AHA 2012 Annual Meeting Program.pdf - Arkansas Hospital ...

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SCHEDULE
AT A GLANCE
Wednesday, October 3
9:00 a.m. – 6:00 p.m.
AHA Annual Meeting Registration (Mezzanine Lobby)
9:30 a.m. – 3:30 p.m.
Leadership Workshop (Salon C)
12 noon – 1:00 p.m.
Leadership Workshop Luncheon (Salon B)
1:00 p.m. – 2:30 p.m.
Arkansas Health Executives Forum Board Meeting
(Hoffman Room)
3:45 p.m. – 5:15 p.m.
AHA Board Meeting (Manning Room)
5:15 p.m. – 5:30 p.m.
AHA Nominating Committee Meeting (Hoffman Room)
6:00 p.m. – 8:00 p.m.
AHA Membership Reception (Salon C)
Thursday, October 4
7:00 a.m. – 6:45 p.m.
AHA Annual Meeting Registration (Mezzanine Lobby)
7:30 a.m. – 9:15 a.m.
CONCURRENT SESSIONS
• ACHE/AHEF Breakfast (Salon C)
• Patient Safety/Quality Leadership Workshop (Arkansas Ballroom)
9:30 a.m. – 11:00 a.m.
AHA/AHAA Opening/Keynote Session (Salons A-B)
11:00 a.m. – 11:45 a.m.
Arkansas Medicaid 2012 Inpatient Quality Awards
AHA Annual Meeting of the House of Delegates (Salons A-B)
11:30 a.m. – 1:00 p.m.
Arkansas Organization of Nurse Executives Luncheon (Arkansas
Ballroom)
11:30 a.m. – 1:00 p.m.
Arkansas Society for Healthcare Marketing and Public Relations
Luncheon (Hoffman Room)
12 noon – 1:00 p.m.
Executive Leadership Luncheon (Salon C)
1:00 p.m. – 2:00 p.m.
ACHE Advancement Session (Manning Room)
1:00 p.m. – 4:00 p.m.
AHA Trade Show (Governor’s Halls I-II)
6:00 p.m. – 6:45 p.m.
AHA Membership Reception (Salon C)
6:45 p.m. – 9:00 p.m.
AHA Awards Dinner (Salons A-B)
Friday, October 5
7:15 a.m. – 9:30 a.m.
Annual Meeting Registration (Salon A Foyer)
7:30 a.m. – 9:00 a.m.
Special Membership Breakfast on Healthcare Reform (Salon B)
9:00 a.m. – 12 noon
ACHE Face to Face Workshop (Salon A)
2 82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
WHO
SHOULD
ATTEND?
The AHA Annual Meeting is designed to meet the
needs of Arkansas healthcare leaders and
frontline providers including:
• CEOs, Administrators and System Executives
• COOs, CFOs
• Trustees
• Nursing and Patient Care Executives
• Compliance Officers
• Quality Leaders
• Marketing and PR Executives
• Human Resource Directors and Managers
• Department Directors and Managers
WHAT’S NEW…
• On Friday morning, we will have a special
“members only” breakfast on the current state of
healthcare reform and to discuss why politicians
and lobbyists can’t “heal” healthcare.
• On Wednesday, don’t miss the dynamic leadership
workshop, “Healthcare Leadership: Thoughts from
My Foxhole,” lessons learned from the Army
Medical Corps and something for your entire
management team!
• During the annual trade show featuring more than
100 exhibiting companies, you will have the
opportunity to talk one-on-one with vendors
offering new and exciting products. A valuable door
prize will be awarded to one lucky participant.
• The ACHE 3-hour Face to Face workshop takes
place Friday morning and is available to all
participants for credit or not, depending on the
registration fee paid.

THIS YEAR’S ANNUAL MEETING of your
Arkansas Hospital Association comes at an especially
opportune time. It’s a time when hospitals need
help, and that’s what we’re offering.
With the theme of “Rebooting Healthcare,” the
Annual Meeting addresses what we all know...
rebooting is exactly what we’re doing on almost every
level in our hospitals these days. We’re meeting new
federal Medicare reimbursement guidelines, potential
changes in the state Medicaid system, and keeping
up with the growing list of expectations put on
hospitals every day.
“Embracing Change to Advance Medicine” is the
rest of our theme. Yes, we’re embracing change. Eyes
wide open, we choose to look at the suggestions
coming from every direction as overall positives.
Because what’s happening in America is a
metamorphosis of the way hospitals provide care and
do business.
If we don’t choose to look at change as a positive,
we may sink under the weight of new expectations.
So our hospitals meet challenges with rapid cycle
change strategies every day.
This affects everyone at every level – our
administrators, trustees, physicians, front line staffs,
certified data specialists, clerical staffs, housekeepers,
Robert “Bo” Ryall
AHA President
Larry Morse
AHA Chairman
dieticians, radiology teams, maintenance specialists –
you get our meaning, here.
Rapid change can feel heavy sometimes, until we
bring the reason back into focus. We are all
passionate about the care of our patients. We want
our patients to heal in an environment where quality
reigns supreme. We are advancing medicine by
changing the way “things have always been done.”
And this annual meeting (and its trade show, which
brings the newest in tools to help you advance care) will
help you and your co-workers with that change.
Wednesday’s Leadership Workshop brings us one
of the best military/medical minds in the business. In
S P E A K E R S
Steve Berkowitz Brian Boyle Megan Cundari Kiki L'Italien
“Thoughts From My Foxhole,” Major General (Retired)
David Rubenstein, FACHE, will share his expertise in
managing healthcare challenges from the front
lines...in environments that can change instantly.
We also bring you sessions addressing
overcrowding in the Emergency Department,
maintaining superior quality and patient safety with
both accountability and cost controls, and looking at
healthcare through the all-important lens of a
patient’s eyes.
Exploration into why politicians can’t fix
healthcare, a candid look at the 2012 elections and a
special ACHE face-to-face workshop on the future of
hospital-physician relations round out the program.
In the midst of honing our skills and learning the
latest, we’ll also take time to celebrate. Please join
us for the annual Awards Dinner, where the finest in
Arkansas healthcare leadership, statesmanship,
distinguished service and healthcare marketing are
honored. And the annual Trade Show promises to
deliver answers to the challenges our hospitals face,
especially in these times.
Please register today, and bring as many from your
hospital teams as possible. This Annual Meeting offers
concentrated, multiple solutions to our Rebooting of
Healthcare that few other meetings can match.
David Rubenstein Benjamin Sasse Sandra Schneider Sue Tedford Daniel K. Zismer
82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
3

LEADERSHIP WORKSHOP
Arkansas Hospital Association
82 nd Annual Meeting and Trade Show
Peabody Hotel and Statehouse Convention Center
Little Rock, Arkansas | October 3-5, 2012
Wednesday, October 3
9:00 a.m. – 6:00 p.m.
ANNUAL MEETING REGISTRATION
(Mezzanine Lobby)
9:30 a.m. – 3:30 p.m.
LEADERSHIP WORKSHOP
“Healthcare Leadership:
Thoughts From My Foxhole”
(Salon C)
Major General (Retired) David A. Rubenstein,
FACHE, Universal City, Texas
From his view in the foxhole, hospital officials and
military leaders share similar missions — both are
leading teams from the front lines. Major General
(Retired) David A. Rubenstein, FACHE, will describe
4 82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
healthcare leadership from his perspective as a senior
military healthcare executive. Drawing on his military
experience and knowledge of healthcare
management, Rubenstein will discuss the challenges
facing healthcare and how to best prepare future
healthcare leaders to face those challenges and
improve the healthcare system.
This presentation is an interactive dialogue that leads
participants to consider the leader development of
themselves and their teammates, and to apply tools
that address leader and mentor development.
Workshop objectives
• Apply case studies to develop or assess personal
leadership mission, vision and philosophy.
• Develop an approach for mentoring and coaching
the next generation of healthcare leaders.
4.5 Nursing contact hours will be awarded to
nurses attending the entire workshop.

Wednesday, October 3 continued
12 noon – 1:00 p.m.
LEADERSHIP WORKSHOP LUNCHEON
(Salon B)
1:00 p.m. – 2:30 p.m.
ARKANSAS HEALTH EXECUTIVES FORUM
BOARD MEETING (Hoffman Room)
3:45 p.m. – 5:15 p.m.
AHA BOARD MEETING (Manning Room)
5:15 p.m. – 5:30 p.m.
AHA NOMINATING COMMITTEE MEETING
(Hoffman Room)
6:00 p.m. – 8:00 p.m.
AHA MEMBERSHIP RECEPTION (Salon C)
Sponsored by Arkansas Blue Cross and Blue Shield
Thursday, October 4
7:00 a.m. – 6:45 p.m.
ANNUAL MEETING REGISTRATION
(Mezzanine Lobby)
7:30 a.m. – 9:15 a.m.
CONCURRENT EDUCATIONAL
SESSIONS
ACHE/AHEF BREAKFAST (Salon C)
“Developing Solutions to Emergency
Department Overcrowding”
Sandra Schneider, MD, FACEP, Immediate Past
President, American College of Emergency
Physicians, Professor and Chair Emeritus,
University of Rochester Medical Center, Rochester,
New York
Dr. Schneider has been a leader on the issue of reducing
overcrowding in the nation’s emergency departments
(ED) and on implementing high-impact, low-cost
solutions to address the problem of holding or
“boarding” patients in the ED. She will discuss her
passion for reducing the number of patients in the ED
to ensure timely care and dollars saved by the hospital.
1.5 Nursing contact hours will be awarded to
nurses attending the entire session.
PATIENT SAFETY/QUALITY LEADERSHIP
WORKSHOP (Arkansas Ballroom)
“Superior Quality and Safety through
Reform…What Successful Organizations
Must Accomplish”
Steven M. Berkowitz, MD, SMB Health
Consulting, Austin, Texas
Impending healthcare reform and the resultant
pressures of accountability and cost control will
challenge even the best organizations to achieve
superior outcomes. Maintaining superior quality is
essential in an era of consumer choice and data
transparency. It is possible to achieve excellent
quality and safety outcomes, and deliver a favorable
bottom line.
Dr. Berkowitz will discuss how embracing data
transparency is a powerful tool to improve clinical
outcomes; review how organizations have
successfully implemented evidence-based practice
guidelines; and demonstrate how it is necessary to
master pay for performance in order to be
successful with Medicare.
Objectives for the meeting are:
• Examine how differentiating Market from Mandate is
essential in understanding healthcare reform
• Present the 12 challenges organizations must
overcome in order to be successful in 2012
1.5 Nursing contact hours will be awarded to
nurses attending the entire session.
9:30 a.m. – 11:00 a.m.
AHA/AHAA OPENING SESSION
(Salons A-B)
Bo Ryall, AHA President and CEO
Larry Morse, AHA Chairman
Lynn Smith, AHAA President
82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
5

KEYNOTE ADDRESS
“Through the Eyes of the Patient: The
Brian Boyle Story ”
Brian Boyle, Author, Iron Heart, Welcome,
Maryland
Brian Boyle tells his personal story of his fight back from
near death after a horrific automobile accident. He will
focus on his experience as a patient who, upon
emerging from a medically induced coma, was unable
to move or talk, yet could hear, see and feel pain. Mr.
Boyle will provide vital information from the patient’s
perspective to help participants gain insight about how
to provide care to patients who are aware, yet unable
to communicate. His incredible story will provide
lessons for all.
1 Nursing contact hour will be awarded to
nurses attending the entire session.
11:00 a.m. – 11:45 a.m.
ARKANSAS MEDICAID 2012 INPATIENT
QUALITY AWARDS (Salons A-B)
AHA ANNUAL MEETING OF THE HOUSE
OF DELEGATES
CEOs of AHA member institutions are
encouraged to attend.
11:30 a.m. – 1:00 p.m.
ARKANSAS ORGANIZATION OF NURSE
EXECUTIVES (ArONE) LUNCHEON
(Arkansas Ballroom)
Update from the Arkansas State
Board of Nursing
Sue Tedford, MNSc, APN, RN, Executive Director
Arkansas State Board of Nursing, Little Rock
Always popular with ArONE members, Sue Tedford,
executive director of the Arkansas State Board of
Nursing, will discuss important issues and updates from
the Board, as well as national trends regarding the
nursing profession.
1 Nursing contact hour will be awarded to
nurses attending the entire session.
6 82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
11:30 a.m. – 1:00 p.m.
ARKANSAS SOCIETY FOR HEALTHCARE
MARKETING AND PUBLIC RELATIONS
(Hoffman Room)
“Leveraging Facebook for Healthcare”
Kiki L'Italien, Senior Advisor, Professional Speaker
and Author, The Nour Group, Inc., Atlanta, GA
Learn how Facebook (and other social media) can help
your hospital interact with patients, physicians and
employees by building a sense of community and longer
term relationships.
12 noon – 1:00 p.m.
EXECUTIVE LEADERSHIP LUNCHEON
(Salon C)
“2012 Election Forecast”
Megan Cundari, Senior Associate Director, Federal
Relations, American Hospital Association,
Washington, DC
Objectives for the discussion are:
• Examine how the November elections will affect
healthcare.
• Review how the election results will affect the
ACA law.
1 Nursing contact hour will be awarded to
nurses attending the entire session.
1:00 p.m. – 2:00 p.m.
ACHE ADVANCEMENT SESSION
(Manning Room)
Michael Givens, FACHE, Administrator
St. Bernards Medical Center, Jonesboro
1:00 p.m. – 4:00 p.m.
AHA TRADE SHOW (Governor’s Halls I-II)
Don’t miss the opportunity to experience some of the
latest innovations in healthcare products and services –
all under one roof. The AHA Trade Show is the perfect
place to visit with vendors, see and compare products
and services, discover new technologies – and save time
by visiting numerous suppliers in one convenient
location. Exhibitor participation in the Trade Show is
very important to the annual meeting and helps YOU

enjoy a low registration fee. Please include the Trade
Show in your Thursday afternoon plans.
6:00 p.m. – 6:45 p.m.
AHA MEMBERSHIP RECEPTION (Salon C)
6:45 p.m. – 9:00 p.m.
2012 AHA AWARDS DINNER (Salons A-B)
Join us to honor recipients of the A. Allen Weintraub
Memorial Award, the AHA’s highest honor; the
Distinguished Service Award; Statesmanship Awards;
and the C. E. Melville Young Administrator of the Year
Award. The Awards Dinner will also feature the
presentation of the annual 2012 Diamond Awards
honoring work by marketing and public relations
professionals.
Friday, October 5
7:15 a.m. – 9:30 a.m.
ANNUAL MEETING REGISTRATION
(Salon A Foyer)
7:30 a.m. – 9:00 a.m.
SPECIAL MEMBERSHIP BREAKFAST ON
HEALTHCARE REFORM (AHA Members
Only) (Salon B)
“Why Politicians and Lobbyists
Can’t Heal Healthcare”
Benjamin E. Sasse, PhD, a former U.S. Assistant
Secretary of Health, President, Midland University,
Fremont, Nebraska
American healthcare is in crisis. Costs are exploding,
quality is uneven and often unknowable, and nearly eighty
million of us are uninsured at some point each year. It is
entirely understandable that the American people want
explanations, solutions and leadership. There is much
discussion of reform in Washington. Unfortunately, little
of this talk amounts to real change. Why not? Because
the problems are actually even worse than the American
people understand. Because of the retirement of the
baby boomers, which started in 2011, we will begin a
decline from 3.8 to 2.4 workers per beneficiary.
Healthcare is already the largest sector of the U.S.
economy and will soon be ballooning beyond any
sustainable level. The three policy levers that are
available that might address this crisis – provider
reimbursement decreases, benefit cuts, or tax increases
– are not the kinds of proposals politicians raise their
hands to propose. And the only real solution – actual
health sector innovation – is not something current
payment systems can stimulate. The future will be
both treacherous and fascinating.
1 Nursing contact hour will be awarded to
nurses attending the entire session.
9:00 a.m. –12 noon
ACHE FACE TO FACE WORKSHOP
(Salon A)
“Integration vs. Competition: The
Future of Hospital-Physician Relations”
Daniel K. Zismer, PhD, Associate Professor of
Health Policy and Management, University of
Minnesota, Duluth, Minnesota
Combining legal and delivery system expertise, Dr.
Zismer will help participants design profitable integration
strategies that offer benefits from the long-term
advantages of an integrated health system, including
physician employment and partnership options.
• Discuss the tools and implementation steps necessary
to create and maintain integrated hospital-physician
relations.
• Identify the real drivers of physician satisfaction and the
steps you can take to improve current conditions.
We will also discuss how:
• An integrated model affects operating economics and
how it can be leveraged to your financial advantage.
• To recognize the market, technology and related
health policy issues that indicate why now may be the
best time to foster hospital-physician collaboration.
3 Nursing contact hours will be awarded to
nurses attending the entire workshop.
12 noon
ANNUAL MEETING ADJOURNS
82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
7

Continuing Education Information
AHA Annual Meeting Educational Sessions, October 3-5
American College of Healthcare Executives (ACHE) Qualified Education
ACHE members wishing to satisfy Qualified Education credit hours (formerly called Category II credit), click on
www.ache.org and update your personal record on the “My ACHE” page by indicating your attendance at the AHA
Annual Meeting.
Nursing Home Administrators
Annual meeting educational session attendance has been approved for a maximum of 12 contact hours of continuing
education by the Arkansas Department of Health and Human Services Division of Medical Services Office of Long
Term Care (AR 5360-100512-12). (On Thursday morning, October 4, participants have the opportunity to attend
one of two sessions for continuing education hours – the ACHE Breakfast Meeting or the Patient Safety/Quality
Leadership Workshop.)
Nursing
Nursing contact hours will be awarded nurses attending designated “approved” sessions. Nurses must attend each
session in its entirety and sign-in at each session.
The Arkansas Hospital Association is an approved provider of continuing nursing education by Arkansas Nurses
Association, an accredited approver by the American Nurses Credentialing Center’s COA.
Quality
Approval is pending for continuing education hours for CPHQ recertification by the Healthcare Quality Certification
Board.
Compliance
Approval is pending for continuing education credit from the Health Care Compliance Association.
American College of Healthcare Executives Workshop (Friday, October 5)
This program is presented locally by the Arkansas Health Executives Forum. The American College of Healthcare
Executives has awarded 3 ACHE Face-to-Face Education (formerly called Category I) credit hours to this program. To
receive credit, participants’ names MUST appear on the sign-in sheet and appropriate registration fees must be paid.
8 82 ND ANNUAL MEETING | OCTOBER 3–5, 2012

Corporate Sponsors and Trade Show Exhibitors
The Arkansas Hospital Association wishes to express its appreciation to the following corporate
sponsors who have contributed to the 2012 Annual Meeting:
Diamond Level
Arkansas Blue Cross and Blue Shield
Platinum Level
Nabholz Construction Services
Gold Level
Horne CPAs and Business Advisors
AAMSCO Identification Products
Administrative Consultant
Service, LLC
AHA Workers Compensation
Self-Insured Trust
Airgas Medical Services, Inc.
Alberici Healthcare Constructors
American Data Network
American Red Cross
ArCom Systems
Arkansas Blood Institute
Arkansas Health Care Access
Foundation, Inc.
ARORA
Care View Communications
CareLearning
Chem-Aqua, Inc.
Commerce Bank, N.A.
Community Health Centers of
Arkansas
Construction Specialties
CoreSource
Correct Care, Inc.
Coventry Health Care
CPSI
Crews & Associates, Inc.
Cromwell Architects Engineers
Silver Level
Arkansas Foundation for Medical Care
BKD, LLP
Bancorp South Insurance Services
CDI Contractors, LLC
Friday Eldredge & Clark, LLP
The Midland Group
Professional Data Services
Crothall Healthcare
DocuVoice LLC
The Estopinal Group
EZ Way, Inc.
Fleming Companies
Garrett Callahan Company
Guldmann, Inc.
Hagan Newkirk Financial Services
Harrison Energy Partners
HBE Corporation
HEALTHeCAREERS Network
Healthland
Hill-Rom
HP Enterprise Services
Hughes, Welch & Milligan
Information Solutions
Inman-EMJ Construction
Innerface Architectural
Signage, Inc.
Johnsonite Flooring
LifeShare Blood Centers
Lonseal
Mass Enthusiasm Inc.
MDM Healthcare
Merritt Hawkins an AMN
Healthcare Company
Bronze Level
EXIT Marketing
Copper Level
Arkansas Association for Hospital
Trustees
Arkansas Health Executives Forum
Midwest Healthcare, Inc.
Morgan Hunter HealthSearch, Inc.
National Research Corporation
NovaSys Health Network
NTelagent
Pinnacle Health Group
Prognosis Health Information
Systems
RehabCare
Robins & Morton
Saint Louis University School
of Public Health
Service Professionals Inc.
Shannon Sales, Inc.
Signet Health Corporation
Specialized Radiology Partners
STL Communications, Inc.
SUNRx
Treadway Electric Company
UAMS Center for Rural Health
UAMS South Central Telehealth
Resource Center
VALIC Financial Advisors
Vision Service Plan
Voice Products, Inc.
Western Waterproofing
82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
9

REGISTRATION AND FEES
Each participant planning to attend the 2012 AHA Annual Meeting
and Trade Show must complete and return a registration form and all
fees to the AHA by 4:30 p.m., Monday, September 24, 2012. After
that time, advance registration will close, and participants must register
on-site (see program agenda for registration times and additional fees
assessed for late registration). Confirmation letters will be sent upon
receipt of registration forms.
Name badges, tickets, and registration packets are to be picked up
at the AHA Registration Desk located in the Mezzanine Lobby of The
Peabody Little Rock during designated registration times (see program
agenda). Registration materials for the Arkansas Hospital Auxiliary
Association’s annual meeting may be picked up at the DoubleTree
Hotel.
Please contact Lyndsey Dumas at 501-224-7878 or
ldumas@arkhospitals.org, with questions about registration. Questions
concerning meetings or program content should be directed to Beth
Ingram at 501-224-7878 or bingram@arkhospitals.org.
The Annual Meeting registration and special event fees are listed on
the registration form.
SPECIAL EVENT FEES
Special event fees are listed on the registration form and are in
addition to the AHA member registration fees. Requests are processed
in the order received. Participants are encouraged to complete and
return the registration form promptly. If available, unallocated seats will
be sold at the registration desk. All meals are guaranteed in advance and
are not refundable after September 24.
REQUESTS FOR REFUNDS
Refunds, minus a $50 processing fee, will be granted if requests are
received in writing by the AHA on or before September 24. No refunds
will be issued after that date. Unpaid registrants who fail to attend must
pay the entire registration fee. Substitutions, however, are permitted.
Registrations that are phoned in or faxed are subject to the same
cancellation policy. Fax any refund requests to Lyndsey Dumas at 501-
224-0519.
10 82 ND ANNUAL MEETING | OCTOBER 3–5, 2012
PARKING
Annual Meeting participants are urged to allow patience and extra
time to secure parking space in downtown Little Rock. The Peabody
Little Rock offers valet parking ($14 per day or $20 for overnight
parking). Additional parking is available at the following locations
(please note prices are subject to change):
• Second and Main Street Parking Garage (one block south of The
Peabody); $9 per day
• Municipal Parking Garage (below the DoubleTree Hotel, a short
walk from The Peabody); $7.50 per day
• River Market parking lot (several blocks east of the Statehouse
Convention Center); $5 per day
HOTEL ACCOMMODATIONS
A room block has been reserved for October 2-4 at The Peabody Little
Rock, which is located at Three Statehouse Plaza in downtown Little Rock.
To take advantage of the annual meeting rate of $145 for single or double
occupancy, please identify yourself as an AHA Annual Meeting registrant.
The room block will expire on September 11. Reservations after that
date will be subject to availability. The hotel will honor the special rate
three days prior to and three days following the official meeting dates on a
space availability basis.
To make reservations, contact The Peabody Little Rock (toll free) at
800-732-2639, specifying the Little Rock location, or call 501-906-4000. All
reservation requests/changes should be made directly with the hotel.
Check-in time is 3:00 p.m. and checkout is 12 noon.
AUDIENCE
The AHA Annual Meeting and Trade Show will be beneficial to
hospital CEOs and administrators; trustees; physicians; senior
leadership team members; nursing, quality, marketing, public relations,
human resources and compliance executives; financial officers, and any
other managers interested in current and future healthcare topics.
DRESS
Business casual is appropriate for all events. Please note that meeting
room temperatures often are difficult to moderate, so dressing in layers is
suggested.

ARKANSAS HOSPITAL ASSOCIATION
82 ND ANNUAL MEETING AND TRADE SHOW, October 3-5, 2012
Advance Registration Deadline – 4:30 p.m., Monday, September 24
(You are encouraged to fax your registration to 501-224-0519)
Please type or print. Reproduce form for additional enrollments.
Name ______________________________________________ Title ______________________________________________
ACHE Affiliate Status: ❑ Fellow ❑ Member
Hospital/Organization _____________________________________________________________________________________
Mailing Address, City, State, Zip______________________________________________________________________________
Email Address _______________________________________ Telephone __________________________________________
REGISTRATION AND SPECIAL EVENTS
Wednesday, October 3
FEE # ATTENDEES AMT. DUE
A. “Thoughts from My Foxhole” Leadership Workshop ...............................................................................$125 x A. ______ $ __________
B. Membership Reception............................................................................................................................n/c B. ______
Thursday, October 4
C. Registration: Fee Required....................................................................................................................$125 x C. ______ $ __________
D. Concurrent Sessions: Choose one of the following
ACHE/AHEF Breakfast Meeting...........................................................................................................n/c D1. ______
Patient Safety/Quality Leadership Workshop.......................................................................................n/c D2. ______
E. Concurrent Luncheons: Choose one of the following
Ark. Organization for Nurse Executives Lunch Meeting .......................................................................n/c E1. ______
Ark. Society for Healthcare Marketing and Public Relations Lunch Meeting ........................................n/c E2. ______
Executive Leadership Luncheon .........................................................................................................n/c E3. ______
F. ACHE Advancement Session ....................................................................................................................n/c F. ______
G. AHA Annual Awards Dinner ....................................................................................................................$ 50 x G. ______ $ __________
Friday, October 5
H . Membership Breakfast on Healthcare Reform ........................................................................................$ 25 x H . ______ $ __________
I. ACHE Face to Face Workshop
Registration fee to receive 3 Face to Face ACHE hours .....................................................................$250 x I1. _______ $ __________
Registration fee without ACHE credit ................................................................................................$100 x I2. _______ $ __________
OTHER FEES
J. Hospital Administration graduate students, not employed by a hospital (must pre-pay) ........................$ 25 $ __________
K. Representatives from non-exhibiting vendor companies must pay the non-exhibiting fee to attend the
annual meeting. (You may not conduct business on the Trade Show floor if you do not have a booth.).........$900 $ __________
For Registrations received after 4:30 p.m. Monday, September 24, please add $50 to the fee.
Note: AHA educational events are not available to persons from hospitals that are eligible for AHA membership, but choose not to become members.
Total Due (Registration Fee and Special Event Seats) $ __________
PAYMENT
❑ Enclosed is my check made payable to the Arkansas Hospital Association.
❑ I authorize AHA to charge my: ❑ MasterCard ❑ VISA (AmEx and Discover not accepted)
Account number: ________________________________________________ Exp. date: __________________________
Cardholder’s name:____________________________________________ Phone: _______________________________
Cardholder’s signature: ______________________________________________________________________________
Mail form and payment to be received by the AHA no later than September 24 to:
Lyndsey Dumas, Arkansas Hospital Association, 419 Natural Resources Dr., Little Rock, AR 72205; 501-224-7878; or fax form with credit card payment
to 501-224-0519.
Refund policy:
Refunds, minus a $50 processing fee, will be granted if requests are received in writing by the AHA on or before September 24. No refunds after that
date. Unpaid registrants who fail to attend must pay the entire registration fee. Substitutions, however, are permitted. Registrations that are phoned or
faxed in are subject to the same cancellation policy. Fax refund requests to Lyndsey Dumas at 501-224-0519.
AHA OFFICE USE ONLY ID ________________ SPEAK_____ SPON _____ COMP _____ AUTH _____ IMIS ____ ______ CONFIRM ______
NOTE _________________________________________________________________________________________________________

FOR ADDITIONAL
INFORMATION
Beth Ingram, Senior Vice President
Arkansas Hospital Association
419 Natural Resources Drive
Little Rock, Arkansas 72205
501-224-7878
www.arkhospitals.org
bingram@arkhospitals.org