Critical Access Hospitals Quality Network

Four North Dakota Hospitals Recognized Among Top Critical Access Hospitals

Four Critical Access Hospitals (CAHs) in North Dakota were named to the Top 20 CAHs for 2023, according to the Chartis Center for Rural Health. This elite group of hospitals was selected from the Chartis Center for Rural Health's 2023 top 100 CAH list, which was released earlier this year. Additionally, one CAH was named to the Top 20 in Quality, and one CAH was named to the Top 20 in Patient Satisfaction, which are best practice designations.

North Dakota CAHs Recognized

• CHI St. Alexius Health Carrington Medical Center in Carrington
• Jamestown Regional Medical Center in Jamestown
• Sanford Mayville Medical Center in Mayville
• Towner County Medical Center in Cando

Best Practice Recipients – Quality

• Mountrail County Medical Center in Stanley

Best Practice Recipients – Patient Satisfaction

• Towner County Medical Center in Cando

Regulatory Update

• Policy & Memos to States and CMS Locations

Rural Health Clinic Network

Practice Manager Workshop Training and Quarterly Meeting

November 15 & 16
Bismarck Heritage Museum, Bismarck

On November 15, Rural Health Clinic (RHC) managers will have the opportunity to attend a full-day educational session, presented by Tressa Sacrey of Health Services Associates, on RHC-specific topics that will include Rally Your Team, Understanding the RHC, Documented Compliance, What’s Next, What's New, and Staying on Track. Following the Practice Manager Workshop, the North Dakota RHC Network Quarterly Meeting will take place on November 16. Both meetings will be held at the North Dakota Heritage Museum, in Bismarck. Attendees will learn about developing performance improvement tropics, hear about first-hand experience of RHC managers who have taken the Certified RHC Professional, Top North Dakota RHC deficiencies presented by Shelly Heilman, and more!

Register Now

Financial/Operational Improvement Update

North Dakota Rural Path to Value Cohort

CRH and the Flex Program continue to work on assisting North Dakota CAHs with the transition to value. In the new Flex year (September 1, 2023 – August 31, 2024), there are seven North Dakota CAHs participating in a cohort of the Rural Path to Value program:

• Mountrail County Medical Center, Stanley
• SMP Health – St. Kateri, Rolla
• Pembina County Memorial Hospital, Cavalier
• Dakota Regional Medical Center, Cooperstown
• Nelson County Health System, McVille
• CHI St. Alexius Health, Carrington
• South Central Health, Wishek

The Rural Path to Value program provides an opportunity to bridge a CAH's work in population health while working towards value. The North Dakota cohort runs October 2023 – August 2024 and is customized to support CAHs and RHCs taking early steps to adopt population health practices. Participants work with the Rural Path to Value team to design a population health-based project that's customized to the unique needs of the communities each CAH serves and can be implemented with available resources. The cohort has access to training, tools, and strategies to accomplish this, learn how to improve and sustain community partnerships and organizational planning projects, and how to help communities navigate the transition to population health.

Project components:

• Completing a population health assessment
• Personalized community data snapshot reports
• Strategy identification workshop
• Action planning workshop
• Two education webinars
• One-on-one support and coaching calls
• Peer sharing calls

Learn more about the Rural Path to Value program.

Funding Opportunity — 2024 North Dakota CAH Subcontract Program

The North Dakota Flex Program has funding available to support North Dakota CAHs through 1) CAH Financial/Operational Improvement Area of Choice; and 2) Community Health Needs Assessment (CHNA) implementation for collaborative population health programming in response to identification of unmet community health and health service needs.

Application timeline:

• RFP release: November 1
• Technical assistance meeting: November 17
• Application due date: December 8
• Award notification date: December 22
• Award completion date: August 31, 2024

Additional information and online application can be found on the 2024 North Dakota CAH Subcontract Program webpage.

SHIP (Regular)

The regular FY23 SHIP funding year runs 6/1/23 – 5/31/24. SHIP funding priority areas returned this year are: 1) consistently reporting MBQIP measures; and 2) implementing ICD-11 coding readiness or implementation activities. The priority areas must be addressed before working on additional SHIP eligible activities. This information is reflected in each CAH's subaward paperwork in the Scope of Work section. Continue working on your selected activities. A December mid-year check-in will occur to see how CAH-selected activities are progressing. The new SHIP FY24 (6/1/24 – 5/31/25) hospital application form will be sent out to each CAH once released from our Federal funder. For SHIP questions, contact Nicole Threadgold.

SHIP American Rescue Plan

SHIP American Rescue Plan (ARP) subawards for COVID-19 testing and mitigation activities continue with the no cost extension period through 12/31/23. All funds must be spent and good/services received by 12/31/23. Any unspent funds at that time will be de-obligated. For SHIP ARP questions, contact Nicole Threadgold.

MBQIP Data Reporting Reminders and Resources

• Emergency Department Transfer Communication (EDTC)
  Due date: October 30
• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
  Due date: January 3, 2024
• Outpatient, (OP-18) – Median Time from Emergency Department (ED) Arrival to ED Departure for Discharged ED Patients
  Due date: February 1, 2024

Workforce Update

2023 Recruitment for Retention Academy

The 2023 3RNET Recruitment for Retention Academy is available at no cost to all of our North Dakota healthcare facilities! This 6-part webinar series began October 6 and will continue through December 12. If you missed the first few sessions, don't worry! All sessions are available to watch as part of your registration. CRH is sponsoring our state's attendance to save you $500 PER REGISTRATION!

Register for the 3RNET Recruitment for Retention Academy. Enter your info and click “add to cart”. It will say $500, but don't worry. On the next page, you will be able to add a coupon code CRH23 to remove the fee. Follow prompts for information, and you'll be all set!

3RNET PLUS TOOLS

If you are a user of 3RNET and are looking for a more efficient way to track candidate interactions, consider upgrading to a 3RNET PLUS TOOLS account!

3RNET PLUS TOOLS can keep you organized and streamline your recruitment process. Begin your free 30-day trial by upgrading your account. Reach out if you need any help navigating this process.

J-1 Visa Waiver Program Efforts

Some physicians who are in North Dakota for residency training hold a J-1 visa. In order for these physicians to remain in the U.S. and North Dakota after residency completion, they must obtain a visa waiver. One way they can obtain this waiver is through the Conrad 30 Waiver program. Through this program, each state can support up to 30 waivers each year. Ten of those 30 waivers can be used in “flex” areas, or non-Health Professional Shortage Areas (HPSAs). The remaining 20 must be used in an HPSA, or medically underserved area or population.

In North Dakota, our typical waiver usage is between 10-15 per year, with most of our waivers going towards flex slots. In an effort to improve usage of our waiver program and the 20 remaining non-flex waivers, the North Dakota Medical Association and North Dakota Health and Human Services partnered to host the inaugural J-1 visa social and dinner in Fargo on October 17. The purpose of the event was to connect J-1 visa holders, waiver recipients, medical faculty, and practicing physicians to educate them about the program's opportunity to fill physician workforce needs in the state. The event is intended to be annual, and there are hopes to expand the event to other cities in the state to accommodate more physician attendance.

Rural Health Interest Group

The University of North Dakota School of Medicine & Health Sciences, in partnership with CRH and the North Dakota Rural Health Association, support a student interest group called the Rural Health Interest Group. This is a group made up of health professions students, with a large number of medical students making up the membership. Current leadership includes Regan Lawrence and Emma Weisner, both 2nd year medical students, and Odele Rajpathy, an undergraduate student pursuing a public health degree. The annual kickoff meeting was held on October 2 to introduce the group to incoming students, and four additional leadership positions will be filled by early November. The purpose of the group is to expand information and knowledge surrounding rural health-related policy, topics, and practice areas. Four informational sessions are held during the school year, and speakers include rural health professionals from all over the state. Members are given opportunities to attend national events including the National Rural Health Association's policy institute and annual conference.

2023 Primary Care Week

CRH and the American Medical Student Association hosted the 2023 Primary Care Week at the UND School of Medicine & Health Sciences the week of October 23 to 27. This annual event includes a full week of sessions to help students understand more about primary care professions. Sessions include Dr. Missy Henke spoke about integrating mental health into a primary care setting, a panel of primary care residency program directors from North Dakota helped students understand what they look for in residency candidates, and a Community Meet and Greet event was held, which serves much like a job fair for health profession students to connect with healthcare employers.

State Office of Rural Health

Community Health Needs Assessments

Reminder that beginning in 2023, CRH will no longer be providing CHNA assistance for CAHs that are part of a large system. Independent CAHs are still eligible to apply for CHNA assistance through the State Office of Rural Health. The cost per facility will be $9,000. Invitations to apply for assistance will be sent to eligible CAHs 15 months prior to their CHNA due date with a deadline of responding approximately one month later (deadline will be included with the invitation).

CRH has expanded its work with assisting CAHs with their CHNA Implementation Plans. This service is available through Flex funding at no cost to the CAH and is open to all North Dakota CAHs. Your organization does not have had to have worked with CRH on your CHNA to receive this assistance. For questions, please email Holly Long.

Dakota Conference on Rural and Public Health

The 39th Annual Dakota Conference on Rural and Public Health, taking place June 4-6, will be held in Grand Forks, North Dakota.

Nominations for the nine Outstanding Rural Health Awards are now open. Please nominate those that you feel are deserving of recognition.

The Dakota Conference provides an opportunity for hundreds of healthcare professionals, educators, and students to share strategies for building and sustaining healthy communities in North Dakota. It includes two- and one-half days of pre and post conference meetings, keynote speakers, breakout sessions, poster presentations, and an awards banquet.

Visit the Dakota Conference on Rural and Public Health webpage for more information about the conference or to submit an awards nomination. The Rural and Public Health Awards Banquet will be held June 5, at 12:05 pm Central at the Alerus Conference Center.

National Rural Health Day

Celebrate Rural Health
National Rural Health Day is November 16 and there are many opportunities for organizations to celebrate all things rural. Learn how you can show support, take part in a photo contest, sign on as a supporter, and more!

Upcoming Meetings

Looking for a particular meeting? Visit the North Dakota Healthcare Partners Events Calendar and search our upcoming events for more information and to register then add to your calendar.

Upcoming Flex Program, North Dakota CAH Quality Network, and RHC Network Meetings

• November 15 – Practice Manager Workshop
  North Dakota Heritage Museum, Bismarck
• November 16 – North Dakota RHC Network Quarterly Meeting
  North Dakota Heritage Museum, Bismarck
• November 21 – DON Networking Meeting
• November 30 – Year 2 RHC Financial/Operational Analysis Presentation (virtual)
• December 5 – North Dakota Eastern Region CAH Quality Networking Meeting
• December 7 – North Dakota Western Region CAH Quality Networking Meeting
• December 13 – North Dakota RHC Managers Meeting “Coffee & Clinics”
• January 11, 2024 – North Dakota CoP Survey Sharing Meeting
• January 17, 2024 – North Dakota RHC CfC Survey Sharing Meeting
• January 18, 2024 – DON Networking Meeting
• January 25, 2024 – Hot Topics and Successful Survey Tips
  Nash Consulting
• February 6, 2024 – North Dakota RHC Network Quarterly Meeting (virtual)
• February 8, 2024 – Year 2 RHC Financial/Operational Best Practices Meeting
  North Dakota Heritage Museum, Bismarck
• February 15, 2024 – DON Networking Meeting
• March 13, 2024 – North Dakota RHC Managers Meeting “Coffee & Clinics”
• March 21, 2024 – DON Networking Meeting
• April 4, 2024 – North Dakota CoP Survey Sharing Meeting
• April 10, 2024 – North Dakota RHC CfC Survey Sharing Meeting
• April 11, 2024 – DON Networking Meeting
• April 17, 2024 – 2024 ND Flex Annual CAH & RHC Annual Meeting
• May 16, 2024 – DON Networking Meeting

Save the Date!

2024 North Dakota Flex Annual CAH and RHC Meeting
April 17, 2024
Bismarck Event Center
Bismarck, North Dakota

The 2024 North Dakota Flex Annual CAH and RHC Meeting is an opportunity for all CAHs and RHCs to come together in person to discuss pertinent issues regarding healthcare in North Dakota. You can expect to hear content related to CAHs and RHCs. All facilities are encouraged to send staff.

Presentations and Photos

Presentations

Staff of the North Dakota Flex team were asked to present on various topics are recent state and national conferences.

• Jody Ward, program director, presented on Quality at the Flex Reverse Site Visit in Washington, D.C. this past July.
• Anna Walter, project coordinator, presented with Ralph Llewellyn from Eide Bailly on the RHC Financial and Operational Improvement initiative in our state at the Flex Reverse Site Visit in Washington, D.C. this past July.
• Nicole Threadgold, senior project coordinator, and Brad Gibbens, CRH acting director, presented “Value Based Care is in a Sea of Change” at the North Dakota Hospital Association Annual Convention.

Photos

Did You Know?

The Flex Program offers a variety of tools and resources in the Virtual Library. The Virtual Library is:

• A free online repository of CAH-specific resources
• A one-stop shop to locate resources, protocols, and best practices related to CAH quality
• Maintained by the North Dakota CAH Quality Network

Email Jody Ward for login information.

Are You New to Your Role or Organization?

Please email Jody Ward, program director of the North Dakota Flex Program for a one-hour orientation on the Flex Program or the North Dakota CAH Quality Network and MBQIP Program. If you are a new RHC manager, please email Anna Walter, project coordinator, for a one-hour orientation on the North Dakota RHC Network.