs will be credited
2:00 pm to 4:00 pm
Fiscal Management Committee Meeting
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6:00pm to 10:00 pm
Welcome Party
Crescenzo’s Brick Oven Eatery
SPONSORED BY COMPLETE HEALTHCARE RESOURCES-EASTERN, INC.
Join PACAH as we start the week with hors d’oeuvres, dinner, beverages and great conversation
with fellow attendees, graciously hosted by Complete HealthCare Resources-Eastern Inc.
6:00pm – 7:00pm – Reception
7:00pm – 10:00pm – Dinner
Tuesday, April 28, 2015
7:00 am to 12:30 pm
Registration
7:00 am to 8:00 am
Continental Breakfast
Grand Ballroom
8:00 am to 9:00 am
“Legislative Update/PACAH Business Meeting”
Opening Session
PACAH’s Executive Director will discuss legislation introduced that could affect long-term care as
well as the chances of the legislation successfully passing through the House and Senate as well
as what the effects will be. In addition, the impact of the Certified Public Expenditure funds,
status of the commonwealth budget for the current year and looking ahead, policy initiatives at
the state and federal level impacting nursing facilities, and a review of PACAH’s priorities and
association initiatives will be on the agenda.
Kelly Andrisano
Executive Director
PACAH
PO Box 60790
Harrisburg PA 17106
(717) 526 – 1010
9:00 am to 9:15 am
9:15 am to 10:15 am
Break
“Antipsychotics and the Dementia Care Initiative”
Breakout Session
In September 2014, The Centers for Medicare & Medicaid Services (CMS) set new goals to
reduce antipsychotic use in nursing facilities: 25% by the end of 2015 and 30% by the end of
2016. These new goals are extensions of CMS’s 2012 mission to improve quality of care provided
to individuals with dementia living in long-term care/post-acute care facilities. Pennsylvania
currently ranks 23rd in the nation for reducing the use of antipsychotic medications with a 17.9%
reduction since the introduction of the initiative. This educational session will provide an
overview of the goals of the National Partnership to Improve Dementia Care, review recent
changes to the State Operations Manual related to dementia and antipsychotic medication use,
describe the role of nursing facility team members in antipsychotic medication reduction, and
explore challenges and opportunities surrounding the reduction of antipsychotic usage in elderly
patients.
Dr. Emily Mallit, PharmD
GardaRX LLC
1596 Hancock Avenue
Apollo PA 15613
(724) 568-4144
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9:15 am to 10:15 am
“Medicaid Eligibility and Transfer Penalties”
Breakout Session
As the changes ushered in by the Deficit Reduction Act are implemented, there is an increase in
the transfer penalties assessed against Medicaid applicants. Long term care facilities need to
know what steps to take to protect their rights to request an undue hardship waiver and/or
appeal the transfer penalty. The presentation will focus on the three options of obtaining
payment in the event of a transfer penalty; the undue hardship waiver request, appeal of the
transfer penalty, and safeguards, actions to be taken prior to a hearing, recent decisions, and
resolutions. The presentation will also discuss potential revisions to the Admission Agreement
and related documents.
John N. Kennedy
KENNEDY, PC LAW OFFICES
PO Box 5100
Harrisburg PA 17110-0100
(717) 233 – 7100
Benjamin Glatfelter
KENNEDY, PC LAW OFFICES
PO Box 5100
Harrisburg PA 17110-0100
(717) 233 – 7100
10:15 am to 10:45 am
Mid-Morning Break
SPONSORED BY LATSHA, DAVIS & McKENNA, P.C.
10:30 am to 12:00 pm
“Documentation Guidelines for Skilled Care”
Breakout Session
With the ever growing list of reviewers, it is more important than ever for documentation to
meet professional standards as well as the criteria for skilled services. All staff, including
physicians, nurses and therapists are expected to provide thorough, professional documentation
in order to be appropriately reimbursed for the care provided. This session will provide some
actual examples of skilled documentation.
This presentation will review the importance of having documentation that supports the
Minimum Data Set, discuss the use of the critical thinking process when documenting, discuss
common documentation mistakes, provide examples of skilled documentation, and define
communication strategies among the members of the interdisciplinary team that promote
continuity of care for the resident
Robyn A. Bunnell, BSN, RN RAC-CT, NHA
Senior Clinical Consultant
Arnett Carbis Toothman, LLP
5700 Corporate Drive, Suite 650
Pittsburgh, PA 15237
(412) 348-6799
10:30 am to 11:45 am
“HALTT – Hospital Admissions Lessened Through Therapy“
Breakout Session
Hospital Readmissions are forefront on CMS' radar in assuring quality patient care. Hospitals are
now incurring penalties with readmissions and in the future LTC facilities will be as well. Your
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therapy staff is one entity in a team approach for identifying and addressing clinical issues timely
as well as working together to achieve the best resident outcomes. Root Cause Analysis is
necessary to appropriately identify issues. Tools and systems will be introduced as well as
therapy's role in helping address each resident's comprehensive needs.
Heather Meadows
Area Director
Premier Therapy
701 Sharon Road
Beaver, PA 15009
(724) 775-8665
12:45 pm to 4:00 pm
Golf Outing
Blue Ridge Trail Golf Course, Mountaintop, Pennsylvania
SPONSORED BY KENNEDY, PC LAW OFFICES
1:00 pm to 4:00 pm
Wine Outing
Maiolatesi Vineyards, Scott Township, Pennsylvania
SPONSORED BY AFFINITY HEALTH SERVICES
Wednesday, April 29, 2015
7:00 am to 6:00 pm
Registration
7:00 am to 8:00 am
Continental Breakfast
8:00 am to 9:00 am
“Where’d We Get That Guy? Legal Issues in Hiring”
Breakout Session
In every size of company, including nursing facilities, hiring the right people is critical to maintaining a
positive work environment. There can be little doubt that hiring mistakes can disrupt your
operations. In this session speakers will address the right way to hire employees in a manner which
lessens risk to the facility and permits employers the best opportunity to weed out unqualified
applicants.
Kevin Skjoldal
Eckert Seamans Cherin & Mellott, LLC
213 Market Street
Eighth Floor
Harrisburg PA 17101
(717) 237 – 6039
Michael McAuliffe Miller
Eckert Seamans Cherin & Mellott, LLC
213 Market Street
Eighth Floor
Harrisburg PA 17101
(717) 237 – 7174
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8:00 am to 9:00 am
“ Everyday Ethics in Nursing Home Leadership”
Breakout Session
The term “ethics” is frequently used in nursing homes but there may not be a clear understanding of
what that encompasses in the day-to-day operations. This presentation will review the
fundamentals of ethics in health care and the application to the daily decisions that are made by the
nursing home administrator. The role of the administrator will be explored as it relates to
establishing and assessing the ethical climate within the nursing center and ways in which to
improve it. You will learn to understand the basic concepts of ethics in the health care setting,
discuss the need for considering ethical perspectives in all decision and understand the role of the
NHA in driving the ethical climate in the nursing home.
The agenda will cover the fundamentals of ethics in health care, principals and moral theories as
well as how to incorporate ethics into decision making. The role of the NHA in establishing the
ethical climate, both internally and externally will be discussed and how to assess the ethical climate
of your facility, focusing on key indicators and how to change this climate if necessary.
Shelley L. Kobuck, PhD(c), NHA
Senior Vice Precident of Operations
Affinity Health Services
942 Philadelphia Street
Indiana, PA 15701
(724) 840-1102
8:00 am to 9:00 am
“Reducing & Stabilizing Energy Costs at Geriatric Center/Skilled Nursing Facilities”
Breakout Session
Simply put, there are two ways to reduce and stabilize Energy Costs - use energy more effectively;
and pay less for the energy being used. There are many ways to accomplish these “simple” goals and
Provident Energy Consulting can help facilities with implementing multiple different and unique
strategies’ to reduce their energy spend over 25%. This session will walk attendees through the
different approaches, recommendations, and technology implementations we have made at other
facilities in order to help educate other facilities of the options currently available.
Joe Solomon
President
Provident Energy Consulting, LLC
55 State Road, 1st Floor
Media, PA 19063
(610) 565-5507
Michael Lang
Principal
Provident Energy Consulting, LLC
55 State Road, 1st Floor
Media, PA 19063
(610) 565-5507
9:00 am to 9:15 am
Break
9:15 am – 10:45 am
“A Paradigm Shift in Post-Acute Care”
Breakout Session
The changing face of post-acute healthcare in the United States calls for the skilled nursing facility (SNF)
team to adjust its approach to patients who are admitted for short-term care. Patients who lived in
SNFs previously are now shifting to assisted living facilities (ALFs), patients who were seen in ALFs
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before are now living at home, patients who were seen at home are now being treated at outpatient
clinics, etc. In addition, patients who want to return to their previous level of function are moving
through the system at a faster pace, spending less time in one care setting before moving to a lower
level. To maximize care and cost, there is an ongoing shift downward to the least restrictive and least
expensive level of care as soon as possible, along with a heightened focus on the patient’s responsibility
in wellness. It is vital to know the payer-specific coverage guidelines and the patient’s individual plan
for transition through care settings. Managed care payers will approve shorter lengths of stay in the
SNF in order to move the patient to a lower level of care as quickly as possible, and approaches to
Medicare patients seen in the bundling pilot also have similar responses.
This presentation will talk about shifting the team’s expectations about treatment planning and goal
setting to accommodate the shorter length of stay and transition plan, communication with
professionals who work in care continuum, as well as the effect on home visits, caregiver education,
and documentation. Incorporating patient ownership of health and wellness will also be stressed.
James Farmer
Clinical Specialist
Aegis Therapies
72 Mountain Road
Mountain Top, PA 15442
(570) 417-0587
9:15 am – 10:45 am
“FOG Meeting”
Breakout Session
PACAH’s Fiscal Officer’s Group (FOG) will meet during the conference and will be joined by Bonnie
Rose from the Office of Long Term living. Among the topics to be discussed will be the status of rates
payments, the nursing facility assessment, the Certified Public Expenditure payments, the MDOI
payments, Pay for Performance status, and other issues impacting the fiscal operations of nursing
facilities.
Kelly Andrisano
Executive Director
PACAH
PO Box 60790
Harrisburg PA 17106
(717) 526 – 1010
Bonnie Rose
Office of Long Term Living
Forum Place - 6th Floor
Harrisburg PA 17101
(717)783-7357
Edward P. Frigo
Director, Fiscal Services
Premier HealthCare Resources
2009 Renaissance Boulevard, Suite 300
King of Prussia, PA 19406
10:45 am to 11:00 am
Break
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11:00 am to 12:00 pm “Department of Health Update”
General Session
The Director of the Division of Nursing Care Facilities will provide timely information on the
operations of her department. She will discuss updates to the Event Reporting System,
antipsychotics initiative, and statistical data on Pennsylvania’s nearly 700 nursing facilities, new
emphasis from the federal government and other issues impacting nursing facilities from the
perspective of licensing and surveys. The Director of the Division of Safety Inspection will talk about
updates to the life safety code as well as life safety issues facilities should focus on.
Susan Williamson
Director for the Division of Nursing Care Facilities
Pennsylvania Department of Health, Division of Long Term Care
Room 526 Health & Welfare Building
625 Forster Street
Harrisburg PA 17120-0701
(717) 787 – 1816
Charles Schlegel
Director for the Division of Safety Inspection
Pennsylvania Department of Health
Room 922, Health and Welfare Building
Harrisburg, PA 17108
(717) 787-1911
12:00 pm to 1:00 pm
Luncheon
SPONSORED BY PELICAN
Thank you to PELICAN for this lunch invitation - extended to all conference attendees – that will
include a PELICAN update.
1:00 pm to 1:15 pm
Break
1:15 pm to 2:15 pm
“CMI Success: When Nursing and Therapy Collide”
Breakout Session
Whether your facility is county-affiliated (Pay for Performance) or private, you should expect your
CMI to be optimally managed as well as “Therapy Driven and Results Oriented.” As experts with
Medicare and Medicaid reimbursements, the therapy team should work closely with the facility staff
to develop strategies to identify residents and track Assessment Reference Dates (ARD’s) to meet
the Case Mix Index (CMI) goals of the facility. CMI management requires a multi-disciplinary
approach to the delivery of care for the residents of a skilled nursing facility including functional,
person-centered clinical treatment, supporting documentation and regulatory compliance. When
optimally managed, you can expect your therapy contractor to have a full understanding of the Pay
for Performance mathematic formulas. Therapy should work closely with the interdisciplinary team
to strategically manage your quarterly CMI score to maximize you PFP bonus opportunity.
Dave Lishinsky, PT, ATC
Vice President of Clinical Compliance
AdvantageCare Rehabilitation, Inc.
5035 Clairton Boulevard
Pittsburgh, PA 15236
(724) 840-4843
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Kathy Kemmerer, LPNAC, RAC-CT 3.0, CPRA
CMI Specialist and Medicare Reimbursement Specialist
AdvantageCare Rehabilitation, Inc.
5035 Clairton Boulevard
Pittsburgh, PA 15236
(484) 274-1359
1:15 pm to 2:15 pm
“Privacy in the Workplace: Internet, Email, Social Media and the Challenges They Present”
Breakout Session
This presentation will include a discussion of nursing facility management’s role in regulating,
monitoring and disciplining employees for certain conduct via email, the internet and social media.
Presenters will discuss the lines between conduct outside of the workplace that may constitute
grounds for discipline, as well as areas that employers cannot regulate without running afoul of
Section 7 rights under the NLRA.
Thomas G. Collins
Shareholder
Buchanan Ingersoll & Rooney
409 North Second Street, Suite 500
Harrisburg PA 17101-1357
(717) 237-4800
2:15 pm to 2:30 pm
Afternoon Break
2:30 pm to 3:30 pm
“Significant Employment Law Changes and Trends for 2015”
Breakout Session
Employment law changes in the past year have created new issues affecting Skilled Nursing Facilities
and Long-Term Care Organizations. These entities must be aware of these issues when developing
policies and procedures for the workplace. This presentation will address what’s hot, what’s not, and
the trends likely to impact the workplace in the upcoming year.
Thomas G. Collins
Shareholder
Buchanan Ingersoll & Rooney
409 North Second Street, Suite 500
Harrisburg PA 17101-1357
(717) 237-4800
2:30 pm to 3:30 pm
“The ABCs of Accountable Care Organizations and Post-Acute Care Providers”
Breakout Session
Post-acute care—a nebulous term that includes a variety of patients, providers, and care settings—
has become increasingly important recently due to a growing aged population and the introduction
of new Medicare and Medicaid law and policy. In particular, imposition of punitive payment
reductions to hospitals with high rates of readmission has spurred hospitals and health systems to
quickly deploy new post-acute programs and services. Simultaneously, the advent of hundreds of
local and regional Accountable Care Organizations (ACOs)—each seeking to reduce cost trends and
improve quality of care—has further stimulated innovation in this space. A third stimulant is the need
for ACOs to meet quality performance standards set by the Centers for Medicare and Medicaid
Services (CMS) which include long-term care residents in the measurement samples.
On the post-acute care (PAC) provider side, pressures on institutional providers to increase
occupancy and on home and community care providers to maintain volumes remain unrelenting.
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These two dynamics—the need for ACOs to reduce acute care costs and the need for PAC providers
to maintain or grow volumes—has created impetus in both parties to collaborate on win-win
solutions. This presentation will describe the array of PAC providers that interface with ACOs, review
the legal, regulatory and contractual environment, provide insights into ACO cost and quality
program innovations related to post-acute care, and close with several recent case studies that
illustrate common collaborations.
Rodney Myer
KENNEDY, PC LAW OFFICES
PO Box 5100
Harrisburg PA 17110-0100
(717) 233 – 7100
3:30 pm to 6:30 pm
Vendor Show
8:30 pm to 11:00pm
Conference Party
Unwind after a busy day with all of your fellow facility and business colleagues with a nightcap.
Thursday, April 30, 2015
7:00 am to 1:00 pm
Registration
7:00 am to 8:00 am
Continental Breakfast
8:00 am to 9:00 am
“Long-Term Care Legislative Budget and Advocacy Update”
General Session
As facilities try to budget for the upcoming year, it becomes difficult with the uncertainty of the FY
2015-2016 state budget. In terms of state funding for long term care facilities, experts in the arena
of long term care legislative and regulatory advocacy including CCAP’s Deputy Director Brinda
Penyak will provide updates on the Governor’s proposed FY 2015-2016 budget, including the
nursing home assessment, Medicaid rates, and what the proposal for long term care managed care
means. With no rate increase proposed, there will also be a discussion on how facilities can utilize
the elected officials and people that make up your community to advocate for an increase in
Medicaid rates, with a focused discussion with Ron Henry from Capitol Strategies who has
represented long term care facilities, including Fair Acres in Delaware County. Pending legislative
and policy changes impacting the bottom line for nursing homes will also be discussed, as will tips
and tricks for advocating on behalf of your nursing facility.
Brinda Carroll Penyak
County Commissioners Association of PA
PO Box 60769
Harrisburg PA 17106 – 0769
(717) 526 – 1010
Ron Henry
Senior Consultant
Capitol Strategies
610 North Third Street
PO Box 70
Harrisburg, PA 17108
(717) 232-4411
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Kelly Andrisano
Executive Director
PACAH
PO Box 60790
Harrisburg PA 17106
(717) 526 – 1010
9:00 am to 9:05 am
Break
9:05 am to 10:05 am
“Top 10 Compliance Issues for SNFs”
Breakout Session
Long term care providers face constant scrutiny from federal and state regulatory agencies, which
are more aggressive than ever in rooting out fraud and abuse within the health care industry. It is
critical for facilities and their corporate compliance officers to understand the major compliance
risks at hand, so that measures can be implemented to prevent, detect and respond to compliance
events. This presentation will cover a “Top 10” list of compliance issues facing SNFs in 2015.
Building upon the target areas identified in the OIG’s Work Plan for 2015, the presenter will also
discuss the primary compliance issues to focus on for the coming year, and will provide strategies
for assessing and responding to compliance issues.
David C Marshall, Esquire
Latsha Davis & McKenna, P.C.
1700 Bent Creek Boulevard, Suite 140
Mechanicsburg, PA 17050
(717) 620-2424
9:05 am to 10:05 am
“First Year Report on the First-of-a-Kind New Household Model”
Breakout Session
CommCare Corporation began their journey of providing highest quality of senior care and living
since their inception in 1994. As their person-centered philosophy of care evolved, CommCare
transformed their operational model and capital strategy toward goals of realizing a new culture of
quality in skilled nursing care and senior resident-focused living. The journey continues with
renewed spirit and reframing of operations organization to enhance resident and family CHOICES
through patient-centered self-determination. In 2007, L.E.A.D.E.R (Louisiana’s Cultural Change
Coalition) was formed, and CommCare’s Goals of resident-focused living were integrated with the
L.E.A.D.E.R. CONCEPTS of person-centered care and the Center for Medicare and Medicaid Services
(CMS) CONSTRUCTS of culture change to form a Next Perspective Vision in quality resident care
and community living environments.
In 2014, CommCare positioned their state certified resident beds and capital opportunity to create
a prototype resident home environment of decentralized care within a new 130-Bed Skilled
Nursing and Rehabilitation Community Care Center. This presentation summarizes a first year
performance report on model from origin of goals, through discovery of a vision, onto realization
of Riviere de Soleil Community Care Center, the first-of-a-kind new household model of care and
living opened March 2014 in Mansure, Louisiana.
John Adams
Vice President – Healthcare
KTH Architects, Inc
1741 Kiwanis Trail
Dubois, PA 15801
(814) 371-1541
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10:05 am to 10:35 am
Mid-Morning Break
SPONSORED BY ECKERT SEAMANS CHERIN & MELLOTT, LLC
10:20 am to 11:20 am
“Collection of Resident Accounts”
Breakout Session
The disruption to cash flow by delinquent accounts is a problem faced by virtually all long-term
care facilities. Controlling and limiting delinquent accounts is a critical component to maintaining
the financial solvency of an organization. This session will review the ways a facility can enhance its
ability to collect from its non-paying residents. Emphasis will be placed on admission agreement
provisions, including the obligations of responsible parties. The presenter will describe how the
facility application and admission process can be used to identify assets, screen applicants, and
ultimately collect a delinquent account. Finally, the presenter will review possible grounds for
litigation against residents, responsible parties, and agents, and demonstrate how the admissions
agreement and application can be used to pursue cases of nonpayment. The relationship between
the admission agreement and MA eligibility will also be addressed. The presentation would be
helpful to any nursing facility provider that faces collection problems.
Steven M. Montresor, Esquire
Latsha Davis & McKenna, P.C.
1700 Bent Creek Boulevard, Suite 140
Mechanicsburg, PA 17050
(717) 620-2424
10:20 am to 11:20 am
“Prepare for Increased Scrutiny of Allegations of Abuse & Neglect”
Breakout Session
This interactive session will explore recent developments concerning allegations of abuse and
neglect and will provide attendees with strategies to prepare for the changed enforcement
environment. Nursing homes are very familiar with a multitude of mandatory reporting
requirements involving allegations of abuse and neglect. Reports are filed with the Department of
Health, the Department of Aging, Area Agencies on Aging and local law enforcement, depending on
the nature of the incident. Under the Adult Protective Services Act (APSA), facilities’ administrators
and employees are required to submit reports for events involving adults who are between 18-59
years old. The Commonwealth has recently contracted with Liberty Resources to implement APSA
reporting and investigations.
In addition to anticipating the involvement of Liberty Resources in investigations under the APSA,
facilities should also develop protocols to handle investigations conducted by the Office of the
Attorney General, Medicaid Fraud Control Unit (MFCU). Come to this session to learn how the
increased scrutiny and investigations may affect your organization and what you can be doing now
to prepare your staff. The speakers will share practical information about where to report, the
structure of the new APSA program, contact information and where to receive ongoing training on
both OAPSA and APSA.
Paula G. Sanders, Esquire
Principal
Post & Schell
17 North Second Street, 12th Floor
Harrisburg, PA 17101
(717) 612-6027
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Cynthia A. Haines, Esquire
Department Counsel
Commonwealth of Pennsylvania, Department of Aging
Forum Place, 5th Floor
555 Walnut Street
Harrisburg, PA 17101
(717) 783-0509
11:20 am to 11:30 am
Break
11:30 am to 12:30 pm
“Office of Long-Term Living Update”
Closing Session
DPW’s Deputy Secretary for the Office of Long Term Living will report on current initiatives
undertaken by her office. These can include updates on DPW’s plans on implementing stakeholder
work groups to review both the various care delivery models for providing care to the dual eligible
population and long-term care as well as the long term care grants, PSEA, and potential Medicaid
payment changes. The Deputy Secretary will also address the FY 2015-2016 budget proposal,
other new initiatives and innovative projects being undertaken by the Department of Human
Services, in particular, the Office of Long Term Living.
Bonnie Rose
Deputy Secretary
Department of Public Welfare
Office of Long-Term Living
Forum Place - 6th Floor
Harrisburg PA 17101
(717) 783-7357
CONERENCE CONCLUDES
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