Critical Access Hospitals Quality Network

Nine North Dakota Critical Access Hospitals Named Top 100

Nine Critical Access Hospitals (CAHs) in North Dakota have been named to the Top 100 CAHs for 2023, according to The Chartis Center for Rural Health. Top 100 CAHs are top performers, excelling in financial efficiency, achieving higher quality, securing better outcomes, increasing patient satisfaction, and operating at a lower cost than their peers across the U.S.

North Dakota CAHs Recognized

• Towner County Medical Center in Cando
• CHI St. Alexius Health Carrington Medical Center
• Pembina County Memorial Hospital in Cavalier
• CHI St. Alexius Health Devils Lake Hospital
• West River Health Services in Hettinger
• Jamestown Regional Medical Center
• Sanford Mayville Medical Center
• CHI Mercy Health Valley City
• South Central Health in Wishek

Regulatory Update

Centers for Medicare & Medicaid Services (CMS) recently published a new fact sheet summarizing the Medicare rules and regulations for CAHs. This latest version includes the revised CAH location requirement relative to other facilities to include areas with only secondary roads available as well as the requirement to inform the patient or their representative of their rights before starting or ending care and establish a grievance process.

Rural Health Clinic Network

Regulatory Update

In response to a change in the way the Census Bureau defines rural and urban areas, CMS released Interim Location Determinations for CMS Rural Health Clinics for determining locations of new Rural Health Clinics (RHCs). For now, CMS will use both the 2010 and 2020 Census urban criteria when determining rural location, and locations meeting either standard will be eligible.

August North Dakota RHC Quarterly Meeting and Chronic Care Management Training In-Person

On August 28, RHC managers will have the opportunity to attend a half-day educational session on requirements for establishing a Chronic Care Management (CCM), Transitional Care Management (TCM), and Principal Management (PCM) into their clinics. Following the educational session, the North Dakota RHC Network Quarterly Meeting will be held on August 29 at the North Dakota Heritage Museum. Attendees will:

• Learn about hot topics in RHCs
• View the financial and operational benchmarks for year two
• Hear first-hand experiences from RHC managers who have recently taken the Certified Rural Health Clinic Professional course through the National Association of Rural Health Clinic
• And much more!

Register for the CCM/TCM/PCM session and the North Dakota RHC Network Quarterly meeting.

Financial/Operational Improvement Update

Rural Healthcare Peer Exchange and Professional Development Program

The North Dakota Medicare Rural Hospital Flexibility (Flex) Program offers the Rural Healthcare Exchange Program which provides opportunities for staff serving North Dakota CAHs to learn from their peers. The program provides travel support for individuals or small groups to meet with similar entities from other areas of the state and share information, ideas, and successful approaches to improving quality and access to healthcare services.

• Four North Dakota Critical Access Hospital Chief Financial Officers (CFOs) participate in 2023 National Rural Health Association CFO Certification Program
  Finance and Operations, one of the core Flex work areas, allows for a variety of outreach, education, and support to our state's 37 CAHs. One form of support that came to fruition in June 2022 was the opportunity for Flex to support a portion of the registration fees for three CFOs to participate in the National Rural Health Association's (NRHA) CFO Certification Cohort. Based on the success from these three, North Dakota Flex once again offered the cost-sharing opportunity to North Dakota CAH CFOs interested in the March 2023 cohort. Four additional North Dakota CAH CFOs applied and were accepted.
  
  The program, developed by successful rural CFOs for their peers, runs 30 weeks with the intent of strengthening CFO leadership skills. The course curriculum focuses on the specific areas of leadership, operations, finance, and clinical. Upon successful completion of the cohort, CFOs will receive a two-year Rural Hospital CFO Certification.
  
  The Flex Program anticipates offering cost sharing opportunities for additional CAH CFOs who apply and are accepted into NRHA's 2024 cohort. The NRHA application information is available at the NRHA Rural Hospital CFO Certification Program. The Flex Program will send out a separate form to monitor interest from those in North Dakota this summer.
• Small Rural Hospital Improvement Program (SHIP)
  • The regular SHIP funding year runs 6/1/23 – 5/31/24. The new SHIP subawards will be sent electronically to the CAH Chief Executive Officer (CEO) for signature. SHIP reporting includes: a mid-year check-in to see how CAH-selected activities are progressing; a final report to see progress of implemented activities; and a reimbursement request once expenses are incurred.
• SHIP American Rescue Plan
  • SHIP American Rescue Plan subawards for COVID-19 Testing and Mitigation activities are now in the No-Cost Extension (NCE) period for those who had funds remaining as of 12/31/22. The extended award period now goes until 12/31/23. Quarterly reporting will continue during the NCE. CAHs are strongly encouraged to develop a plan for use of their funds within the new time frame as another NCE will not be granted.

MBQIP Data Reporting Reminders and Resources

• 2023-2024 Data Submission Deadlines Calendar (no longer available online)
• Quality Improvement Measure Summaries for MBQIP
• MBQIP Quality Reporting Guide
• Interpreting MBQIP Hospital Data Reports for Quality Improvement (March 2021)

Workforce Update

During the 2023 Flex conference in Minot last month, Stacy Kusler, workforce specialist, gave a presentation about recruitment for retention strategies, specifically focused on job posting do's and don'ts. This presentation was adapted from a 3RNET 2-part webinar series to North Dakota back in March 2022.

While posting a job may seem quite easy and straight-forward, there are some great insights as to what draws the candidate to click and read more about a certain job (creating it like a marketing piece), and what causes them to scroll past (a laundry list of duties).

In the recordings linked below, the series walks through job posting details and so much more. Learn about the four parts of the recruitment and retention process, from planning and preparation through retaining the employee at your facility. Note: You can set the viewing speed to 1.25 or higher to view these presentations faster.

Stacy is available for follow up discussions and can be reached by email to set up a time to meet.

Recruitment for Retention Strategies for Rural and Underserved Communities – 3RNET

• Part 1: Recording | Slides
  Passcode: 3RNET329!
• Part 2: Recording | Slides
  Passcode: 3RNET331!

State Office of Rural Health

R-COOL-Health Scrubs Program Highlight

A memorable and effective method to grow the healthcare workforce is to introduce it to students while they are young. This is the idea behind the Rural Collaborative Opportunities for Occupational Learning in Health (R-COOL-Health) Scrubs Program. This program provides opportunities for students to learn about careers in healthcare directly from professionals in fun and interactive ways.

The R-COOL-Health Scrubs Program is funded by the Center for Rural Health and offers three different formats: Scrubs Academy I and Scrubs Academy II, four day/three night camps hosted on college campuses for students in grades 6-8 and 9-11, respectively, and Scrubs Camps, one-day camps hosted in rural communities.

Unity Medical Center, located in Grafton, along with North Valley Career & Technology Center, and the Walsh County Job Development Authority recently hosted two Scrubs Camps for students in the surrounding area. Ninth graders from Drayton, Grafton, Midway, Minto, and Park River attended the camps, resulting in 173 students participating in engaging activities promoting careers in the healthcare industry. Health professionals presented different careers to the students and included hands-on activities like putting in IVs, taking X-rays, drawing blood, and intubating a practice manikin.

Scrubs Camp Grant Applications
Scrubs Camp grant applications are now being accepted for the 2023-2024 cycle and are due August 1 at 4:00 pm Central. Awardees will be notified on August 3. Camps can begin to take place August 15 and must be completed by April 30, 2024. Note that this timeline has been altered to allow for flexibility in the event of winter weather. A technical assistance meeting recording is available for interested applicants. Learn more about the grant guidance, see example documents, and submit the proposal.

Dakota Conference on Rural and Public Health will be June 14-16 in Bismarck

The 38th Annual Dakota Conference on Rural and Public Health, taking place June 14-16, will be held in Bismarck, North Dakota. Registration is now open. The Conference includes four keynote addresses, 16 sessions, four intensive sessions, a health workforce panel, a North Dakota Department of Health and Human Services panel, and a legislative policy panel. Continuing education credits will be available.

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.

A session that will be helpful to hospitals is an intensive: Value Based Care – A Dive Into What It Looks Like for Our North Dakota Facilities. Is this session, Rural Health Value and Newpoint Healthcare Advisors will facilitate a panel of five North Dakota CAH CEOs to discuss their experience in the Rural Health Value – North Dakota Project. This project developed a North Dakota health and healthcare environmental scan, provided direct technical assistance to five core CAHs, and designed a strategy for North Dakota to continue the journey to value-based care and value-based payment. It will explain:

• How a CAH can build its value-based care capacity
• How a CAH can engage local community organizations to improve health
• The financial implications of value-based payment

One of the keynotes is Betty Rambur, PhD, RN, FAAN, a national expert on health reform, value-driven care, and nursing. Dr. Rambur will present Health Structural Change Including Value and Impact on Providers/Nurses. She is a professor of Nursing, Routhier Endowed Chair for Practice, and interim dean, at the College of Nursing within the University of Rhode Island in Kingston, Rhode Island. Dr. Rambur is originally from Bismarck, North Dakota, and served as a faculty member at the University of Mary.

To learn more, visit ruralhealth.und.edu/dakota-conference, or

• View the schedule (No longer available online)
• Register

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/Rural Health Clinic Network Meetings

• June 8 — Motivational Interviewing
  Blue Cross Blue Shield, Fargo
• June 14-16 — Dakota Conference
  Bismarck Event Center, Bismarck
• June 26 — The 5 Star Nurse & Swing Bed Census Break Through
  Heritage Center, Bismarck
• June 27-28 — 2nd Annual Nurse Leadership Conference, North Dakota Hospital Association
  Heritage Center, Bismarck
• August 16-17 — Conditions of Participation (CoP) 5-part Series for Appendix W, CAH Regulations by Gayle Nash Consulting
  Heritage Center, Bismarck (2 days in person)
• August 24 — North Dakota CoP Webinar Education and CoP Telemedicine
  North Dakota CAH Quality Network (virtual)
• August 29 — North Dakota RHC Financial Hot Topics, Conditions for Coverage Checklist and Deficiencies, Eide Bailly
  Heritage Center, Bismarck
• August 30 — Eastern CAH Regional Meeting (virtual)
• August 31 — Western CAH Regional Meeting (virtual)

Save the Date!

2024 North Dakota Flex Annual CAH & RHC Meeting
April 17, 2024
Bismarck, North Dakota

The 2024 North Dakota Flex Annual CAH & 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.

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.