Licensure | Qualifications | Certifications · CERTIFICATE PROGRAMS 16 THE PROCESS of ACCREDITATION and STATUS UPDATE 19 TECH CORNER: LIVING ... CCM, CDMS, CRC Shelly Kinney, RN,

Licensure | Qualifications | Certifications

PEER-REVIEWED EXCELLENCE IN LIFE CARE PLANNING SINCE 2006

AANLCP JOURNAL OF NURSE LIFE CARE PLANNING ISSN 1942-4469

SPRING 2019 PEER-REVIEWED EXCELLENCE IN LIFE CARE PLANNING SINCE 2006 VOL. XIX NO. 2

2

TABLE OF CONTENTS4 QUICK QUIZ10 CERTIFICATION v. CERTIFICATE PROGRAMS16 THE PROCESS of ACCREDITATION and STATUS UPDATE19 TECH CORNER: LIVING22 THE BUSINESS of NLCP26 PLACE HOLDER FOR NANCY HAMADY

American Association of Nurse Life Care Planners299 S. Main Street. #1300-91732Salt Lake City, UT 94111PH & FAX: 801.274.1184

Website: www.aanlcp.org/

BOARD OF DIRECTORSPresidentErin T. OConnell, MSN, MBA, RN, CNL, CNLCP®, MSCCPresident-ElectKimberly Kushner, RN, BSN, CLCPPast PresidentDenise W. Wrenn, RN, BSN, MHSA, CCM, COHN-S, CMSP, CLCPSecretaryKelly Dawson, RN, BSN, CLCP TreasurerLa’Toya Lowery, RN, BSN, MBA, CCM, CNLCP®

JOURNAL OF NURSE LIFE CARE PLANNINGEditor & Journal Committee ChairWendie A Howland, MN, RN-BC, CRRN, CCM, CNLCP®, LNCC

Journal Committee for this Issue

Lynn Belcher RN, BSN, MHA, CLNCSue Cacciola, RN, LNC Kelly K. Campbell, RN, BSN, CP, CLCNDawn L Cook RN, LNCP-C, CLCP, CLNCMichele Cook, RN, MA, CCM, CRC, CLCP, ABVECheryl L. Halkowicz, RN, MS, CPHQ, CLCPShanna Huber, MN, RN, CCM, CLCP, CNLCP®Linda Husted, MPH, RN, CNLCP, LNCC, CCM, CDMS, CRCShelly Kinney, RN, MSN, CCM, CNLCP®Nellie Kreimer, RN, BSN, MSHATricia West, RN, BSN, MBA/HCM, CHN, PHN

TABLE OF CONTENTS4 QUICK QUIZ

10 CERTIFICATION v. CERTIFICATE PROGRAMS Barbara Bate RN-BC, CCM, CNLCP®, CRRN, LNCC, MSCC

17 THE PROCESS of ACCREDITATION and STATUS UPDATE AprilPettengillRN,CRRN,CDMS,CNLCP®,MSCC

20 TECH CORNER: LIVING DustinWright

22 THE BUSINESS of NLCP H. Adam Aguilar RN, BSN, PHN, CNLCP® 26 LIFE CARE PLANNING CERTIFICATIONS: A PERSONAL VIEW Nancy Hamady RN, CCM, CNLCP®, CLCP, LNCC, MSCC

JOURNAL OF NURSE LIFE CARE PLANNINGSPRING 2019

DEPARTMENTS3 From the Editor5 InformationforAuthors6 A Message from the President7 Contributors to this Issue28 Looking Ahead29 IIssue Index

http://www.aanlcp.org/



3

Welcome to the May 2019 issue of the JNLCP. In keeping with theclassicspringtimethemesofrebirthandnewbeginnings,wehaveanarticleonhowtosetanhourlyrateforyourservicesthat will certainly be helpful to our newer members…and also, like Spring itself, holds some surprises for people who have seen many springs unfold already.

We’vealsoputtogetherafewthingsoncertificationasareminderforanyonewhoneeds a refresher on the idea— we think some of our clients would appreciate clarity onthis.TheCertificationBoardhascontributedsomeinformationontheirhistorywithcertificationandthelaboriousprocessofobtainingaccreditationfortheCNLCPexamination-basedcredentialfromtheAmericanBoardofNursingSpecialtyNursingCertifications(ABSNC).Thinkyouknowallaboutthis?Guessagain.Seehowyoudoonthisquickquizonfactsgermanetothisdiscussion.Checkthearticleonpage17foranswers.

As I write this, Spring is well and truly upon us. We’ve had a great conference with many excitingideas,renewoldfriendshipsandbeginnewones,opportunitiestonetworkandlearn from each other, and perhaps sample some of the novel joys of Louisville. I had someofthebestfriedchickenIevertasted,andsampledmyfirsteveroldbourbon.Not bad. Back home, I can see mated pairs of cardinals prepping nests and hear the matingcallsofmanyothersthroughopenwindows,ablessingafteracoldwinter.ThemammalsthatcameoutintheFebruarythawtomateshouldbebringingforthoffspringany day now— a new crop of raccoons, skunks, foxes. There’s a bald eagle nest not far away,thefirstinMassachusettssince1907.ThehawksandospreysarebackfromSouthAmerica.Whilewehavetodealwithadauntingfourorfivecordsofoakandmaplefornext winter’s heat piled all over the garden, it’s not all bad: the lichen on the downed branchesisgoingofftolinenestsandprovidesnackfordeerandcottontails,andthechipmunks have a huge condo. Life is sweet.

I hope everyone’s new beginnings are full of promise. Here’s to a rewarding new year.

Warm regards,

From

the

Edito

r

Wendie A. Howland MN RN-BC CRRN CCM CNLCP® LNCCEditor, JNLCP [email protected]



4

Quick Quiz:1.TheCNLCP®CertificationBoardreportstotheAANLCPExecutiveBoard. A. TrueB. False *Extracredit:Whyorwhynot?

2. ThefirstyeartheCNLCP®CertificationBoardappliedforaccreditationwasA. 2007B. 2010C. 2015D. 2018

3. TheapproximatetotalnumberofCNLCP®credentialsevergrantedisA. 400B. 700C. 1000D. >1200

4. AbouthowmanypeopleholdanactiveCNLCP®credentialtoday?A. 125B. 200C. 300D. 525

Answers are in the article on page 17



5

AANLCP® invites interested nurses and allied professionals to submit articlequeriesormanuscriptsthateducate and inform the Nurse Life Care Planner about current clinical practicemethods,professionaldevelopment,andthepromotionof Nurse Life Care Planning within the medical-legal community.Submittedmaterialmustbeorigi-nal. Manuscripts and queries may be addressed to the Editorial Com-mittee.Authorsshouldusethefollowingguidelinesforarticlestobeconsideredforpublication.PleasenotecapitalizationofNurseLife Care Plan, Planning, etc

TextManuscript length: 1500 – 3000 words• UseWord©format(.doc,.docx)orPages(.pages)• Submit only original manuscript notunderconsiderationbyotherpublications• Putthetitleandpagenumberinaheaderoneachpage(usingtheHeaderfeatureinWord)• Use Times New Roman, Arial or Calibri 12 point font• Place author name, contact information,andarticletitleonaseparatetitlepage,soauthor• Name can be blinded for editorial review• UseAPAstyle(PublicationManualof the American Psychological Assoc.6thEd)

Art, Figures, LinksAllphotos,figures,andartworkshould be in JPG or PDF format (JPGpreferredforphotos).Lineartshouldhaveaminimumresolutionof1000dpi,halftoneart(photos)aminimum of 300 dpi, and combina-tionart(line/tone)aminimumof500dpi.Eachtable,figure,photo,or art should be on a separate page, labeled to match its refer-ence in text, with creditsifneeded(e.g.,Table1,Commonnursing diagnoses in SCI; Figure 3, Timetoendpointsbyintervention,AmericanCancerSociety,2003)Live links are encouraged. Please include the full URL for each.

EditingandPermissionsThe author must accompany the submissionwithwrittenreleasefrom:• Anyrecognizableidentifiedfacility for the use of name or image• Any recognizable person in a photograph, for unrestricted use of the image• Any copyright holder, for copyrighted materials including illustrations,photographs,tables,etc.

All authors must disclose any rela-tionshipwithfacilities,institutions,organizations,orcompaniesmen-tionedintheirwork.Allaccepted

manuscriptsaresubjecttoediting,which may involve only minor changesofgrammar,punctuation,paragraphing, etc. However, some editingmayinvolvecondensingorrestructuringthenarrative.Au-thorswillbenotifiedofextensiveediting.Authorswillapprovethefinalrevisionforsubmission.Theauthor, not theJournal, is respon-sible for the views and conclusions of a published manuscript. Submit yourarticleasanemailattach-ment,withdocumenttitlearticle-name.doc, e.g., wheelchairs.doc

All manuscripts published be-come the property of the Journal. Manuscripts not published will be returned to the author. Queries may be addressed to the care of the Editor at: [email protected]

Manuscript Review Process Submittedarticlesarepeerre-viewed by Nurse Life Care Planners with diverse backgrounds in life care planning, case management, rehabilitation,andthenursingprofession. Acceptance is based on manuscript content, originality, suitability for the intended audi-ence, relevance to Nurse Life Care Planning, and quality of the sub-mittedmaterial.Ifyouwouldliketoreviewarticlesforthisjournal,please contact the Editor.

Information for Authors

Journal of Nurse Life Care Planning is the official peer-reviewed publication of the American Association of Nurse Life Care Plan-ners. Articles, statements, and opinions contained herein are those of the author(s) and are not necessarily the official policy of the AANLCP® or the editors, unless expressly stated as such. The Association reserves the right to accept, reject, or alter manuscripts or advertising material submitted for publication. The Journal of Nurse Life Care Planning is published quarterly in spring, summer, fall and winter. Members of AANLCP® receive the Journal subscription electronically as a membership benefit. Back issues are available in electronic (PDF) format on the association website. Journal contents are also indexed at the Cumulative Index of Nursing and Allied Health Literature (CINAHL) at ebscohost.com. Please forward all email address changes to AANLCP® marked “Journal-Notice of Address Update.” Contents and format copyright by the American Association of Nurse Life Care Planners. All rights reserved. For permission to reprint articles, graphics, or charts from this journal, please request to AANLCP® headed “Journal-Reprint Per-missions” citing the volume number, article title, author and intended reprinting purpose. Neither the Journal nor the Association guarantees, warrants, or endorses any product or service advertised in this publication nor do they guarantee any claims made by any product or service representative. In order to make safe and effective judgments using NANDA-I nursing diagnoses it is essential that nurses refer to the definitions and defining characteristics of the diagnoses listed in this work.



6

A Message from the PresidentERIN OCONNELL AUGUST 2018 – DECEMBER 2019MSN, MBA, RN, CNL, MSCC, CCM CNLCP®

First, I would like to thank the Conference Committee for organizing an excellent 2019educationalconference.Ienjoyedallofthespeakers,fromthePre-Con-ferencesessionsto“CritiquingaLifeCarePlan”to“WinningGovernmentCon-tracts.”Ourspeakersprovidedawidevarietyofexcellentinformation.Second,Iwouldliketowelcomeallofthenewstudentsandfirst-timeAANLCPConferenceattendees.Wehadanincredibleattendanceandlookforwardtoworkinghardand breaking that number next year. Thanks in advance to Kelly Campbell and Jenn Craigmyle, our 2020 Conference co-chairs, already hard at work.

During the 2019 annual conference, I had the opportunity to be present on the stage when Anne Sambucini receivedthe2019AANLCPDistinguishedServiceAward,presentedbypastrecipientsWendie Howland and Becky Czarnik.Anneisalwaysquietlygivingtotheassociation.She’samentorandwilllendsupportandguidance whenever needed. I was very honored to present the 2019 AANLCP Ambassador Award to Shelene Giles. ThoseinattendanceprobablyheardmyvoicecrackalittleasIannouncedShelene’sname.IconsiderSheleneagreatmentor,educator,andadvocate.Iamhonoredtocallbothofthesebeautifulwomenfriends.

As we move forward this year, we plan to revamp and kickstart the Mentor Programsowe’llberequestingmentorssoon.(Hint!Hint!)Don’tforgettheOutreach Committee, chaired by the wonderful Phelicia McCal-lum,soinstrumentalformemberretention,renewal,andattractingnewmembers.Thisisagreatwaytomeetnewpeopleandgivebacktotheassociation.TheEducation Committee isalsolookingfornewcommitteemembers, giving you an opportunity to schedule webinars on topics you’ve always wanted to hear. Contact Chair Becky Czarnik.

IwanttothankWendieHowlandforallofherhardworkanddedicationtotheJNLCP.IwasveryexcitedwhensheacceptedthepositionasJournal editorespeciallysinceourJournalandcommitteewereareasthatIknewwe had to focus in order to increase membership, stability, interest, and excitement. Wendie and Debra Lloyd, ournewexecutivedirector,jumpedinandworkedveryhardtopublishourWinterjournal.Wendiehasreig-nitedtheJournalcommittee’sfireandexcitementevidentduringtheJournalcommittee’smonthlymeetingsandatourrecentannualconference.Morethanadozenofyoujoinedthejournalcommittee!

I’mlookingforwardtotherestof2019andespeciallyworkingwiththeExecutiveBoard,thenewmanage-mentcompany,andallofourcommittees.

Finally, I would like to thank our conference sponsors. Don’tforgettocheckouttheirmembershipdiscounts!

Erin OConnell MSN, MBA, RN, CNL, MSCC, CCM ,CNLCP®AANLCP President August 2018 - December [email protected]



7

Contributors

BARBARA T. BATERN-BC, CCM, CNLCP®, CRRN, LNCC, MSCC

Barbara Bate is Principal of Northeast Life Care Planning, Inc.,anurseconsultingcompany,providing a variety of services nationwide,includingmedicalcasemanagement,medicalfilereviews/chronologies, medical costprojections,Medicareset-asideallocations/conditionalpayment review, as well as life care plan development/review.

Barbara has over 35 years of experience as a registered nurseandholdscertificationsinrehabilitationnursing,legalnurseconsulting,casemanagement,nurse life care planning, and MedicareSet-Asideconsulting.Barbara is a past AANLCP President(2010),joiningtheCertifiedNurseLifeCarePlanner(CNLCP®)CertificationBoardin2012 and currently serving as Co-Chair.

APRIL PETTENGILLRN, CRRN, CDMS, CNLCP®, MSCC

Ms. Pettengill has over 32 years of experience as an RN, working inthehospitalsettingingeriat-rics, pediatrics, telemetry, and orthopedics. For the last 29 years she has been a case manager for work related injuries and illness-es.Ms.Pettengillhasextensiveexperience with catastrophic injuries and in 2004 became certifiedasaNurseLifeCarePlanner.

Ms.PettengillbecameaMedi-careSetAsideConsultantCerti-fiedin2005andbeganwritingMSAs. She currently works per diem for a local home health agency to keep her hands-on clinical skills current, working withpatientsoverthecontinu-um of care including high tech pediatricpatients.Shehasbeena member of AANLCP since 2004, oftenworkingontheconferencecommittee.SheservedastheCNLCP®CertificationBoardSec-retary from 2007 to 2018.

DUSTIN WRIGHT

Dustin Wright began his career as a Direct Support Professional with a private provider in Indi-ana,whileattendingPurdueUni-versity.Aftergraduation,Dustincontinuedhisworkinthefieldofdevelopmentaldisabilitiesasa front-line supervisor and then Director.

In2006Dustinwasoneofthefounders of Rest Assured as theirExecutiveDirector.Inthisrolehedirectedoperationsanddevelopment at the company’s cutting-edgeremotesupportcenter. He has also helped many state regulators shape remote support policy and reimburse-ment models.

DustinisthefounderofDisabil-ity Cocoon. Disability Cocoon is a disability technology cat-alyst whose mission is to help peopleenablepossibilitieswiththeappropriateapplicationoftechnology. He can be reached at [email protected]



8

to this IssueH. ADAM AGUILARRN, BSN, PHN, CNLCP®

H. “Adam” Aguilar, BSN, RN, PHN, CNLCP is a California nurse life care planner with over 23 years of experience in emergen-cy,criticalcare,andotherspe-cializedfieldsofnursing.Heiscurrently pursuing a nursing doc-torate / adult-gerontology acute carenursepractitionercertifi-cation.Hehasoperatedseveralbusinesses over his professional career and in 2018 opened his firstlifecareplannerbusinessin Southern California. He can be contacted at [email protected]

NANCY HAMADYRN, CCM, CNLCP®, CLCP, LNCC, MSCC

Nancy Hamady RN, CCM,CNLCP, CLCP, LNCC, MSCChas been a life care planner since2002. She opened her business,QualityRehabilitationandConsultingServicesin2004,recently relocated from Ohio andnowbasedinGraftonMA.Sheserved as AANLCP President in2014andhasremainedactiveintheassociation.Shecanbereached [email protected]



9

https://www.aanlcpconference.com/2020-sun-san-diego



10

CERTIFICATION v. CERTIFICATEPROGRAMS

According to the American Nurses Association (ANA), nurses should engage in lifelong learning that reflects current nursing practice and promotes futuristic thinking (ANA Scope and Standards of Practice, 3rd edition page 12 ).

TheAmericanAssociationofNurseLifeCarePlanners(AANLCP)alsopromotescontinuingeducationfornurselifecareplannerswhilesupportingtheincorporationofthatnewknowledgeintothenurselifecareplanners’dailypractice(AANLCP,COREpage12,AANLCPScopeandSOP,page5).

Key Words:

Certified Nurse Life Care Planner

Certification Board (CNLCP®)

American Board of Nursing Specialties (ABNS)

Specialty Nursing PracticeBY BARBARA T. BATERN-BC, CCM, CNLCP®, CRRN, LNCC, MSCC

Whilethereareavastnumberofcontinuingeducationprogramsavailabletonursesandnurselifecareplanners,understandingthedifferencebetweencertificateandcertificationprogramsiscritical,particularlyforthenurselifecareplannerprovidingexperttestimony.Forexample,althoughsomepeopleconsidercertificateprogramstobecredentialingprocesses,thecertificatemaynotbeheldtothesameobjectivestandardsrequiredbyothercertifyingprograms.Whilebothcanprovidevaluableeducation,thisarticlewillexplainthedifferences.



11

STANDARD 1

NEED FOR ASSESSMENT-BASED CERTIFICATE PROGRAM

Thegrantingorganizationdemonstratesaneedfortheassessment-basedcertificateprogramwhichisbasedonadistinct,well-definedhealthcareareaofpracticeinwhichregisterednurses and other healthcare team members maypractice.Bydesign,theknowledgeandskillscoveredbyanassessment-basedcertifi-cate program are limited in scope to an aspect ofthatareaofpractice.

STANDARD 2

EDUCATION COMPONENT

Theeducationcomponentforanassess-ment-basedcertificateprogramisbasedongenerallyacceptedprinciplesforinstructionaldesign.Itreflectsidentifiedneedsandrelevantlearner outcomes.

STANDARD 3

ASSESSMENT COMPONENT

The assessment component of the assess-ment-basedcertificateprogramlinkstoeachlearningoutcomeoftheeducationcompo-nent. The assessment component incorporates principles of measurement, including validity, reliability, minimum performance standard, administration,andsecurity.Assessmentcanbeconductedbywrittenorpracticalexamination,portfolio,otherreflectivelearningactivities,oranotheractivitywithappropriateperformancecriteria. cont...

ABSNC Standards for organizations to receive accreditation for their assessment-based certificate programs.

VALUE OF CERTIFICATIONIn2016,ABNSChostedameetingwithover100health care professionals to discuss the value of certificationinhealthcarepractice.Theirconceptualframeworkforthemeetingandadditionalresearchlistedthesebenefitsofcertification:

• Advances safety• Clarifies and defines the roles and work

of health care providers and other team members

• Improves organizational culture• Improves job satisfaction, empowerment

and confidence• Improves processes of care• Improves quality of care• Improves recruitment and retention,

employability, and job prospects• Is recognized as validation of knowledge

in the specialty• Provides a measurable return on

investment• Provides professional support• Shapes future practice

http://nursingcertification.org/resources/documents/research/Value-of-Certification-Convening-Executive-Summary-Final.pdf

CERTIFICATE PROGRAMS

Acertificateprogramistypicallygearedtowardsaspecificsubjectandaccessedbythosewithvariousamountsofexperience(www.aalnc.org/page/certification-vs.-certificate).Participantsreceiveacoursecompletioncertificateandmaytakeanexamor other type of assessment tool to demonstrate relevant knowledge of course content and objectives.Therearenorenewaldatesorcontinuingeducationrequirementsandaspecificcredentialisnotawarded.Thiscertificateshouldnotbeconfusedwithacertificateofattendance/participation,whichiscommonlygiventoverifyattendance/participation.

http://nursingcertification.org/resources/documents/research/Value-of-Certification-Convening-Executive-Summary-Final.pdfhttp://nursingcertification.org/resources/documents/research/Value-of-Certification-Convening-Executive-Summary-Final.pdfhttp://nursingcertification.org/resources/documents/research/Value-of-Certification-Convening-Executive-Summary-Final.pdfhttps://www.aalnc.org/page/certification-vs.-certificatehttps://www.aalnc.org/page/certification-vs.-certificate



12

STANDARD 4

PROGRAM OVERSIGHT/MANAGEMENT

Thegrantingorganizationmanagestheassess-ment-basedcertificateprogrameffectivelytoprotect candidate rights, ensure program cred-ibilitythroughresponsetomisrepresentationor noncompliance with eligibility criteria, and includecontinuouscorrectiveandpreventiveactionsforqualityimprovement.

STANDARD 5

ORGANIZATIONAL AUTONOMY

Thegrantingorganizationofferingtheassess-ment-basedcertificateprogramshallhaveadefinedbusinessstructureandlegalstandingtoensureconfidenceinitsintegrityandabilitytoprovide a relevant, credible program.

STANDARD 6

NONDISCRIMINATION

Thegrantingorganizationadministeringtheassessment-basedcertificateprogramdoesnotdiscriminate among candidates as to age, sex, race,religion,nationalorigin,ethnicity,disabili-ty,maritalstatus,sexualorientation,andgenderidentity.Thegrantingorganizationtakesstepstoeliminate or reduce bias and stereotyping from allaspectsoftheassessment-basedcertificateprogram.

http://nursingcertification.org/absnc/assessments

TheNationalOrganizationforCompetencyAssurance(NOCA)isanon-profitorganizationthat“provideseducational,networkingandadvocacyresourcesforthecredentialingcommunity.”(www.standardsportal.org/usa_en/sdo/noca.aspx).AccordingtoNOCA,therearethreedifferenttypesofcertificateprograms:knowledge-based,curriculum-based,andcertificateofattendanceorparticipation.

Aknowledge-basedcertificateprogramhasanarrowscope,offeringcourseworkonknowledgeneededtoperformspecificjobduties.Theparticipantneedstopassanassessmenttooltoobtainthecertificate.

Acurriculum-basedcertificateprogramoffersacourse or series of courses. This also requires the participanttopassanassessmenttooltoobtainthecertificate.AsperNOCA,“thecontentoftheassessment is limited to the course content and thereforemaynotbecompletelyrepresentativeofprofessionalpractice(andthereforeitisnotasdefensible to use this or the knowledge-based type ofcertificateforregulatorypurposesascomparedtoaprofessionalcertification).”

Acertificateofattendanceorparticipationverifiesattendance,orparticipation,inacourse.Thereisnopost-completionassessmenttool.Participantsdo not have to demonstrate competence per professionalortradestandards.(www.cvacert.org/documents/CredentialingConcepts-NOCA.pdf)

TheAccreditationBoardofSpecialtyNursingCertification(ABSNC),formallytheABNSAccreditationCouncil,offersaccreditationtonursingcertificationorganizations.Theyaretheonlyaccreditingbodyspecificallyfornursing-relatedcertificationprograms.(www.absnc.org)

ABSNCoffersaccreditationforassessment-basedcertificateprograms,definedas“non-degreegrantingprogramsthatprovideevidence-basededucationonanarrowsubsetofknowledgeand skills that add value to the clinician and the healthcareconsumer.”Theprogrammustbeappropriate for registered nurses and/or advanced practicenursesbutmayalsobeinterdisciplinary.Criteria require that 200 candidates have completed theprogramorthattheprogramhadbeenofferedforatleastoneyear(whichevercomesfirst),

andbeadministeredbyabusinessentity(e.g.,specialtymembershiporganizations,healthcareorganizations,certifyingorganizations,academicinstitutions,commercialentities).

http://nursingcertification.org/absnc/assessmentshttp://www.standardsportal.org/usa_en/sdo/noca.aspx



13

CERTIFICATION

Professionalcertificationis“thevoluntaryprocessbywhichanon-governmentalentitygrantsatime-limitedrecognitionanduseofacredentialtoanindividualafterverifyingthatheorshehasmetpredetermined and standardized criteria. It is the vehiclethataprofessionoroccupationusestodifferentiateamongitsmembers,usingstandards,sometimesdevelopedthroughaconsensus-drivenprocess,basedonexistinglegalandpsychometricrequirements.”(www.nursingworld.org/education-events/faculty-resources/research-grants/styles-credentialing-research-grants/credentialing-definitions/AmericanNursesCredentialingCenter,ANCC)

TheCertifiedNurseLifeCarePlannerCertification(CNLCP®)Boardcallscertification“aformalrecognitionthatvalidatesknowledge,experience,skillsandclinicaljudgmentwithinaspecificnursingspecialty;and,assuch,isreflectiveofamorestringentprofessionalpracticestandard”thanthatof basic nursing licensure.

http://cnlcp.org/position-statements/

TheAmericanBoardofNursingSpecialties(ABNS)definescertificationas,“theformalrecognitionof the specialized body of knowledge, skills, and experience demonstrated by the achievement ofstandardsidentifiedbyanursingspecialtytopromoteoptimalhealthoutcomes.”

STANDARD 1

DEFINITION & SCOPE OF NURSING SPECIALTY

Thecertificationexaminationprogramisbasedonadistinctandwell-definedfieldofnursingpracticethatsubscribestotheoverallpurposeandfunctionsofnursing.Thenursingspecialtyisdistinctfromothernursingspecialtiesandisnationalinscope.Thereisanidentifiedneedfor the specialty and nurses who devote most of theirpracticetothespecialty.

STANDARD 2

RESEARCH-BASED BODY OF KNOWLEDGE

A body of research-based knowledge related to the nursing specialty exists. Mechanisms have been established for the support, review, and disseminationofresearchandknowledgeinthespecialty.Activitieswithinthespecialtycon-tribute to the advancement of nursing science within the specialty.

STANDARD 3

ORGANIZATIONAL AUTONOMY

Thecertifyingorganizationisanentitywithorganizationalautonomygovernedinpartorinwholebycertifiednursingmembers.

STANDARD 4

NON-DISCRIMINATION

Thecertifyingorganizationdoesnotdiscrimi-nate among candidates as to age, sex, race, reli-gion,nationalorigin,ethnicity,disability,maritalstatus,sexualorientation,andgenderidentity.

STANDARD 5

PUBLIC REPRESENTATION

ThecertifyingorganizationincludesatleastonePublicMemberwithfullvotingrightsonitsBoard of Directors.

ABNSC Standards for organizations to receive accreditation for their exam-based nursing certification programs.

http://cnlcp.org/position-statements/



14

STANDARD 6

ELIGIBILITY CRITERIA FOR TEST CANDIDATES

ABSNCiscommittedtopromotingthehigheststandards for the future of specialty nursing practice.ABSNCbelieveseducationalprepara-tionfornursesandnon-RNnursingteammem-berscombinedwithspecialtycertificationwillenhanceclinicalpracticeandpatientoutcomes.This Standard outlines the eligibility require-ments and licensure.

STANDARD 7

VALIDITY

Thecertifyingorganizationhasconductedvalidationstudiestoassureinferencesmadeon the basis of test scores are appropriate and justified.

STANDARD 8

TEST DEVELOPMENT

Certificationexaminationsareconstructedandevaluated using methods that are psychometri-cally sound and fair to all candidates.

STANDARD 9

RELIABILITY

Thecertifyingorganizationassurestestscores,includingsubscores,aresufficientlyreliablefortheir intended uses.

STANDARD 10

TEST ADMINISTRATION

Thecertificationexaminationisadministeredina manner that minimizes construct-irrelevant varianceandmaintainsexaminationsecurity.

STANDARD 11

TEST SECURITY

Procedures are in place to maximize the securi-tyofallcertificationexaminationmaterials.

STANDARD 12

STANDARD SETTING, SCALING, AND EQUATING

Thepassingscoreforthecertificationexamina-tionissetinamannerthatisfairtoallcandi-dates, using criterion-referenced methods and equatingandscalingproceduresthatarepsy-chometrically sound.

STANDARD 13

RECERTIFICATION AND CONTINUING COMPE-TENCE

Thecertifyingorganizationhasarecertificationprograminplacethatrequirescertificantstomaintain current knowledge and to provide doc-umentationofhowcompetenceinthespecialtyismaintainedand/ormeasuredovertime.

STANDARD 14

COMMUNICATIONS

Thecertifyingorganizationprovidesinformationthatclearlydescribesthecertificationandre-certificationprocesstocandidates,certificants,and other stakeholders.

STANDARD 15

CONFIDENTIALITY AND SECURITY

Thecertifyingorganizationassuresconfidentialinformationaboutcandidatesandcertificantsisprotected.

STANDARD 16

APPEALS

Thecertifyingorganizationhasanappealprocessavailabletocandidates/certificantswho have been denied access to test or retest, recertification,orwhohavehadcertificationsuspended or revoked.



15

FortheCNLCP®CertificationBoard’sexplanationonthe nuts and bolts of obtaining ABNSC approval for theCNLCPcredentialandanexcitingupdateontheirprogress,pleaseseethenextpage(Pettengill).

ForinformationregardingCNLCP®Certification:www.cnlcp.org

AANLCPsupportscertificationthroughtheCNLCP®CertificationBoard

CNLCP®isaregisteredtrademarkoftheCertifiedNurseLifeCarePlanner(CNLCP®)CertificationBoard

Additional Resource:

JointPositionStatementbetweenAANLCPandCNLCP®CertificationBoard,6/6/14

EducationandCertificationforNurseLifeCarePlanners

STANDARD 17

MISREPRESENTATION AND NONCOMPLIANCE

Thecertifyingorganizationhasamechanisminplace to respond to instances of misrepresenta-tionandnoncompliancewitheligibilitycriteriaorthecertifyingorganization’spolicies;thismechanismincludesreportingcasesofmisrep-resentationandnoncompliancetoappropriateauthorities.

STANDARD 18

QUALITY IMPROVEMENT

The certifying organization shall have an in-ternal audit and management review system in place, including provisions for continuous corrective and preventive actions for quality improvement.

https://www.absnc.org/sites/default/files/docs/2019/1_edited_absnc_examina-tion-based_accreditation_standards_final.pdf

http://www.cnlcp.orghttps://www.absnc.org/sites/default/files/docs/2019/1_edited_absnc_examination-based_accreditation_standards_final.pdfhttps://www.absnc.org/sites/default/files/docs/2019/1_edited_absnc_examination-based_accreditation_standards_final.pdfhttps://www.absnc.org/sites/default/files/docs/2019/1_edited_absnc_examination-based_accreditation_standards_final.pdf



16

https://www.figeducation.com/



17

THE PROCESS of ACCREDITATION andSTATUS UPDATE

Key Words:

Certified Nurse Life Care Planner

Certification Board (CNLCP®)

American Board of Nursing Specialties (ABNS)

INTRODUCTION: STANDARDS

The American Board of Nursing Specialty Nursing Certifications(ABSNC)isthepremier-andonly-accreditingboardforanynursingcertificationwishingtoseeknationalrecognition.ABNSCistocertificationwhattheAmericanNursingAssociationistospecialtynursing.Nursesholdingacertificationaccredited by ABNSC have met stringent standards to demonstrate their quality and consistency in knowledge and competence.

ABNSChas18standardsdefiningthespecialty’sscope, research-based body of knowledge, validity, testreliability,publicrepresentation,andqualityimprovementprocesses.Anaspiringcertificationboardmustdocumentspecificitemstodemonstratetheir policies and procedures to meet these standards.

View the ABSNC standards on page 12 or at

https://www.absnc.org/accreditation-standards-examination-based-certification

THE CERTIFICATION BOARD’S HISTORY WITH CERTIFICATION

TheCertifiedNurseLifeCarePlannerCertificationBoard(CNLCP®CB)isthecertifyingbodyfortheCNLCP. We are an independent board with 8 directors and one public member. We support the AmericanAssociationofNurseLifeCarePlanners(AANLCP)membershiporganizationbuthaveorganizationalautonomy.JanRoughancurrentlychairs the Board.

TheAANLCPCertificationBoardfirstappliedforaccreditationin2007.Unfortunately,theABNSCrejectedtheapplicationforlackofwell-definedcriteria:evidencefororganizationalautonomy,aformalpsychometrically-scoredroledelineationsurvey, a research agenda, a core curriculum, multipletestforms,andaqualityimprovementprogram. They also noted that our policies and proceduresfellshortofexpectations.Whilethisrejectionwasdisheartening,itprovidedthesubsequent Board a clear blueprint to proceed with the items needed to reapply.

Thefirstitemaddressedwastheneedforanindependent, autonomous board with bylaws, policies,andprocedures.Wehiredanattorney.ThenamewasofficiallychangedfromtheAANLCPCertificationBoardtotheCNLCPCertificationBoard,andtheCNLCP®CBbecamealegallyseparateentityfrom AANLCP®. Both boards set an agenda for co-developmentofacorecurriculum(published2013)and research goals.

APRIL PETTENGILLRN, CRRN, CDMS, CNLCP®, MSCC

https://www.absnc.org/accreditation-standards-examination-based-certificationhttps://www.absnc.org/accreditation-standards-examination-based-certification



18

ROLE DELINEATION STUDY

The next major hurdle was to conduct a role delineationstudy(RDS),otherwiseknownasaroleandfunctionstudytoobjectivelyoutlinewhatnurse life care planners do. We put out a request for proposals to several companies for this. Many of these proposals came in at well over $30,000. Fortunately,ourcurrenttestingorganization,ProfessionalTestingCompany(PTC)inNewYork,provided this service for about $15,000.

Weareasmallorganizationwithonlyapproximately700CNLCPssinceourinceptionin1998andabout300peopleholdinganactiveCNLCPtoday.Itwasa major challenge to fundraise for the RDS but we were successful.

DEVELOPING THE RDS

NextwecreatedacommitteetodeterminetheRDS measurement criteria. Then-Board member KertrinaMillerspentmanyhourscontactinghundreds of current and previous CNLCP and CLCP nursesanduncertifiedpeoplewhoweredoinglifecare planning. She also spent hours reworking the policies and procedures to format them and change language to meet the ABSNC standards.

Hercommitteemetseveraltimeswiththeguidance from PTC and Penelope Caragonne, PhD, AANLCP® Associate member, who had experience indevelopingrolestudies.OncethecommitteefinalizedtheRDS,itwasreadyforbetatesting.Wesent it to another group of nurses to test for validity andresponsevalidity.Followingthebetatesting,we sent the survey link to the AANLCP membership, CNLCP-holdingnurses,andtheInternationalAssociationofLifeCarePlanners(IALCP),andpostedit on several online life care planning community lists.

Whenwehadastatistically-validnumberofresponses, PTS commenced the psychometric scoring and analysis for validity. Their results indicatedtheneedtorevisetheexamination

content to match the RDS. This meant we had to makeapushformoretestitemsinspecificcontentareas.Thisprocesscontinuedoverthenextfewyears.

We also trademarked and registered the exam and the CNLCP mark to protect them from copyright infringement and encourage the public and stakeholderstohaveconfidenceinthecertification.

QUALIFYING FOR THE EXAM

In 2014, ABNSC updated their standards to remove grandfathering or reciprocity. This meant we had to require applicants to sit for and pass theexaminationtoearnCNLCPcertification.TheCNLCP®CBmodifiedtherequirementstositfortheexam hoping more people would qualify and the numberofthosecertifiedwouldcontinuetogrow.Aftereachupdate,wewererequiredtoreassessthe exam for several cycles for validity. As you can imagine, this consumed quite a considerable amount oftime.

EXAM ACCESS

Toallowforbetteraccesstotheexam,theCNLCP®CBofferedtheexamfourtimesperyear.Formerly, it was a paper and pencil exam, which requiredmoretimetoscorebythetestingcompany.CNLCP®CBworkedwithPTCtoofferon-demandcomputerizedtestingstartinginJanuary2017,allowingapplicantsawindowof3monthsafteracceptanceoftheirapplicationstositfortheexamination.

Overthenextseveralyears,wemodifiedqualifications,collectednewtestitems,anddeveloped new test forms. Each change required timebyCNLCP®CBandthetestingcompanytoassessitseffectanddetermineiftheresultsremained psychometrically valid.



19

APPLICATIONS

Wesubmittedthe2007applicationinthreebignotebooksofhardcopies.Nowtheapplicationgoeson a thumb drive with hyperlinked documents. We havetosendaletterofintenttoapplyatleast90days before submission and ABSNC can reject any submissioniftheyfeeltheydonothavethetimetoreview.

Inthepriorapplicationitwasa“oneanddone”situation;anorganizationhadonlyonechancetofinalizeanapplication.Now,theABSNCallowstheirreviewerstorequestadditionalinformationifneeded.Anorganizationhasupto10daystorespond to a request for supplemental materials. ABNSC reviewers can make up to 3 requests forsupplementsbeforeanapplicationmustbecompletelyresubmitted.Thereviewershave60businessdaysafterreceivingtheapplicationtomakeanaccreditationdetermination.Theyhavediscretiontoextendthisiftheywantadditionalinformation.

WesentourletterofintenttoapplytoABNSCand it was approved in December 2018. As of this writinginearlyApril,PTChadthedocumentationtocompletetheapplication.OnceABNSCmakesadetermination,likelywithinthreemonths,wewillannounce the outcome to our membership.

www.cnlcp.org

Purchase your own copy of

this essential guide

published by AANLCP

https://www.aanlcp.org/store/

https://cnlcp.org/https://www.aanlcp.org/store/



20

This begins a four-part series dedicated to exploring how assistive technology solutions can make a positive impact on patients’ lives.

Thefirst,Living,focusesonsolutionsthatusetechnologytoassistpatientsintheirhomesandintheirsociallives.ThefirstpartofLivinghighlightssome new services and products and discuss the affectsthey’rehaving.

Rest Assured (restassuredsystem.com)providesremote monitoring services to individuals who want to increase their level of independence within the home. Using a system of cameras and sensors, they ensurethatpatientsalwayshavesomeonewatchingover them when they need them. Tele-Caregivers activelymonitorthesiteduringspecifiedmonitoringtimes.Additionally,theyprovideotherservicessuchasmedicationreminders,visitorcheck-ins,andkitchen safety. This allows individuals who would otherwise require health or safety supervision to remainintheirhomeswithoutattendants.PatientssimplypressabuttontogetintouchwithliveTele-Caregivers.

LIVING

Cornerstone Ventures, Inc. created HomeSmart Assistant(homesmartassistant.com),asystemthatuses Amazon’s Alexa or Google Home’s Assistant to connect smart devices in the house. Their focus has primarilybeenonhelpingpatientswithquadriplegiaaccomplish tasks others take for granted, just by using their voice. For example, individuals can open/close and lock/unlock doors, change a thermostat, control a TV and DVR, and even change speed settingsontheirceilingfans.What’smore,theycancontactlovedoneswithvoice-activatedvideochatsfrom anywhere in the home.

Raizer by Liftup(raizer.com)isn’tacomprehensivesystem designed to improve overall independence. It’s a small, portable device designed to physically liftindividualswhohavefallenandareunableto get up. It comes in two small bags, is easy to assemble,anditcarefullyandslowlyliftsapersontoanear-standingposition.Itcanbechargedinthecar or by a regular wall outlet and stows easily in a closet or under the bed. The Raizer removes the needfortraditionalslingsortwo-personteamstosafelyliftindividualswhohavefallen.It’sasmallbutsophisticatedsingle-usepieceofassistivetechnologythattacklesonecaregivingchallengeexceptionallywell.

Key Words:

Assistive Technology | Home-Care

Caregiving

BY DUSTIN WRIGHT

Tech Corner

http://restassuredsystem.comhttp://homesmartassistant.comhttp://raizer.com



21

TelecommunicationservicesconnectingpatientsandhealthprofessionalslikeKareCall(karecall.com)andStationMD (stationmd.com)trytoreduceriskofhospitalizationsbyincreasingconnectedness.KareCallusesvirtualassistantstocallindividualsforregularverbalhealthcheckups.Anyresponsesindicatingahealthissuepromptthevirtualassistanttorelayinformationtoalivehealthprofessionalforfollowup.Thisfreesnursesandotherhealthprofessionals/caregiversfromhavingtoperformroutinehealthchecksandallowsthemtofocuswherethey’reneededmost.StationMDworkssimilarly,butinsteadofregularcallsfromavirtualassistant,patientscallaproviderforscreeninginterviewswhentheythinktheyhavehealthproblems.Thismeanssomeonewithanewhealthconcerndoesn’tneedtogototheERfirstforassessment.ProviderscantellpatientstogototheERifit’snecessary,andreassurethemwhenit’snot.

Theseareonlyasmallsampleofthemanythetechnology-basedsolutionsavailableforindividualswithvariousabilitiesthatwediscovered.Nodoubtthefuturewillholdexcitingandgame-changinginnovationsforpatientsthatgowellbeyondthem.Butpresentorfuture,wecanbesurethattechnologycanhelpreducetheneedforcaregiverhours,helpfreeuphealthcareprovidersandcaregiversforotherresponsibilities,and,perhapsmostimportantly,delivercontrolbacktothepatientssotheycanlivetheirlivesfully,independently,and with dignity.

http://karecall.comhttps://www.stationmd.com/



22

STARTING YOUR OWN BUSINESS? How to determine your rates.

Congratulations on your decision to start your own business. As Thoreau famously said, ““If you have built castles in the air, your work need not be lost; that is where they should be. Now put foundations under them.”

How to charge for your time?

Many sources report that nurses are underpaid and underappreciated, as many nurses might already know(Salary.com,2018;Johnson,2015;OnlineNursingDegrees,2018).Thereareseveralreasonsfor this. Even so, nurses should not accept it at face value,especiallytheNurseLifeCarePlanner(NLCP)

who has decided to venture out as a business. Before opening for business, the NLCP should put careful thought and planning into improving the odds of success.

One of your most important decisions is what to chargeforyourtime.Don’taccepttheideathatyoushouldchargewhatthecompetitioncharges:Useobjectivedatatosetyourrates.Thisarticlewilldiscusshowtoestimatewhatahome-based,sole-proprietor, NLCP entrepreneur should charge duringtheinitialonetothreeyearsinbusiness.Afterthat,youmaydecidetoadoptotherfinancialprinciples and concepts as you build a solid business foundationandincomestream.

You might worry about charging too much for fear of losing business or not receiving any; this is true ofbothnewandseasonedNLCPs.Itiscriticallyimportant to remember, whether working for your own client or as a subcontractor, that you are a business owner and should charge a viable rate for your business, not someone else’s.

Key Words:

Business | Marketing | Finances |Limited Liability Company | Sole Proprietor | Pay Scale | Earning

Starting Your Own Business? How to set your rates.BY H. ADAM AGUILARRN, BSN, PHN, CNLCP®

The Business of NLCP



23

Abusinessplanisimportant,yetitmaybedifficulttocreatewithinsufficientstatisticaldata.Colleaguesmaybereluctanttoshareinformationabouttheirbusinessincome,expenses,andotherfinancialdata.This might mean you would work with anecdotal data,clearlynotreliable.Doanobjectiveanalysistodetermine the appropriate rates for your business.

Is Your Billing Rate Too Low? Probably.

In2010,anarticleintheJournalofNurseLifeCarePlanningfoundthatoneoutofseven(14.3%)NLCPssurveyedreportedsignificantlyimprovingtheirfinancialsituationbybecomingalifecareplanner(Brock,2010),yettheremaining85.7%didnot.Thesefindingsweresignificantnotonlybecausewasitspecifictothenurselifecareplanningpopulation:it indicated a majority of those surveyed may have fallenvictimtoinadequatebusinessplanningorother errors that limited their entrepreneurial success.

In 2006, Babitsky, Mangraviti Jr., & Babitsky offered two steadfast rules for expert witnesses when setting fees.

• Far more experts undercharge than overcharge, usually the result of inexperience and a psychological hesitancy to charge hundreds of dollars per hour for theirtime.

• When experts increase their fees, they get more work.

Attorneysarepaidtowin.Theyseekoutthebestpossible experts to do that. Many assume that abetterexpertchargesmore.Thisassumptionresultsinincreaseddemandforthe“best”expertswhochargeapremiumfortheirservices(Babitsky,MangravitiJr.,&Babitsky,2006).Simplyput,

the more you charge for your services, the more prospectiveclientswillvaluethem.Keepthisinmind.

Before You Decide

You might want to earn what you earned immediately before opening your business or a salarylikeothernurseswithadvancedskills.Afterall,youinvestedineducationbybecomingcertifiedas a life care planner and may feel you deserve an advanced-skills salary. There is no one answer that willfiteveryone’ssituation.

Youcouldlookatstatistics.Forexample,the75thpercentileofRegisteredNurse(RN)annualsalariesis$85,960(U.SBureauofLaborStatistics,2018).Butthismaybetoogeneralized:AANLCPdefinesNLCPasaspecialtyrequiringadvancedskills(AmericanAssociationofNurseLifeCarePlanners,2015).Thismeansyoucouldchoosethe90thpercentile,or$102,770(U.SBureauofLaborStatistics,2018),asyour goal.

Inadditiontobeinganursewithadvancedskills,consider that a successful NLCP must be highly knowledgeable,proficientwithwords,anexpertwitness, and a smart business owner. Compare this expertisetonursesearningsomeofthehighestincomes,suchasaCertifiedNurseAnesthetists(CRNA).The2017nationalannualmeansalaryforaCRNAwas$169,450(UnitedStatesDepartmentofLabor,2017).Also,considerthataCRNAistypicallyan employee. You are self-employed, and an expert, deservingofapremiumfortheeffortsandrisksyouare undertaking. These risks are above and beyond thoseofaCRNAemployeeanddeserveafinancialreward.

Think about why many physician expert witnesses charge $600-$800 per hour, or more depending on specialty, for medical-legal work. One may assume it is based on the amount of work they performed or the number of years they received a formal education;thatassumptionmightnotbecorrect.Most physician experts hire smart business people to advise them on what to charge. You should learn similarbusinessadministrativeskillsandseekpropercounsel.



24

Obtaining accurate and reliable NLCP billing rate datacanbechallenging.NursingBusiness(2013)reports that life care planners are charging between $80-$400 per hour, a wide range. Another source claims life care planners charge, on average, $150/hour(FIGServices,Inc.,2013).In2013,onelifecareplanner reported she charged precisely $150 per hour(KristenJonesConsulting,2013),whichwhenadjustedforinflationwouldbeapproximately$175per hour in 2018.

SEAK, Inc. recently released a survey of expert witnessfeesin2017(Mangraviti,Jr.,Esq.,Babitsky,Esq.,&Donovan,Esq.,2017).Atotalof40LCPsresponding reported an average billing rate for case preparationandreviewof$267perhour(range,$150to$500).Thoughthissmallsamplesizedidnotdifferentiateamongthelifecareplanners’certifications,education,andtraining,thefindingswere nevertheless enlightening.

Zero percent found that raising their rates priced them out of the market, evidence that LCP rates may be underpriced and that the marketplace lacks resistance to increases. Also, experts doing mostlydefenseworkreportedsignificantlyhigherhourlyfeesacrosstheboardthanplaintiffexpertsor experts who work equally for defendants and plaintiffs.

Determining Your Rates

There are many schools of thought on how to determinerates.StephenFishman(2013)notestwowaystodetermineanhourlyrate:1)calculatebasedontheexpenses,and2)investigatethemarketplaceto see if you should adjust the rate up or down. Dependingonmarketconditions,youmaybeableto charge more, or might have to get by on less.

However, there is a limit to how low to go. If the marketplaceisfullofcompetitorswhoconsistentlyundercharge for their services, it will be hard to grow your business; you may need to consider relocatingormarketyourselftomakeyourselfstandout. Fortunately, many NLCPs can accept cases from large geographic areas, working with an internet-

basedmodel,sothiscanmitigatetheeffectoflocalmarketplace limits.

Should a seasoned NLCP charge a higher rate thananewone?Shouldunderlyinglicensureorcertificationmakeadifference?Whilethereisdebate, this is clear: the marketplace decides if an excessive hourly rate is too high, and according to the SEAK survey, that point has not been reached.

Once the business is operating on a solid foundation another set of criteria may help you modify the appropriate hourly rate. As the business grows, its financial ratios should also improve, resulting in higher income and profitability.

Calculate Prior Year Expenses

Assumingyoustartabusinessfromhomeafterleavingafull-timeemployeeposition,thebasisforyourinitialsalary(Figure1)isyourlastyear’spersonal living expenses. This is the smallest salary necessary to maintain your present lifestyle while yourbusinessisstarting,notwhatyoushouldexpectto earn into the future.

Begin by determining non-business expenditures wereovertheprioryear(e.g.,rent,mortgage,insurance,utilities,food,fuel,medications).Donotincludeincometaxes.Aquickwaytoestimatetheseexpenditures is looking at gross income amount from the past year’s tax return minus income taxes paid. You can also create a prior year income/expensereportusingpersonalfinancesoftware,ifapplicable.

Rememberyouarelookingtoestimatepersonalexpenditures;anapproximationwillwork.ThePriorYearExpenditures(PYE)inFigure1willrepresentthe income needed to maintain current lifestyle. Assume that you are the sole source of household incomeandstartingahome-basedbusinessasasoleproprietor(i.e.,nolimitedliabilitycompany[LLC],partnership,S-Corp.,orC-Corp.)Inthisexample,our NLCP is a California RN earning the mean annual Californiasalaryof$102,700(U.SBureauofLaborStatistics,2018).



25

When you become self-employed, you will lose any employer-based health insurance. You’ll need to account for replacement coverage cost. Typically, an employee and employer share this cost, so make sure to determine the whole cost you’ll be taking on. The health insurance cost represented in Figure 1wasestimatedusingehealth.com.Thecostforthis NLCP and family of four was $1,100-$1,200 per month. Added to her mean RN salary, this yields an annual PYE of $116,500.

Add Business Fees and Taxes

Business Entities.Youwillhavefixedcoststomaintain your business. How you choose to classify itwillgreatlyaffectinitialoperatingcosts.Considerdifferenttypes,suchasaC-Corp.,S-Corp.,LLC,sole-proprietorship, or partnership. Each state has fees associated with registering and maintaining business entities.Researcheachbeforechoosing.Also,ifyoucontinuetoworkasanemployeeforanotherorganization(e.g.,ahospital)whileoperatingyourbusiness separately, the tax liability and other associated expenses could be complicated. Your tax preparer can help you, or get advice from a tax attorney.

For example, in our example, California charges a business owner $800 per year plus a $25 annual StatementofInformationfilingfeetomaintainaC-Corp., S-Corp., or an LLC, regardless of any income orprofit.Latefilingincursapenaltyof$250.Thesefees can be less in other states.

Donotforgetthecosttofileataxreturn,whichinCalifornia runs about $1,250-$1,500 per year, due totheuseofaCertifiedPublicAccountanttofileanLLC or corporate return. In many states, you can use your local tax preparer for far less.

Taxes. Add the cost of income taxes and self-employment tax, if any, to the Annual Personal Expenses.Calculateyoureffectivefederalandstatetax rates. Take the amount of tax paid the year prior (i.e.,federalandapplicablestatetax)anddivideitby the taxable income from the tax returns, then multiplyby100toarriveatapercentage(Lee,

2018).MultiplytheeffectivetaxratesbythePYEtoestimateyourfederalandstatetaxes.AddthistotheAnnualPersonalExpenses(Figure1).

Self-employment tax may be due in some states; ask a local tax preparer if this applies to you and how to calculate it.

Summary

One of the biggest mistakes new nurse entrepreneurs make is undervaluing their worth and, consequently, their billing rates. Now you’ve estimatedtheincomeneededtomaintainyourcurrent lifestyle. This doesn’t include business operatingexpenses,northeadditionalincomeneededtoproduceaprofit,i.e.,morethanyouneed to maintain your current lifestyle. In the next installment,we’lltalkaboutprofit,therewardfor taking the risks of being in business and not considered part of payroll expense or salary cost.

[Figure 1:]

https://wealthyeducation.com/financial-ratio-categories/

https://wealthyeducation.com/financial-ratio-categories/ https://wealthyeducation.com/financial-ratio-categories/



26

Life Care Planning Certifications:A personal ViewBY NANCY HAMADYRN, CRRN, CCM, CLCP, MSCC, CNLCP®

Key Words:

Life Care Planning | LCP Certifications

Nurse Life Care Planning

The ICHCC (https://www.ichcc.org/)

• Requires a minimum of three years of fieldexperiencewithinthefiveyearsprecedingapplicationforcertification.Acandidatemustcomplete one of the following components;• SupervisionofoneyearwithaCertifiedLife Care Planner. • Graduationfromanaccreditedtrainingprogramwhichincludespracticumorinternship,of which requires the development of an inde-pendentlifecareplanforreviewandcritiquebyafacultymemberwhoisaCertifiedLifeCarePlanner(CLCP).• Hold the entry-level academic degree or certificate/diplomaforlicensedprofession.

AccordingtotheCNLCPCertificationboard,“certifi-cationisaformalrecognitionthatvalidatesknowl-edge, experience, skills and clinical judgment within aspecificnursingspecialty;and,assuch,isreflectiveofamorestringentprofessionalpracticestandard.Itreflectsachievementofproficiencybeyondbasiclicensure”.

Therearetwolifecareplanningcertificationsavail-abletonurses,CertifiedLifeCarePlanner(CLCP)andtheCertifiedNurseLifeCarePlanner(CNLCP).TheCLCPcredentialisavailablethroughtheInternationalCommissiononHealthCareCertifications(ICHCC),andtheCNLCPdesignationisavailablethroughtheCertifiedNurseLifeCarePlannerCertificationBoard(CNLCPCB).Eachcertificationrequires120hoursofpost-graduate or post-specialty degree training in lifecareplanningandcompletionofalifecareplan.

https://www.ichcc.org/



27

The CNLCP Certification Board (https://cnlcp.org/)

• Requires a current unrestricted registered nurse license, minimum three years.• Minimumoftwoyearsfulltimepaidpro-fessionalexperienceinarolethatutilizesthenursing process in assessing an individual’s long term/lifetimetreatmentneedsandcostsacrossthecontinuumofcare.• Completionof120continuingeducationunits related to life care planning or in equiva-lent areas that can be applied to the develop-ment of a life care plan or pertain to the service delivery applicable to life care planning within thefiveyearsimmediatelyprecedingapplica-tion.

Or:

• Verificationoftwoyearsoflifecareplan-ning experience, or a variant thereof that in-corporates the nursing process and skill set inherenttotheassessmentanddeterminationoftreatmentneedsandtheirrespectivecosts,acrossthecontinuumofcare,withinthepastfiveyearsimmediatelyprecedingtheapplica-tions.

Thedifferenceinthetwocertificationsistheuse of the nursing process by the CNLCP and a current valid RN license. The CLCP is avail-abletoindividualsfromdifferentfieldssuchasvocationalrehabilitation,occupationaltherapy, physical therapy, and psychology, and counseling. The nurse life care planner mustbeabletoexplainthedifferencebe-tween them related to underlying licensure duringdepositionand/ortrial.

IoriginallyobtainedtheCLCPcredentialin2003through the University of Florida, and my CNLCP from the CNLCPCB granted through reciprocity in 2011. However, in 2015, I took the FIG Nurse Life Care Planning course to strengthen my understand-ing of the nursing process and bolster my standing as

anexpertindepositionandtrial.Thenursingpro-cessasdefinedbytheAmericanNurses’Association(ANA)includesassessment,analysis,planning,intervening/delegating,andreassessment(Apuna-Grum-mer,D.,&Howland,W.2013).Iamcomfortablethat

I have completed the necessary training through FIG. Ihavenotbeenchallengedinadepositionabouthavingbothcertifications.

Nurseshaveanimportantroletoplayinthefieldoflife care planning. Our training and experience en-able us to recommend items in the plan that other disciplines can’t such as home health care, consul-tations,andtherapies,tonameafew.Asnurses,weareuniquelyqualifiedtoadvocateforourclientsthroughourholisticapproachtocareandcollabo-rativeskills.Usingnursingdiagnosesinourplansfurthersupportsourrecommendationsandsetsusapart from other disciplines.

I graduated from nursing school in 1980, and like manynursesofmygeneration,IcompletedmyRNtraining in a diploma school of nursing. When ques-tionedinadepositionwhyIdonothaveaBSN,Isaythatitwasapersonaldecisionatthetime,andtheopposingattorneyseemedsatisfiedwithmyanswer.Myeducation,licensure,trainingandyearsof experience as a nurse, nurse life care planner, and nursecasemanagerqualifymetopracticelifecareplanningandmakerecommendationswithinmynursingscopeofpractice.Nonetheless,Idecidedtocomplete my degree and am currently enrolled in Chamberlain RN to BSN program.

Resources:

Apuna-Grummer,D.,&Howland,W.A.(2013).Acore curriculum for nurse life care planning. Bloomington, Illinois: iUniverse, LLC.

https://cnlcp.org/



28



29

2012XII.1 CodingandCostingXII.2 ElectricalStimulationTechnologyXII.3 Preconference / Brain InjuryXII.4 VeteransAdministration

2013XIII.1 LCP for Motor and Developmental DisordersXIII.2 Ethical Topics in LCPXIII.3 Preconference / Exemplars in NLCPXIII.4 HomeModifications

2014XIV.1 Technology UpdatesXIV.2 LCP Across All AgesXIV.3 Psych topics in LCPXIV.4 LCP and the ACA

2015XV.1 TopicsinTransplantationXV.2 Updates in Spinal Cord InjuryXV.3 BurnsXV.4 Perinatal / Childhood

2016XVI.1 PainXVI.2 GI issuesXVI.3 InternationalLCPXVI.4 Home Care

2017XVII.1 Brain InjuryXVII.2 The Business of Life Care PlanningXVII.3 Back and SpineXVII.4 MobilityandExtremityFunction

2018XVIII.1CostingandCoding

2019XIX.1 Presidents Issue

Index of Past Issues

Documents

Licensure | Qualifications | Certifications · CERTIFICATE PROGRAMS 16 THE PROCESS of ACCREDITATION and STATUS UPDATE 19 TECH CORNER: LIVING ... CCM, CDMS, CRC Shelly Kinney, RN,