Rural Route
August, 2020
In this Issue
FORHP Updates
Stratis Health Podcast: Quality Time: Sharing PIE
TASC Updates
2020 Rural Behavioral Health Care Coordination Summit
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Resource Library


State Flex Profiles




Rural Health Value


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.

Andy Naslund
Program Coordinator

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
 CAH Regulatory Update
Continue reading CAH Regulatory Updates (Flex Forum login required - contact TASC for details)
No new updates this month! Please keep your Flex staff contact information current by emailing Andy Naslund and completing the State Flex Program Contact Information Form whenever there are staffing changes in your office. 
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.

TASC Updates
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.

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.

TASC is also pleased to announce that an updated version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Overview: Vendor Directory is now available. Please share this resource with your rural health facilities.
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.
Please send your MBQIP questions to TASC will ensure your question reaches the appropriate person.
Webinars, Recordings & Events
Rural Health Leadership Radio was launched to support rural health leaders in sharing stories and information about best practices and lessons learned. Check out their latest podcasts now! 

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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