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Hello everyone,
Happy fall! I hope you all had a great end to your summer and are enjoying fall so far.
Thank you to everyone who attended the Flex Performance Improvement and Measurement System (PIMS) Updates webinar earlier this month. As you work on your PIMS reporting, please note that the recording and slides are available here and the updated PIMS collection tool and an example of the tool with example data and other resources and instructions can be found here.
This is also the first edition of the Rural Route newsletter for Fiscal Year (FY) 20. To make sure this monthly newsletter is valuable for Flex programs throughout your program year, we have created the 2020 Rural Route Assessment so you can provide feedback on the newsletter. The assessment is only a few short questions and we'd really appreciate you filling it out before or after you read the newsletter. As always, we also appreciate you taking the time to read this newsletter.
If you have questions or need assistance, please do not hesitate to reach out to me or TASC.
Best, Andy Naslund Program Coordinator TASC
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Federal Office of Rural Health Policy (FORHP) Updates
I want to acknowledge your continued efforts in the face of wildfires, hurricanes, racial injustice, and loss, all during a worldwide pandemic. I know many of you are juggling caring for loved ones around the clock, being a teacher, and working fulltime. Thank you for all that you are doing.
Your FY 2019 Flex PIMS reports are due in the Electronic Handbook (EHB) system on October 30th. Please review the webinar recording and PIMS support documents on the Technical Assistance and Services Center (TASC) website. Please ensure that you check your list of critical access hospitals (CAHs) before you begin reporting in the system. If you need to add/delete/edit any CAH information, please reach out to your Project Officer and we will be able to make the change immediately.
This week, I will be releasing the guidance for the FY 2019 End of Year Report which will be due through the Request for Information Process in EHBs, it will be due on November 30th. This End-of-Year Report will help FORHP streamline the Non-Competing Continuation (NCC) Progress Report, by asking you to report a full budget year of activities once the year has ended. This will also help show the impact of a full year of the Flex Program. Future NCC reports (due in May 2021) will look similar to this year's submission with an update on any major changes & challenges, updated work plan for the next year of the project period, and a budget justification for the next year of the project period.
For the eight Flex Programs that received FY 2019 EMS Supplement awards, you will have an End of Year Report due in EHBs on November 29th, this should already be a task for you in the system. The guidance for the EMS End of Year Report will be released alongside the regular Flex End of Year Report.
FORHP distributed the first set of Medicare Beneficiary Quality Improvement Project (MBQIP) Quarterly Data reports produced by the Flex Monitoring Team (FMT) in late September. Reports reflect Emergency Department Transfer Communication (EDTC) data from 2020 (Quarters 1 & 2). FORHP will host "MBQIP Open Office Hours" to solicit feedback from State Flex Coordinators on the new report format and content. This event will be held on October 29th, 2020 from 1:00pm-2:00pm EST. An invitation from the MBQIP Lead, Natalia Vargas, is forthcoming. This interactive webinar event is appropriate for State Flex Coordinators, and State Contractors assisting with MBQIP efforts. For any questions, please email [email protected].
 CAH Regulatory Update
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Stratis Health Podcast: Quality Time: Sharing PIE (Performance Improvement Experience)
Listen and learn from the lived experience of skilled critical access hospital quality improvement (QI) staff from across the country! Stratis Health's virtual QI mentors come together periodically for quality time to share PIE-their performance improvement experience. They discuss key themes that help drive quality improvement in their rural hospitals. Hear their lessons learned, strategies, tips, and ideas. Find valued supportive resources for each of their topics, along with their favorite real pie recipes! Go to the Quality Time: Sharing PIE page for more information on the podcast.
The newest episode, "The Impact of COVID-19 on Quality Improvement" is available now here.
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TASC Updates
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2020 Fall Virtual Flex Workshop
Flex Program Colleagues, you are invited to participate in the Federal Office of Rural Health Policy (FORHP) Virtual Flex Program Workshop to be held in November. This Workshop is supported by the FORHP and coordinated by the Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center (The Center).
The goal of the Flex Program Workshop is to provide new or existing Flex Program staff an orientation to the Medicare Rural Hospital Flexibility (Flex) Program. Through live and recorded content, this workshop will cover multiple topics including basic value-based health care, population health, critical access hospital (CAH) finance, quality and performance improvement concepts, emergency medical services (EMS), and Flex Program core competencies and best practices. Upon Workshop completion, participants will better understand Flex Program goals and services available to support Flex Program excellence.
The Flex Program Workshop will consist of four online sessions beginning Monday, November 9th and concluding Monday, November 16th, see below:
- Monday, November 9, 2020 - 1:00 p.m. - 4:00 p.m. Central Time
- Thursday, November 12, 2020 - 1:00 p.m. - 3:30 p.m. Central Time
- Friday, November 13, 2020 - 2:00 p.m. - 4:00 p.m. Central Time
- Monday, November 16, 2020 - 1:00 p.m. - 4:00 p.m. Central Time
There is no fee to participate in the workshop, however, please see workshop participant criteria below:
- Has been a Flex Coordinators 12 months or less
- One Flex Coordinator per state
- Must be willing and able to participate in all 4 days of the workshop
- Must be willing to do a manageable amount of pre-work for each workshop day
If you are interested in participating in the November Flex Workshop, please let Andy Naslund know by October 14, 2020, as even in a virtual setting, space for this workshop is limited.
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TASC, supported by FORHP, convened a virtual summit of key stakeholders to examine the current state of post-acute care (PAC) in rural America. The COVID-19 pandemic has brought PAC/long-term care (LTC) into the national spotlight, as a significant percentage of pandemic deaths in the U.S. are occurring in LTC and skilled nursing facilities (SNFs). Summit attendees explored issues, challenges, and strategies related to the integration of rural acute and PAC and considered how rural PAC can be successfully included in a population health and value-based payment future.
We are pleased to announce that the full report is now available. This report provides a background on PAC, the Summit participants, the process used at the Summit, comprehensive lists of identified strategies and tactics to address high priority rural PAC issues, a discussion on how state Flex Programs can help rural providers address PAC, and a collection of PAC best practices from the field.
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This resource provides information on HCAHPS including the benefits and challenges to implementing a HCAHPS survey process with small rural hospitals, specifically CAHs. The resource identifies certified HCAHPS vendors that have opted to have their services listed in the directory, including a description of their experience working with small rural hospitals. This particular resource is beneficial to both the Small Rural Hospital Improvement Grant Program (SHIP) and the Flex Program's Medicare Beneficiary Quality Improvement Project (MBQIP) work to support hospital HCAHPS initiatives.
This resource is supported by the FORHP and coordinated by TASC.
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MBQIP Updates
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On November 18th, FORHP and the Centers for Disease Control and Prevention (CDC) will be hosting a webinar on the Implementation of Antibiotic Stewardship Activities in Critical Access Hospitals. The one-hour long webinar will start at 3PM EST, please register in advance for this webinar.
Updated Resources
Please send your MBQIP questions to [email protected]. TASC will ensure your question reaches the appropriate person.
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NOSORH Weekly COVID-19 Listening Sessions
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The National Organization of State Offices of Rural Health (NOSORH) has been hosting weekly listening sessions with all 50 SORHs to identify challenges and opportunities with the COVID-19 pandemic. A list of the minutes from those calls, as well as peer-identified resources and innovative rural strategies, can be found on the NOSORH website.
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Small Rural Hospital Transition (SRHT) Project: 2020 Rural Behavioral Health Care Coordination Summit
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With the support of the Federal Office of Rural Health Policy, the National Rural Health Resource Center (The Center) hosted the 2020 Rural Behavioral Health Care Coordination Summit. Summit panelists included 10 nationally recognized leaders in rural health policy, practice, and payment to identify a path for rural healthcare leaders to operationalize the movement to population health management, specifically regarding behavioral health (BH). Panelists also explored effective care coordination and transitions of care strategies that maximize the use of available resources and new technology. This summit built upon the findings of the 2019 Rural Care Coordination and Population Health Management Summit.
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New from the American Hospital Association: Advancing Health Podcast -- Living and Learning through COVID-19 in Oregon's Rural Communities
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The American Hospital Association (AHA) has compiled several case examples demonstrating the struggles and successes of rural hospitals battling COVID-19 in their communities. These have been organized in a compendium available on the AHA website at www.aha.org. For this podcast, AHA honored our hospital heroes and examine how two rural hospitals are living and learning through COVID-19. In this podcast, AHA meets with Dr. Lesley Ogden, CEO, Samaritan North Lincoln Hospital, and Samaritan Pacific Communities Hospital located in Lincoln County, Oregon. Listen to the podcast here.
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Webinars, Recordings & Events
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Webinar Playbacks
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This six-part educational video series, designed for critical access hospital board members, focuses on developing systems thinking and visionary leadership skills as keys to thriving in the changing health care landscape.
Recommendation for Board Training
Rural critical access hospital Board of Directors should plan to watch one of the six 15-20 minute videos every other month over the course of 12 months. Each video will end with discussion questions for Boards to add to their agenda the month after watching each video. Each video module is accompanied by discussion questions that can be used by a board to explore the relevance of the module's topic to their hospital and community, and one or two "homework" activities, made up of things to pay attention to or things to discuss with others before the next module.
Each Module Includes 3 Parts
Educational Content | Discussion Questions | Suggested Activities
Upon completion of the 12-month series, participants will be able to:
- Clearly articulate a long-term vision for their organization with an understanding of their vision's role in the transition to value and population health
- Communicate about the vision in ways that inspire a diverse set of internal and external audiences
- Incorporate systems thinking into long- and short-term planning and decision making
- Build and strengthen collaborative relationships inside and outside the organization
- Identify desired qualities of future administrative leaders and have a plan to select for and develop these skills
- Develop a culture of accountability within their organization
Featuring Rural CEO and Board Member Interviewees
Lead Development Specialist
Shannon Studden, MS, PHR
Senior Program Specialist
(218) 216-7044
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The most recent interviews include discussions about prostate cancer awareness for Prostitute Cancer Awareness Month and multiple new conversations with rural health leaders.
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