Formal training programs at nursing homes for staff and patients and families might be able to be funded with Civil Monetary Penalty (CMP) funds from compliance fines. Any advice or help with Grant Writing/Applications to CMP from the OpenIDEO team would be appreciated! As I have worked this week, building the Medicare Annual Wellness program at a local Primary Care Physicians office, I am reminded how many opportunities the medical world is missing without these critical conversations to help re-imagine the end-of-life experience. I am excited to begin to bring workshops to doctor's offices to raise the comfort level of healthcare providers in discussing what matters most to their patients in their health and in their death. And I'm excited to help physicians begin to embrace the new billing code so they can be reimbursed for time spent on appointments to discuss end-of-life and advance care planning (ACP). Many consumers aren't aware of the new bundled payments and penalties for unnecessary re-admissions to hospitals from nursing homes or home health, so I anticipate the trend will be for for more meaningful conversations about goals for care that align with what matters most to the patients and families. If more conversations occur, combined with training of staff about advance directives, the likely result will be fewer knee-jerk transfers from nursing homes to hospitals for concerns that could be treated comfortably in place. I'm excited to be a change agent by helping patients and families have these conversations often. My only other "update" and observation for the week would be to donate the time and supplies once a month for a free workshop at local libraries or Senior Centers, and get on their community calendars as well. Also funeral homes may be interested in reaching out to the community as locations for workshops for the public.