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North Dakota Critical Access Hospitals Receive Funds to Implement Projects

May 20, 2024

Seven North Dakota Critical Access Hospitals (CAHs) recently received funding to assist with implementation activities and financial/operational improvement areas. The awards come from the CAH subcontract program, supported by the North Dakota Medicare Rural Hospital Flexibility (Flex) program. Flex is housed at the Center for Rural Health (CRH) within the University of North Dakota School of Medicine & Health Sciences.

Implementation Activity

CAH subcontract funding must be used to support a Community Health Needs Assessment (CHNA) implementation activity. Through the Affordable Care Act, every CAH must conduct a CHNA every three years. Once completed, the CAH works to strengthen areas identified in the CHNA and develops an implementation plan.

The objective is to support new collaborative population health improvement programming and activities that address a significant need identified by the hospital's most recent CHNA; assess determinants of health based on data review, encourage collaboration between the CAH, local public health units, and other community organizations and stakeholders; and promote community engagement and healthy behaviors. Two CAHs received this funding.

  • Mountrail County Medical Center (MCMC), in Stanley, was awarded $4,200 to assist in establishing the infrastructure necessary to implement behavioral health services. MCMC will apply remote support services for patients with emergent behavioral health issues within MCMC and provide timely assessment and access to care for patients by linking MCMC's emergency room staff to a remote behavioral health team led by a psychiatrist at Avel eCare Behavioral Health.
  • CHI St. Alexius Health Turtle Lake was awarded $5,000 to promote a wellness challenge consisting of focusing on increasing exercise times, weight loss, and making healthy lifestyle changes. The challenge was based on two-person teams and lasted for 12 weeks. Monthly presentations were given on topics such as benefits of exercise, healthy eating habits, and healthy lifestyle changes.

Financial/Operational Improvement

CAH subcontract funding must be used to allow CAHs to self-identify a financial or operational area for improvement and intervention. Suggested interventions include, but are not limited to: chart audit, chargemaster review, chargemaster scrub, 340B external audit, etc. Six CAHs received this funding.

Nicole Threadgold

Nicole Threadgold, senior project coordinator for CRH, shared why these awards are important to CAHs across the state. "As CAHs create their implementation plans in response to identified CHNA needs, funds for implementation plan activities are sometimes difficult to secure. This funding helps CAHs get started on those activities as they work towards addressing the identified needs of the communities they serve."

"And the CAH financial and operational improvement," she continued, "is a core area of the Flex workplan. Activities such as an audit are important to support for a CAH's sustainability and growth as it delivers valuable healthcare to rural North Dakotans."

Future funding through the Flex subcontract funding will be announced as they are available.


Holly Long, Project Coordinator
(701) 777-5588