Conditions of Participation Information Request 

CMS published a notice on August 30, of the intent from CMS to continue collecting information as part of the CAH Conditions of Participation. Information collected is used by surveyors to ensure CAHs are eligible to participate in the Medicare Program. Comments regarding the proposed information collection must be submitted by September 29.

With the support of the FORHP, Rural Health Innovations (RHI), a subsidiary of the National Rural Health Resource Center, is excited to announce the next funding cycle for the Small Rural Hospital Transition (SRHT) Project.

The SRHT project will select and support nine hospitals for on-site technical assistance that helps them to transition to a value-based system and prepare for population health. Applications may select either a financial operational assessment (FOA) or quality improvement (QI) project. At least three hospitals will be selected for FOAs and at least three hospitals for QI projects.

The 2017-2018 SRHT application period opened September 25 and will close midnight on October 16, 2017. Visit the SRHT application page which includes helpful hints for submitting a successful application. Applicants must be willing and able to meet hospital readiness and participation requirements.

Small rural hospitals located in a rural community as defined by FORHP, persistent poverty county or a rural census tract of a metro persistent poverty county, and have 49 staffed beds or fewer as reported on the hospital's most recent filed Medicare Cost Report are eligible to apply for the SRHT Project.

Email srht@ruralcenter.org or call (859) 806-2940 with questions.

Access to home health in rural areas is an important public policy concern, particularly with the growing number of older adults residing in rural America. This qualitative study seeks to better understand how home health services are provided in rural areas, and identifies facilitators and barriers to providing care. Rural home health agency administrators and discharge planners reported a variety of challenges with providing home health services to rural Medicare beneficiaries, including insufficient reimbursement, Medicare requirements and recruiting and retaining an adequate workforce. External financial support, affiliation with a hospital, integrated electronic health record systems and strong relationships with hospitals were identified as facilitators for providing rural home health services. The facilitators and challenges identified in this study offer insights about the delivery of home health services in rural communities that should be considered by policy makers, innovators and providers as rural healthcare evolves.

TASC Tasks 

It's the start of a new program year so we are currently doing some work plan adjustment with FORHP to best support states participating in the Flex Supplemental funding - more to come on that support in the coming weeks. Other items we are working on or recently released:

• The semi-annual update of the HCAHPS Vendor Directory was just released. Please use this resource for your program's technical knowledge, but also to support your CAHs that are looking for HCAHPS vendors

• The Sliding Fee Scale Discount Program Guide for CAHs was recently updated to include new information about National Health Service Corp and to include information relevant to RHCs. Please see the guide and 1-page summary and, again, share with your state partners and facilities

• We will soon be releasing a cybersecurity tool for CAHs and RHCs, highlighting tools relevant for these rural facilities to prepare for and respond to a cybersecurity threat

• Later this fall TASC will be updating the Flex Program Fundamentals Guide and will be seeking your update of your state's online State Flex Profile - stay tuned

• Save the date for the TASC 90 webinar on November 8 - topic to be determined

• Sally Buck, Terry Hill, Tracy Morton and Bridget Hart will be at the NRHA RHC and CAH Conference this week in Kansas City, MO. Please send an email to tasc@ruralcenter.org if you want to meet up with one of us, but can't find us; let us know and we will do our best to connect. Also, please stop by the presentation on Friday, September 29 at 9:30 a.m. about Resources for Vulnerable Hospitals and Communities presented by Sally Buck, Kassie Clarke from NOSORH, a CEO from a CAH in South Dakota and Sarah Young from FORHP.

Rural Americans Less Likely to Wear Seat Belts, More Likely to Die in Crashes

In the latest edition of its Morbidity and Mortality Weekly Report (MMWR) Rural Health Series, researchers at the Centers for Disease Control and Prevention (CDC) examined passenger vehicle occupant deaths among adults ages 18 years or older, and used data from their Behavioral Risk Factor Surveillance System to estimate how often drivers and passengers used seat belts.  

Overall, the study found lower seat belt use, higher death rates, and a higher proportion of drivers and passengers who were not buckled up at the time of the fatal crash in rural areas.  While death rates varied by region, adult motor vehicle drivers and passengers in the most rural counties across the United States had motor-vehicle death rates 3 to 10 times higher than those in the most urban counties. 

There are several policy options for increasing seat belt use outlined in the report and a number of resources can be found on CDC's Motor Vehicle Safety page.

Read CDC's full report on Rural and Urban Differences in Motor Vehicle Deaths. 

HRSA Office of Pharmacy Affairs Transitioning to New Information System 

The HRSA Office of Pharmacy Affairs (OPA) is transitioning to a new information system. The new information system will be coming online in September. Please share this information with rural hospitals and clinics that participate in 340B-who should have also received the below email as participating covered entities.

September 13, OPA recorded a webinar for covered entities that must register and recertify to participate in the 340B program.

Things to remember about 340B:

• The list of all 340B covered entities is publicly available using the new 340B OPAIS public search feature
• HRSA OPA manages the 340B program and the annual recertification for all covered entities to maintain eligibility
• Please direct 340B participants with specific questions to Apexus Answers (ApexusAnswers@340bpvp.com, 1-888-340-2787), the 340B call center and technical assistance provider

Please post any questions about 340B in the Flex Program Forum.

SRHT Project Releases New Templates for Rural Hospitals 

• Use the Value-Based Summit Template Guide
• Download the Strategy Map Template and begin to communicate strategic initiatives, and effectively execute and implement the strategic plan
• Download the BSC Template and begin to track and monitor performance and achievement towards goals, as well as demonstrate the value of the organization
• View the Webinar Playback, podcast and view the presentation slides. A tutorial and update on the Rural Hospital Toolkit for Transitioning to Value-based Systems are included.

Weekly Rural Health Leadership Radio Program

 

A weekly radio program, Rural Health Leadership Radio , was launched a year ago to support rural health leaders to share stories and information about what is working, and what is not. To read the story of the program's development please visit an article promoting the resource from the National Organization of State Offices of Rural Health. To name just a few, previous and upcoming speakers include names you may be familiar with include:

• Christian Curtis, Fort Peck Tribes Health Promotion Disease Prevention Program
• Don Kelso, Indiana Rural Health Association (IRHA)
• Lara Brroks, Oklahoma Office of Rural Health and Dr. Brian Witacre, Oklahoma State University 
• Brian Bauer, Hall, Render, Killian, Health and Lyman, PLLC
• Michelle Mills, Colorado Rural Health Center

Montana Rural Healthcare and Department of Public Health and Human Services, EMS & Trauma Systems' Performance Improvement/Trauma Performance Improvement Project  

The joint collaboration between the Montana Rural Healthcare Performance Improvement Network (PIN) and Department of Public Health and Human Services, EMS & Trauma Systems for the 2016-2017 PIN/Trauma Performance Improvement Project was such a success it's being repeated in 14 hospitals within the Eastern & Western Regional Trauma Advisory Committees (RTAC) regions.

The project's primary focus was reimbursement for trauma related activities at Montana CAHs. The goal was to assist a cohort of facilities develop a Trauma Team Activation Fee and ensure proper billing/coding to maximize reimbursement for trauma activation and/or critical care codes. The report explains some of the outcomes for the pilot group of hospitals which have shown immense improvement which equaled improved reimbursement. 

For more information or if you have questions, please contact Jamie Schultz with the Montana Hospital Association.

New Rural Health Research 

Rural Curricular Guidelines Based on Practice Scope of Recent Residency Graduates Practicing in Small Communities

Sliding Fee Scale Discount Guide for Critical Access Hospitals  and Rural Health Clinics Updated 

In cooperation with the Federal Office of Rural Health Policy (FORHP) the Sliding Fee Scale Discount Guide for Critical Access Hospitals and Rural Health Clinics has been updated with new information and details relevant to rural health clinics.

This guide provides critical access hospital and rural health clinic executives and management teams with concepts and guidance in developing a sliding fee scale discount program. It also assists in providing an understanding of how sliding fee discount programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps.

The Updated Guide Includes the Following:

Connect Peer to Peer in Flex Program Forum 

Do you have a question, idea, success or challenge to share with your Flex Program peers? Don't miss the ongoing discussions on the Flex Program Forum . 

If you have questions about the Flex Program Forum, please contact TASC.  

Stay in the loop by following the National Rural Health Resource Center blog. 

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