Arkansas Hospitals, Spring 2014

SPRING 2014

www.arkhospitals.org

CEO Profile: Barry Davis Arkansas General Assembly Fiscal Session

A M A G A Z I N E F O R A R K A N S A S H E A LT H C A RSpring E 2014 PRO F E S SHospitals I O N A L1 S I Arkansas

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Arkansas Hospitals

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419 Natural Resources Drive • Little Rock, AR 72205 501-224-7878 / FAX 501-224-0519 www.arkhospitals.org

BOARD OF DIRECTORS

Peggy Abbott, Camden Chris Barber, Jonesboro David Berry, Little Rock Tim Bowen, Mena Kristy Estrem, Berryville John Heard, McGehee Ed Lacy, Heber Springs Jim Lambert, Conway James Magee, Piggott Ray Montgomery, Searcy Robert Rupp, Newport Sharon Sly, Siloam Springs Barbara Williams, Conway

EXECUTIVE TEAM Robert “Bo” Ryall / President and CEO W. Paul Cunningham / Executive Vice President Beth H. Ingram / Senior Vice President Tina Creel / Vice President, AHA Services, Inc. Don Adams / Vice President, Rural and Mental Health Services Elisa M. White / Vice President and General Counsel Jodiane Tritt / Vice President, Government Relations Pam Brown / Vice President, Quality and Patient Safety

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CEO Profile: Barry Davis Arkansas General Assembly Fiscal Session

is published by

Doug Weeks, Little Rock / Chairman Walter Johnson, Pine Bluff / Chairman-Elect Darren Caldwell, DeWitt / Treasurer Larry Morse, Clarksville / Past-Chairman Ron Peterson, Mountain Home / At-Large

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FEATURED SECTIONS

Arkansas Hospital Association

Beth H. Ingram, Editor

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CEO Profile

25 Crisis Response Training Offered by AHA

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26 AHA Services Spotlight Article: careLearning

CEO Profile: Barry Davis

NewsSTAT

28 ICD-10 Education for Coders Continues 29 ACHE Opportunities for Face to Face Education

11 Arkansas General Assembly Fiscal Session

29 Apply to Advance to ACHE Fellow

12 NEA Baptist Health System Open for Business

30 “Do It Right” Campaign Saves Lives

13 Two Midnight Rule Enforcement Delayed

32 OIG Issues 2014 Work Plan

14 AHA Annual Meeting May 4-7, Washington, DC

33 Save the Date – Summer Conference

15 Paragould Medical Park Opens

34 Rural Hospitals Need to Recruit, Embrace, Engage

15 AHA Diamond Awards: Call for Entries

34 Group Issues Tool for Hospitalist Practices

16 Program to Improve Care for Beneficiaries

35 Mamie’s Poppy Plates

16 Walmart Provides Meals on Wheels Transportation 19 Prediction for 2014: A Bumpy Ride for Hospitals

Quality/Patient Safety

20 Mounting Pressure for America’s Hospitals

36 CMS Grants Third Year for HENs

22 Sparks Associates Honored with Patriot Awards

36 Annual Report Shows Improvements in Quality

22 Physician Education Continues

38 New Pharmacist-Led Collaborative

24 Arkansas PAC Contributions Recognized

40 AFMC’s Quality Conference, April 3-4

24 IRS Guidance for Tax-Exempt Hospitals

41 Quality Award Health Care Seminar Set

25 Hospitals Recognized for Outstanding Performance

Medicare/Medicaid 42 Private Option Enrollments Continue 43 Medicaid to Cover Inpatient Care for Inmates

Emergency Preparedness

DISTRIBUTION

Arkansas Hospitals is distributed quarterly to hospital executives, managers, and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas.

44 Managing Health Issues After a Disaster 44 Regional Drill Practices with Alternate Care Site

Governance 46 A Toolkit for Health Care Boards

Departments pcipublishing.com Created by Publishing Concepts, Inc. David Brown, President • dbrown@pcipublishing.com For Advertising info contact Michelle Gilbert • 1-800-561-4686 ext.120 mgilbert@pcipublishing.com edition 86

Cover Photo Waterfalls at the Chateau on the Lake, Branson, Missouri, site of the AHA’s Hospital Executive Leadership Conference June 11-13.

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From the President

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Arkansas Newsmakers and Newcomers

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All About Arkansas Hospitals

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Education Calendar

Photography courtesy of Carolyn Wright, https://www.facebook.com/ccwriNatureGreetings

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F R O M

T H E

P R E S I D E N T

Hospitals of the Future We used to gauge our cars by how fast they could accelerate: 0 to 60 in…10 seconds? 8 seconds? 7 seconds?

Photo courtesy of Jason Burt

Today, we gauge our information access by how many Google hits we get, and when you Google “Hospital of the Future,” you go from 0 to 466,000,000 in .27 seconds. Seems the whole world is seeking answers or offering opinions on the subject.

At the Arkansas Hospital Association, we’re seeking answers, too. We’re planning for the future as you are, and our planning is focused on how best we can serve Arkansas hospitals. There are many moving parts in the healthcare world today, and we’re all trying to be adept and adapt to changes as they come, thick and fast.

Hospitals and health systems in the U.S. are facing an unparalleled force to change. In the current regulatory and economic environment, hospitals must focus their efforts on performance initiatives that are essential in the short term and that will also remain critical for longterm success.

Every hospital is forging its own tailored pathway to the future, but there are some consistent themes we meet along the way as we seek to collaborate with our physicians, engage patients and improve outcomes. Here are some identified by the American Hospital Association: 1. Designing and implementing patient-centered, integrated care

Our role in providing educational offerings to keep hospital staff on the leading edge of change continues to grow. We’re bringing hospital physicians into discussions with our CMO Leadership Workshops. Webinars and face-to-face sessions on topics from ICD-10 to CMS Order Sets (and topics in between) are constant offerings to healthcare leaders and employees.

Our expanding role in hospital quality addresses not only quality improvement, but also patient and family engagement, healthcare disparities, and leadership for the future. Our quality team visits on-site with hospital teams, and also convenes quality leaders regularly in regional quality forums that address the hottest topics of the day. It holds conferences, hosts care-improvement collaboratives and offers webinars and calls to address our hospitals’ needs. Resources, tools, education and assistance are all offered to both improve care and address cost-of-care issues.

And our Hospital Engagement Network (HEN) is making great strides in 11 specific healthcare topic areas toward the 3-year goal of reducing healthcare-acquired conditions by 40% and preventable readmissions by 20% as a new baseline for quality.

We continue to support our administrative and governance leaders, and work closely with community leaders to find ways to best partner for our citizens’ – our patients’ – health.

Yes, things are changing fast. We’re moving with the tide and trying to keep our hospitals ahead of the next wave.

2. Planning strategically in an unstable environment

All change is scary. The struggles we face today in healthcare are daunting. But we represent you, we understand where you are, and we are here to serve.

3. Collecting and utilizing electronic data for performance improvement

We welcome your thoughts and ideas, and welcome your input on specific areas we can address for our hospitals.

4. Creating accountable governance and leadership

A generation from now we may look back and say this was the time when healthcare took its turn for the best, when hospitals bravely changed course and laid the groundwork for a great future!

5. Seeking population health improvement and improving the patient experience while reducing the per capita cost of healthcare 6. Collaborating both internally and externally 7. Aligning hospitals, physicians and other providers across the care continuum 8. Educating and engaging employees and physicians to create leaders

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Spring 2014 I Arkansas Hospitals

Bo Ryall President and CEO Arkansas Hospital Association

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ARKANSAS

NEWSMAKERS and NEWCOMERS Becker’s Hospital Review has named two Arkansas hospital CEOs to its inaugural list of “50 Rural Hospital CEOs to Know.” Congratulations go to Ray Montgomery III, FACHE, president and CEO of White County Medical Center in Searcy, and Debra Wright, CEO of Howard Memorial Hospital in Nashville. According to Becker’s, this group of individuals “have shown commitment to providing high-quality, accessible care to their patient populations and have approached the challenge of rural healthcare with great aplomb.”

Governor Mike Beebe has named Brian Thomas, COO, Jefferson Regional Medical Center, Pine Bluff, to the Governor’s Trauma Advisory Council, succeeding Keith Moore of Little Rock. The appointment expires July 1, 2015.

Nancy Godsey has joined the AHA staff as director of quality and patient safety. She was formerly a quality specialist at the Arkansas Foundation for Medical Care and familiar to many hospital quality staff. For the past 20 months, she has been working through a contract between the two organizations for the AHA’s Hospital Engagement Network.

Jason Miller has been named Interim CEO of The BridgeWay in North Little Rock following the January 4 death of hospital CEO Barry Pipkin. Miller has been with the hospital for two years as chief operating 6

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officer. Before moving to The BridgeWay, he served in other administrative positions with Arkansas Children’s Hospital and St. Vincent Health System in Little Rock.

Barry Pipkin, CEO of The BridgeWay Hospital in North Little Rock for the past 20 years, died January 4 following a long illness. In addition to his role as hospital CEO, Barry also served as the divisional vice president of Universal Health Services, which owns The BridgeWay. He worked as a clinical psychologist prior to taking on his role in healthcare administration. Barry devoted his life to helping others and worked tirelessly to make the lives of those struggling with mental illness better. Memorials may be made to Little Rock Compassion Center, First United Methodist Church of Maumelle.

Effective December 31, two Arkansas hospitals changed hands and names: Booneville Community Hospital entered into a lease agreement with Mercy Health. Ryan Gehrig, Mercy Hospital Fort Smith president, announced the name change to Mercy Hospital Booneville. Baptist Health began operating HSC Medical Center in Malvern. The facility’s new name is Baptist Health Medical Center – Hot Spring County.

Michael Truman has been named CEO of Riverview Behavioral Health and Vista Health Outpatient in Texarkana, succeeding Scott Kelly.

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all about

ARKANSAS HOSPITALS Groundbreaking was held recently in Little Rock for the new CARTI Cancer Center, a $90 million cancer center expected to open in fall 2015. The “new” CARTI will offer under one roof medical, surgical and radiation oncology and diagnostic radiology, as well as hematology services. It also will feature clinics dedicated to imaging, research, pharmacy and support programs.

The 170,000-square-foot center is located off Riley Drive in west Little Rock, adjacent to Interstate 630.

“Since first opening our doors in 1976, CARTI has been committed to its mission of promoting the finest quality cancer treatment and compassionate patient care while also improving our knowledge through education and research,” said Jan Burford, CARTI president and CEO. “It is that commitment that brings us here to celebrate the next phase in the future of CARTI.” St.Vincent Health System recently participated in “Operation Walk USA,” a nonprofit group that coordinates a week-long surgery event each year to replace the diseased and damaged joints of patients who are uninsured or do not qualify for government assistance. Of the 230 national surgeries planned for the event this past year, St. Vincent performed 26 surgeries replacing hips and knees – all completely free of charge. Those donating their services included three St. Vincent orthopedic surgeons, dozens of anesthesiologists, nurses, radiologists, physical therapists and other staff. Hospital vendors donated supplies and equipment, including artificial joints. UAMS medical residents participated as well.

DeWitt Hospital recently celebrated its 50th Anniversary by hosting an open house event. Tee shirts depicting the hospital’s anniversary logo were sold as a fundraiser for the Hospital’s Children’s Fund. The fund was established in the late 1990s to raise funds to purchase Christmas presents for children in the community as well as for local nursing home residents.

White River Health System in Batesville will soon open a satellite emergency room at the WRMC Medical Complex in Cherokee Village. The satellite ER will be open and staffed by physicians 24-hours a day, 7 days a week. Telemedicine equipment will offer ongoing dialogue between physicians in Cherokee Village and Batesville. “We have always been a dedicated partner

in bringing high quality healthcare to Sharp County,” said Gary Bebow, CEO/administrator of WRHS. “The time is right to expand the services we offer to the residents of Sharp County and surrounding areas.”

Ashley Memorial Medical Center announces the addition of GE Healthcare’s leading CT imaging technology, the Optima CT660 Freedom Edition Scanner, which makes possible images of small structures and fine details, or the possibility of examining large patients up to 500 pounds without compromising imaging quality and speed. Low dose reconstruction technology is included that significantly reduces dose while maintaining the high image quality and low contrast detectability needed for accurate diagnosis across a wide spectrum of procedures including cardiac, angiography, brain, chest, abdomen, orthopedic, and more.

Saline Memorial Hospital and the University of Arkansas for Medical Sciences (UAMS) have joined to open a neurosurgery clinic in Benton to make services more convenient for local patients and to support the healthcare system in the Benton area. In early February, surgeons from the Department of Neurosurgery in the UAMS College of Medicine began seeing patients in the clinic located next to Saline Memorial Hospital and performing several types of surgery at the hospital.

“This collaboration will expand services within a community that is underserved in terms of practicing neurosurgeons. UAMS has a local and national reputation for excellence, and together we will be able to offer more patients access to the latest technology and services,” said Bob Trautman, Saline Memorial CEO. Patients with hand injuries now have access to the nation’s first hand trauma telemedicine program established with partnerships by the University of Arkansas for Medical Sciences (UAMS), the Arkansas Trauma Communications Center and the Arkansas Department of Health. Through the Hand Telemedicine Program, patients and their physicians in hospitals throughout Arkansas can consult in real time with hand trauma surgeons and specialists via a high-definition broadband video connection provided through e-Link Arkansas. The surgeons, using an iPad or other mobile device, will connect to local doctors and hospitals that use telemedicine equipment called e-Link carts.

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EDUCATION CALENDAR April 3-4, Little Rock AFMC Quality Conference April 16, Little Rock Arkansas Health Executives Forum Spring Meeting April 16-18, Hot Springs Society for Arkansas Healthcare Purchasing and Materials Management Annual Meeting April 17, Little Rock AHA Hospital CEO Orientation April 24, Little Rock Addressing 2014 Key Compliance Issues – HIPAA & EMTALA Workshop April 25, Little Rock Arkansas Association for Healthcare Quality Spring Conference April 30, Little Rock ICD-10 Workshop Series, Session IV

April 30-May 2, Hot Springs Healthcare Financial Management Association Spring Workshop

May 21, Little Rock ICD-10 Workshop Series, Session V

May 1, Little Rock Arkansas Society for Marketing and Public Relations (ASHMPR) 2014 Spring Conference

May 22, Little Rock ACHE 6-hr Face to Face Workshop, “Growth in the Reform Era” June 11-13, Branson, MO Arkansas Hospital Executive Summer Leadership Conference

May 4-7, Washington, DC American Hospital Association Annual Membership Meeting

June 25, Little Rock ICD-10 Workshop Series, Session VI

May 7-9, Little Rock Arkansas Association for Healthcare Engineering Annual Meeting

July 23, Little Rock ICD-10 Workshop Series, Session VII

May 13, Little Rock Chief Medical Officer Leadership Workshop May 14-16, Little Rock Basic Emotional First Aid Crisis Response Training May 20, Little Rock Arkansas Association of Hospital Trustees Spring Workshop

Program information available at www.arkhospitals.org/events.

Webinar and audio conference information available at www.arkhospitals.org/events.

SAVE YOUR HOSPITAL SO MUCH MONEY, THE BOARD APPLAUDS YOU. With more vendors, options and increased savings, there are plenty of reasons to let us guide you. Call us today, and we’ll make you the rockstar around the hospital.

419 Natural Resources Drive, Little Rock, AR 72205 501-224-7878 Office • 501-224-0519 Fax • ahaservicesinc.com AHA SERVICES, INC. IS A WHOLLY OWNED SUBSIDIARY OF THE ARKANSAS HOSPITAL ASSOCIATION

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CEO PROFILE

CEO Profile: Barry Davis How many hospital CEOs can say they know every square inch of their buildings? Barry Davis, FACHE, CEO of Arkansas Methodist Medical Center in Paragould can, and does.

A standout high school basketball player in Paragould, he secured a basketball scholarship for his college education. Davis began his career at AMMC almost 32 years ago as plant manager, the day after his graduation with a bachelor’s degree in public administration from Arkansas (now Lyon) College in Batesville. In that position, he was responsible for overseeing environmental service, elements of maintenance and upkeep of the grounds. One year later, he moved on to create and manage the hospital’s first credit and collections office.

Recognizing his potential, then-hospital CEO Dale Christian tapped Davis to become assistant administrator. While taking on a whole new level of responsibility in this new role, he also completed his master’s degree in public administration by attending evening classes. After CEO Ron Rooney was hired in 1988, Davis served as assistant administrator and then chief operating officer of AMMC for two decades.

So it was natural that after the retirement of Rooney at the end of 2011, Davis was appointed interim CEO, a position he held for three months before the board named him CEO of the 129-bed hospital. A position well earned by Barry Davis.

“I think the employees know I’ve come up through the trenches,” Davis said, reflecting on his three decades of service. “I hope they feel like they can interact with me because they know I’ve been through what they go through. I can relate.”

Barry Davis

knows what areas of the hospital need the most attention. He notes the need to complete the ongoing conversion of semi-private rooms to fully private ones for patient comfort. A need to add additional patient rooms and the need to focus on physician recruitment are among many items on an ambitious list of goals.

The hospital’s most recent projects include the 2012 opening of a Wound Healing Center and the December 2013 opening of Paragould Medical Park, both joint ventures with St. Bernards Medical Center in Jonesboro. In addition, the hospital is undertaking a patient room renovation project and continues to add new diagnostic equipment to enhance services offered by the hospital and medical staff.

In my more than 30 years of working in healthcare, I believe this to be the most difficult, rapidly changing and uncertain period of time for hospitals and physicians that I have witnessed.

“When I started in 1981, there were about 250 employees,” he continued. “Now there’re more than 600, and the hospital itself has doubled in size. I have been very blessed to be surrounded by quality people at the Board level, in management and our medical staff. I also owe a great deal to Ron Rooney, AMMC’s former CEO, who was a good mentor through the 20 plus years we worked together. I feel that surrounding yourself with quality administrators and managers, and letting them do their job is the key to success. I see the CEO’s role as providing leadership and guidance.”

Because of his years of service up through the ranks, Davis

Davis is president of the Paragould Chamber of Commerce, serves on the Economic Development Corporation for the city, the executive committee of the Northeast Arkansas Workforce Investment Board and is a member of the Kiwanis Club.

Long active in the Arkansas Hospital Association, he is vicechairman of the AHA Workers’ Compensation Self-Insured Trust Board, past-president of the Arkansas Hospital Administrators Forum, past-president and treasurer of the AHA’s Northeast Hospital District and a member of the Arkansas Health Executives Forum. He is a continued on page 10 Spring 2014 I Arkansas Hospitals

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Fully Invested.

Fellow in the American College of Healthcare Executives and in 2008, received the ACHE’s Regent’s Award.

He also serves on the board of the VHA Arkansas-Oklahoma region.

Davis has two sons, both of which he is very proud.

Tyson is a teacher at Greene County Tech in Paragould and Trase is completing his final year at Arkansas State University in Jonesboro majoring in information technology.

Both young men have grown up attending AHA summer events through the years.

“In my more than 30 years of working in healthcare, I believe this to be the most difficult, rapidly changing and uncertain period of time for hospitals and physicians that I have witnessed.

Hospital administrators are dealing with national, state and local issues on a daily basis. Changes in reimbursement (at all levels), new coding requirements, private options/ insurance exchanges, physician recruitment, mandated quality measures, and more are happening at a pace not seen before in healthcare.

“Due to this rapidlychanging environment, it is essential to have an organization, such as the Arkansas Hospital Association, to guide us and interpret healthcare laws and regulations. Smaller facilities do not have the manpower and/ or ability to stay abreast of all the changes taking place, so the Arkansas Hospital Association is vital in keeping hospitals current on the issues. AHA also plays a significant role in representing us legislatively at the state level,” Davis commented.

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N E W S S T A T

by Jodiane Tritt, Vice President, Government Relations, Arkansas Hospital Association

Arkansas General Assembly Fiscal Session Editor’s Note: On February 20, the Arkansas Senate approved by a vote of 27-8 SB111, which is the appropriation for the Department of Human Services Division of Medical Services that includes the Arkansas Private Option. On March 4 by a vote of 76-24, the Arkansas House of Representatives passed the bill, which was transmitted to the Governor who then signed it into law.

The Arkansas Hospital Association thanks all of our hospital employees for all you have done to make your voices heard. This issue is of utmost importance for our hospitals and especially the patients, families, and communities that we are able to serve!

If you have not done so already, please make sure you take time to thank our legislators who stood with our hospitals. Why? Because it’s the right thing to do, and because the issue will again come into play with the 90th Arkansas General Assembly in 2015.

February 10, 2014, marked the first day of the third-ever fiscal session for our state. In 2008, the citizens of Arkansas voted to amend the Arkansas Constitution to create fiscal sessions in evennumbered years. Prior to Amendment 86, the legislature met in odd-numbered years and not only created and approved the state’s budget for a two-year period, but it also created and amended nonfiscal laws. Fiscal sessions are permitted to run for 30 calendar days.

If the legislature needs more time, a three-fourths vote is required to allow an additional 15 days of the fiscal session.

There is no question that the biggest issue facing Arkansas hospitals during this fiscal session is the appropriation of the Department of Human Services, Division of Medical Services budget. This appropriation bill is the one that holds the appropriation for the Arkansas Private Option. Not only that, this appropriation bill is the one that contains the authority for the state to pay for nursing home care, physician visits, prescription drug expenses, mental health care, dental care, and much more. It would seem like a no-brainer that the legislature would approve this

appropriation. After all, no one really wants to shut down healthcare by choosing not to pay healthcare providers for the services that they render to our most vulnerable patients, right?

Not so fast! Arkansas’s Constitution disallows the legislature to approve this type of appropriation bill with a simple majority.

In fact, in order for the measure to be approved, three-fourths of the House of Representatives and Senate must agree. This means that just nine Senators or just 26 House members can block the appropriation. During the regular session when the Arkansas Private Option was created and approved, 77 House members and 28 Senators voted to authorize the appropriation for the Arkansas Private Option. One of those Senators is no longer in the Senate – replaced with a vocal opponent to the Arkansas Private Option.

One more of those 28 Senators who was previously in favor has now proclaimed to be against.

Procedurally, appropriation bills follow the same path in either a regular or a fiscal session; however, during a fiscal session, in order to consider non-fiscal matters, twothirds of both the House of Repre-

sentatives and the Senate must agree to bring up the issue. The likelihood of having another policy bill on the Arkansas Private Option during the fiscal session is incredibly low. As a matter of fact, the only non-fiscal bill being discussed for introduction is one that would allow the Governor to avoid calling a special election for the Lieutenant Governor’s vacant seat. The question then becomes whether the Arkansas Private Option gets stripped from the overall appropriation for the Division of Medical Services appropriation bill. The likelihood of that is small, too.

Here’s why. Prior to the legislative session, the legislature holds a series of budget hearings. In these hearings, the Governor proposes the overall state budget. The legislature then has the ability to accept the Governor’s executive recommendations or create its own recommendations. These recommendations then are drafted into the large number of appropriation bills to be voted on during the session. Those appropriation bills are first heard in the Joint Budget Committee and then voted on by each House separately. The legislature chose to include the Arkansas Private Option continued on page 12 Spring 2014 I Arkansas Hospitals

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N E W S S T A T in the overall appropriation bill that authorizes spending for the Division of Medical Services.

In order to strip out the Arkansas Private Option from the overall bill, the legislature would have to amend the appropriation bill. While it only takes a simple majority to amend the bill in committee, the number of supporters of the Arkansas Private Option who serve on the Joint Budget Committee far exceeds a simple majority and, therefore, would likely block an amendment to harm the Arkansas Private Option.

It is a very real possibility that there are neither enough votes to pass the appropriation that includes the Arkansas Private Option nor are there are enough votes to amend the appropriation in a way that authorizes the Division of Medical Services budget. This means that the legislature could leave the Division of Medical Services appropriation bill unauthorized.

Notwithstanding the merits of the Arkansas Private Option, there are serious implications for the state budget as a whole if the appropriation is not approved.

Right at $89 million of the state’s $5 billion budget relies on projected savings from implementing the Arkansas Private Option. The Governor is quick to explain that about half of the state’s budget is allocated to K-12 education and a large portion of that is mandatory spending. That means that if the $89 million must be cut from other places in the budget, not only would provider payments through the Medicaid program be further jeopardized, but cuts in spending for prisons, higher education, and a host of other state responsibilities would be imminent.

Speaking of the merits of the Arkansas Private Option, likely the biggest advocates for continuing the program should be the 100,000

(or more) newly insured Arkansans.

Hospitals and other healthcare providers have definitely made the case for the need for adequate reimbursement for taking care of patients.

Don’t forget that hospitals are eating more than $2 billion in Medicare payment reductions over the next 10 years (not to mention the additional anticipated $400 million in uncompensated care each year) and the Arkansas Private Option potentially allows for about $200 million of uncompensated care to now be compensated.

The Arkansas Private Option allows patients who choose to sign up the opportunity to pay for their healthcare. Many of these Arkansans have been uninsured because insurance was unavailable to them or unaffordable for them. These are the voices that must be heard in the marble hallways of the State Capitol. These voices – our patients’ voices – are the reason we fight!

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NEA Baptist Health System in Jonesboro Open for Business

Constructing a new hospital from the ground up is a monumental task built with the underpinnings of vision, ideas, commitment and dreams. What seemed like a dream on April 1, 2011 when construction began, became a reality in January 2014 as employees, physicians and patients moved into the new $400 million NEA Baptist Health System in Jonesboro.

The system comprises NEA Baptist Memorial Hospital, NEA Baptist Clinic and Fowler Family Center 12

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for Cancer Care. The total complex covers 765,703 sq. ft. and houses 181 inpatient beds in the hospital’s all-private rooms.

“We’ve been preparing for this day for several years,” said NEA Baptist CEO Brad Parsons. “This is the combination of a lot of planning, scenarios and training, but we know that we’re ready to take great care of our patients,” he said just prior to the January 12 move. The hospital had formed many commit-

tees to plan the successful move.

On the evening of Saturday, January 11 in preparation for the move the next day, NEA Baptist colleagues took time to form a Prayer Walk and pray for the new facility and everyone involved in the move the following day.

The new campus offers care in heart, cancer, women’s bariatric, neurology, orthopedics, plastic surgery, outpatient rehabilitation, emergency services and more.

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N E W S S T A T

Two Midnight Rule Enforcement Delayed The Centers for Medicare & Medicaid Services on January 31, extended for six months the partial enforcement delay of its two-midnight policy for inpatient admission and medical review criteria. Under the extension, recovery auditors and other Medicare review contractors will not conduct post-payment patient status reviews of inpatient hospital claims with dates of admission on or after October 1, 2013 through September 30, 2014.

However, Medicare Administrative Contractors will continue to conduct pre-payment “probe and educate” audits on select claims for patients admitted between

October 1, 2013 and September 30, 2014. For more on the claims review policy, see CMS’ updated guidance at http://cms.gov/ResearchStatistics-Data-and- Systems/ Monitoring-Programs/MedicareFFS-Compliance-Programs/Medical-Review/Downloads/ReviewingHospitalClaims_forAdmission_ forPosting_01312014_508Clean.pdf.

“We are pleased that CMS has extended its enforcement moratorium on the two-midnight policy for an additional six months, as the AHA has urged,” said American Hospital Association executive vice president Rick Pollack. “…At the same time, we continue to urge

CMS to fix the critical flaws of the underlying policy by immediately engaging stakeholders to find a workable solution that addresses the reasonable and necessary inpatient-level services currently provided by hospitals to Medicare beneficiaries that are not expected to span two midnights.”

CMS also posted new guidance clarifying its physician certification and order requirements under the two-midnight policy. It is available at http://www.cms.gov/ Medicare/Medicare-Fee-for- Service-Payment/AcuteInpatientPPS/ Downloads/IP-Certification-andOrder-01-30-14.pdf.

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FEEL SECURE WITH YOUR COMMUNITY BLOOD SUPPLIER.

Join the AHA members who made the decision to be our partner in healthcare.

“We couldn’t be more pleased with the quality of customer service, availability of products and level of medical expertise we receive as a partner with Arkansas Blood Institute.”

– Tim Bowen, CEO, Mena Regional Health System

arkbi.org Del Holloway, Executive Director 800-934-9415

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N E W S S T A T

AHA Annual Meeting May 4-7, Washington, DC Attendees have the opportunity to visit personally with their congressman and the state’s two senators to deliver their messages on how federal legislative and regulatory issues are affecting their hospitals and communities, in particular the deepening Medicare and Medicaid reductions.

“Ensuring a Healthier Tomorrow” is the theme for the American Hospital Association’s (AHA) annual membership meeting May 4-7 in Washington, DC. This annual meeting provides an excellent forum for hospital execs and trustees to learn firsthand about AHA’s advocacy agenda and strategy for 2014. In addition, attendees have the opportunity to visit personally with their congressman and the state’s two senators to deliver their messages on how federal legislative and regulatory issues are affecting their hospitals and communities, in particular the deepening Medicare and Medicaid reductions.

As it has for the previous five years, the Arkansas Hospital Association will reimburse each hospital CEO up to $1,000 for his/her registration fee and airline ticket. However, to receive the stipend, attendees must participate in all Arkansas activities, including the very important visits with our congressional delegation.

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During the meeting, participants will have the opportunity to attain American College of Healthcare Executives Face to Face credit; attend executive briefings on topics such as how hospitals are using social media, a 340B update, integration and transformation, Medicaid issues, the future of quality measures, workforce and new care models, and innovative arrangements in private insurance marketplaces.

Other educational opportunities will be available for hospital trustees covering issues such as mega trends and mergers, trustees transforming healthcare, and insights on America’s current political climate.

Attendees also will hear presentations from MSNBC’s Joe Scarborough, former White House chiefs of staff Andrew Card and Bill Daley, Washington Post policy columnist Ezra Klein, and other Washington insiders.

However, the most important events are the times set aside to meet with the state’s Washington delegation and their key aides on health matters. The AHA will host a reception for congressional aides on Monday evening, May 5; and on Wednesday, May 7, attendees from each congressional district will meet as a group with their respective congressman in his Capitol Hill office. Additionally, plans are being made for a Wednesday morning breakfast with Senator Mark Pryor and Senator John Boozman.

Meeting and registration information is available online at www. aha.org. Please fax a copy of your meeting registration form to Beth Ingram at the Arkansas Hospital Association (501-224-0519) to receive special mailings detailing Arkansas events. You may also email attendance plans to bingram@arkhospitals.org. Register

by March 21, 2014 and save!

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N E W S S T A T

Paragould Medical Park Opens Arkansas Governor Mike Beebe joined with officials from Arkansas Methodist Medical Center and St. Bernards Healthcare in mid-December, for the official ribbon cutting for Paragould Medical Park.

The 60,000-square-foot complex, located at 4000 Linwood Drive (U.S. 49 South) in Paragould, is complete, and physicians and other healthcare providers have been seeing patients in their new surroundings since the opening.

The $12 million project houses four physician clinics, in addition to other services available on site including wound care, outpatient radiology, outpatient lab, preadmission testing for both Arkansas Methodist and St. Bernards, physical therapy, a specialty clinic and infusion center.

In his address, Governor Beebe talked about the importance of

strong healthcare partnerships and collaboration rather than turf wars in ensuring that Arkansans have access to quality care. He praised both Arkansas Methodist Medical Center and St. Bernards for forging a partnership that has resulted in a beautiful new facility where residents of Paragould and Greene County can receive the finest care available.

Paragould Medical Park is a joint venture between Arkansas Methodist Medical Center and St. Bernards Healthcare in Jonesboro and sits on a 48-acre plot located on U.S. 49, just south of the proposed route for the U.S. 412 Bypass around Paragould. Contractor for the project was Nabholz Construction, and the architect is Brackett Krennerich Architects.

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AHA Diamond Awards: Call for Entries The 2014 Arkansas Hospital Association (AHA) Diamond Awards Call for Entries has been announced.

The open nominations are co-sponsored by the AHA and the Arkansas Society for Healthcare Marketing and Public Relations. Last year, 19 hospitals received awards presented at the AHA’s Annual Awards Dinner held in conjunction with the AHA Annual Meeting and Trade Show.

This year’s recipients will receive their awards during the October 9, 2014 Awards Dinner at the Little Rock Marriott.

The 2014 Diamond Awards recognize excellence and encourage

improvement in the quality, effectiveness and impact of healthcare marketing and public relations in the state of Arkansas. Awards will be presented in several categories, such as advertising, annual report, Internet website, publications, special video production, writing and electronic marketing campaign. Diamond Awards’ divisions include hospitals with 0-25 beds (Critical Access Hospitals), 26-99 beds, 100-249 beds and 250 or more beds. Entries will be judged individually by a panel of judges not affiliated with any Arkansas hospital. Emphasis will

be placed on the budget for each entry within each division.

Nominations and entries, accompanied by appropriate documentation, must arrive at AHA headquarters no later than May 16, 2014 with a discounted registration fee available for those who submit three or more entries. A brochure providing details of the awards competition was mailed to hospital CEOs and marketing and public relations directors and is available at http://www.arkhospitals.org/events/annual-meeting, selecting “2014 Diamond Awards Brochure.”

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Spring 2014 I Arkansas Hospitals

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ACOs Join Program to Improve Care for Medicare Beneficiaries Arkansas Health Network in Little Rock has been selected as one of 123 new Accountable Care Organizations (ACOs) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to high-quality, coordinated care across the United States, Health and Human Services (HHS) Secretary Kathleen Sebelius announced in late December. Five ACOs have been selected to serve Arkansas since the program’s inception in 2012. In addition to Arkansas Health Network, they are AR Accountable Care, LLC; Central US ACO, LLC; Fort Smith Physicians Alliance ACO; and Mercy ACO, LLC. Doctors, hospitals and healthcare providers establish ACOs in order to work together to provide higher-quality coordinated care to their patients, while helping to slow healthcare cost growth. Since passage of the Affordable Care Act, more than 360 ACOs have been established, serving over 5.3 million Americans with Medicare. Beneficiaries seeing healthcare providers in ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs share with Medicare any savings generated from lowering the growth in healthcare costs when they meet standards for high quality care.

A partnership between physicians and St. Vincent Health System, Arkansas Health Network (AHN) is a physician-driven, clinically integrated network initiative that builds on the strengths of participating providers to improve patient health, increase efficiency and enable physicians to succeed in today’s changing healthcare payment and delivery environments.

AHN provides participating physicians with tools to help them manage patients with complex medical needs through care coordination and information technology. The network has access to significant resources to ensure that it will be successful with a variety of payer initiatives. It also offers national clinical and technical resources in the form of advanced information technology, data analytics and other tools.

To comply with Medicare criteria, ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using 33 quality measures on patient and caregiver experience of care, care coordination and patient safety,

appropriate use of preventive health services, and improved care for atrisk populations.

The Affordable Care Act provisions have a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, and this trend has continued into 2013. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.

The next application period for organizations interested in participating in the Shared Savings Program beginning January 2015 will be in summer 2014. More information about the Shared Savings Program is available at https://www. cms.gov/Medicare/Medicare-Feefor- Service-Payment/sharedsavingsprogram/index.html?redirect=/ sharedsavingsprogram/.

For a list of all the ACOs announced thus far, visit: http:// www.cms.gov/Medicare/MedicareFee-for-Service-Payment/sharedsavingsprogram/News.html

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Walmart Provides New Meals on Wheels Transportation The Walmart Foundation recently provided a $37,000 grant to Mercy Hospital Hot Springs’ Mercy Senior Care department through the Foundation’s State Giving Program. The grant was used to purchase a new 16

Spring 2014 I Arkansas Hospitals

delivery vehicle for the Meals on Wheels program. The vehicle will be used to deliver daily meals throughout Garland County.

“The grant is a blessing, as it strengthens our ability to continue

providing daily nutrition to Garland County seniors, many of whom could suffer from food insecurity and hunger without our Meals on Wheels services,” said Diane Harry, Mercy Hospital senior services director. “In

The grant is a blessing, as it strengthens our ability to continue providing daily nutrition to Garland County seniors. addition, their delivery person is more than likely the only person they see every day, monitoring their well being.”

“At the Walmart Foundation, we understand that organizations such as Mercy Hospital Hot Springs are essential to building stronger communities. They share our values and are committed to helping those in need in the communities we serve,” said Chris Neeley, Walmart public affairs director. “Through this grant, we are hopeful that residents in this state will feel a positive effect, and through that effect our impact will be expanded.”

The Walmart Foundation’s State Giving Program supports organizations that create opportunities so people can live better, awarding grants that have a longlasting, positive impact on communities across the U.S. To be considered for support, perspective grantee organizations must submit applications through the Walmart Foundation State Giving Program’s online grant application. Applicants must have a current 501(c)(3) taxexempt status in order to meet the program’s minimum eligibility criteria. Additional information about the program’s funding guidelines and application process are available online at www.walmartfoundation.org/stategiving.

•

employee benefits

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Spring 2014 I Arkansas Hospitals

17

Only a

away!

Connect

to free resources and tools for your patients!

Go to www.afmc.org and get instant access to information that health care providers like you need every day. You’ll find free quality improvement tools available for order and download, details about AFMC’s quality improvement projects, survey results, professional publications geared toward Arkansas providers and MORE!

THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC), THE MEDICARE QUALITY IMPROVEMENT ORGANIZATION FOR ARKANSAS, UNDER CONTRACTS WITH THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS), AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE ARKANSAS DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL SERVICES. THE CONTENTS PRESENTED DO NOT NECESSARILY REFLECT CMS AND ARKANSAS DHS POLICIES. THE ARKANSAS DEPARTMENT OF HUMAN SERVICES IS IN COMPLIANCE WITH TITLES VI AND VII OF THE CIVIL RIGHTS ACT. QP3-AHA.CONNCT.AD, 1-3/14

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Spring 2014 I Arkansas Hospitals

N E W S S T A T

by Paul Cunningham, Executive Vice President, Arkansas Hospital Association

Prediction for 2014: A Bumpy Ride for Hospitals Everyone has an opinion about the Affordable Care Act (ACA), née Obamacare. Most are based on ideology. It is either good policy or bad; it’s a God-send or a disaster; it will make the U.S. more competitive in a world market or it will bankrupt the country. The one thing folks on both sides of the argument will agree on, including anyone who professes intent to repeal the law, is that the ACA is here to stay. What’s left is to determine how exactly it will affect the key players in the ongoing drama of healthcare reform – patients, providers and payers.

Dr. Paul Keckley has some interesting takes on the matter and it’s a good bet that his predictions are based on more than simple guess work. A health economist and former executive director for the Deloitte Center for Health Solutions, Keckley – a Ph.D. rather than an M.D. – is regarded as a leading expert on healthcare reform stemming from the ACA. Studies conducted under his direction while at the Deloitte Center are noted in Congressional testimony, his insights are common in industry publications and he is the author of three books, more than 150 articles, and a weekly report on healthcare reform that is circulated among 20,000-plus readers. If you attended the Arkansas Hospital Association’s Annual Meeting a few months ago, you’ll recall Keckley’s presentation on the effects of healthcare reform in the coming decade.

In his final weekly report for 2013, Keckley narrowed the scope of his predictions to cover just a single year. In a week marked by “That Was the Year That Was” look-backs at 2013 focused on how

we got to where we are, his thoughts aim toward the vicinity of where we’re likely to go in the next twelve months, and particularly on the big healthcare stories we’ll be hearing and reading about in 2014.

Keckley’s crystal ball includes few surprises. His predictions of things to come in 2014 probably reinforce much of what many of you might already expect, but they also accelerate the time table. It’s no shock that Dr. K would predict that hospitals will be battling for survival in 2014 due to unprecedented payment cuts from all payers. That’s old news! The big story this year will be how hospitals are quick to fight back with moves by reducing operating costs and purging clinical programs no longer affordable, operating their inpatient business as a cost center, and setting up enterprises as regional care management organizations assuming risk for costs, outcomes and safety.

Want a real surprise prediction for the year? Try this one! After accounting for consulting fees and costs for information systems and staffing, the net savings attributable to the Medicare Shared Savings Program (MSSP) will fall short of the costs for their set-up and operation.

Who’d’uv thunk!? Only anyone who can remember other miracle cures to save Medicare that sprang from HCFA/CMS over the years; think capital expenditure review, PPS, DRGs and HMOs? As a result, Dr. Keckley believes that “accountable care” arrangements will evolve to concentrate more on episode-based payments and case management services to drive higher savings in higher cost populations for employers and for Medicare and Medicaid popula-

tions. Sounds like Arkansas is on the cutting edge of this one, with its payment improvement initiative.

Among other healthcare reform related stories developing for 2014, Dr. Keckley foresees that the ACA’s individual mandate will be delayed following the March 31 close of the insurance sign-up date due to a dearth of healthy young invincibles who have signed up for coverage; and physicians will mount the equivalent of an all hands on deck effort to protect the future of the profession.

According to Keckley, “they’ll dust off advocacy advertising campaigns to drum up resentment of market pressures that threaten to reduce their profession to a guild employed by plans or hospitals.”

A similar battle for the hearts and minds of the people could be in store for hospitals as they face more public outcry over the value in healthcare due to a lack of transparency about costs, prices, outcomes and user experiences. Public sentiment on the issue could grow to such proportion that the defunct Occupy Wall Street movement of 2011-2012 redevelops and deploys as Occupy Health Care in a “campaign to align profit and purpose.”

Whether any or all of the above comes to pass is up in the air. Keckley is good, so don’t discount anything; but he’s never professed to be Nostradamus. In any event, Happy New Year! To paraphrase the Bette Davis quote from the 1950 film All About Eve, “Buckle up, it’s going to be a bumpy ride.”

Editor’s note: If you’d like to read or subscribe to Paul Keckley’s weekly column, click here http:// www.paulkeckley.com/. Interesting reading.

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20

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OF REVIEWED CLAIMS DENIED

SOURCE: AHA RACTrac, November 2013 Spring 2014 I Arkansas Hospitals

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N E W S S T A T

Sparks Associates Honored with Patriot Awards Five Sparks Health System (Fort Smith) associates were honored in a recognition ceremony January 22 with Patriot Awards from the Department of Defense (DoD) for their continued support of a fellow employee who serves in the U.S. Navy Reserve.

Juston Evenson, anesthesiologist, M.D., Julie McBride, manager surgical services, Lori Sallee, R.N., director of surgery, Misty Sharp, OR supervisor and Shawna Steely, supervisor ancillary services, received the award from the Arkansas Employer Support of the Guard and Reserve (ESGR), a DoD operational committee.

All five associates work in the surgical department with Andrew Barkley, Certified Anesthesia Technician.

Barkley is a senior line corpsman in the U.S. Navy Reserve attached to the 3rd Battalion, 23rd Marines. As part of his duties, he’s required to serve one weekend a month and two weeks a year, often in Little Rock.

Barkley nominated his fellow associates for the ESGR award because of their ability to pick up the slack and accommodate his schedule while he serves his country and contributes to the medical care of more than 160 marines.

“I know that it’s a burden on their part when I leave,” Barkley said. “It’s just a way of saying ‘Thank You.’”

From left to right: Lori Sallee, R.N., director of surgery); Misty Sharp, OR supervisor; Andrew Barkley, a Certified Anesthesia Technician; Shawna Steely, ancillary services supervisor; Juston Evenson, M.D., anesthesiologist; and Charles Stewart, CEO, Sparks Health System & Summit Medical Center. Not pictured: Julie McBride, surgical services manager.

“The Patriot Award was created by ESGR to publicly recognize individuals who provide outstanding patriotic support and cooperation to their employees, who, like the citizen warriors before them, have answered their nation’s call to serve,” said Jon Woodham, Northwest Arkansas Area ESGR area chairperson. “Supportive supervisors are critical to maintaining the strength and readiness of the nation’s Guard and Reserve units.”

Employer Support of the Guard and Reserve (ESGR), a Depart-

ment of Defense operational committee, seeks to foster a culture in which all employers support and value the employment and military service of members of the National Guard and Reserve in the United States.

More information about ESGR Employer Outreach Programs and volunteer opportunities is available at http://www.esgr.mil, https:// www.facebook.com/ARKANSAS. ESGR, by calling Jon Woodham at 479-459-3342, or by calling Richard Green at 501-212-4096.

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Physician Education Continues In mid-February, Dr. Joe Nichols of Health Data Consulting was the featured speaker for the second Arkansas Hospital Association-sponsored physician education workshop. Dr. Nichols, an ICD-10 22

Spring 2014 I Arkansas Hospitals

certified trainer, discussed why physicians must champion this unprecedented event in their hospitals and what impact the coding changes will have on their hospital, as well as on their practice.

The afternoon session was led by Julie Ginn Moretz of UAMS and the AHA’s vice president for quality and patient safety Pam Brown. They shared stories of why patient and family engagement is so important

As the regulations and reimbursement become increasingly complicated, patient care, population health and community health needs to be at the center of all decisions. for hospitals to achieve, and how to make those ideas work in your hospital.

Physicians are urged to mark their calendars now for May 13 when the AHA will host a physician leadership workshop, “Physician Leadership During Complex and Ever-Changing Times.”

Respected ACHE workshop facilitator and frequent AHA speaker Tom Atchison, EdD will lead the four-hour discussion. He says that physician lead and professionally managed is the only formula that will provide sustainable, positive change in today’s complex world.

As the regulations and reimbursement become increasingly complicated, patient care, population health and community health needs to be at the center of all decisions. The increasing role for physicians as the clinical experts in any change process will continue for many years.

That’s why it is imperative that physician leaders need proper tools and techniques for success to occur.

A program brochure will be available at www.arkhospitals.org/events.

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“Harding’s MBA program, with its 12-hour concentration in health care management, is a great opportunity for clinical managers to demonstrate their understanding of the complex business issues involved in successfully leading their organization into the post-reform era.”

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Spring 2014 I Arkansas Hospitals

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N E W S S T A T

Arkansas PAC Contributions Recognized During 2013, the Arkansas Hospital Association Political Action Committee (AHAPAC) received $18,225.00 in contributions, primarily from hospital executives and employees throughout the state.

These donations, which are shared between the Arkansas Hospital Association and the American Hospital Association, make possible the financial support those organizations are able to provide to political

candidates seeking state or federal elective offices.

Contributions of any amount, from all contributors to the AHAPAC, are seriously needed and deeply appreciated. However, special acknowledgement is given to individuals who contribute at certain threshold levels. Those individuals qualify for recognition as members of the American Hospital Association’s Ben Franklin Club, Chairman’s Circle or

its Capitol Club. Ben Franklin Club membership is awarded for individuals who contributed $1,000 or more to AHAPAC. Chairman’s Circle membership is awarded for individuals who contributed $500 or more to AHAPAC during the year, while the Capitol Club membership is earned with a $350 donation. Individuals from Arkansas who qualified for membership in each of these clubs in 2013 are:

Ben Franklin Club:

Ryan Gehrig, Mercy Hospital Fort Smith Bo Ryall, Arkansas Hospital Association Scott Street, Rogers Jodiane Tritt, Arkansas Hospital Association

Scott Peek, Chambers Memorial Hospital Ron Peterson, Baxter Regional Medical Center Nancy Robertson Cook, Arkansas Hospital Association Douglas Weeks, Baptist Health Medical Center – Little Rock Elisa M. White, Arkansas Hospital Association

Chairman’s Circle:

Capitol Club:

Don Adams, Arkansas Hospital Association Darren Caldwell, DeWitt Hospital/Delta Memorial Hospital Tina Creel, AHA Services, Inc. Paul Cunningham, Arkansas Hospital Association Russell D. Harrington, Jr., Baptist Health Beth Ingram, Arkansas Hospital Association Debbie Love, Arkansas Hospital Association Raymond W. Montgomery, II, White County Medical Center Larry Morse, Johnson Regional Medical Center

Chris B. Barber, St. Bernards Healthcare Gary L. Bebow, White River Health System Tim Bowen, Mena Regional Health System Greg Crain, Baptist Health Medical Center – Little Rock Kristy Estrem, Mercy Hospital Berryville Lee Gentry, Baptist Health Rehabilitation Institute Walter E. Johnson, Jr., Jefferson Regional Medical Center Edward L. Lacy, Baptist Health Medical Center – Heber Springs Jim M. Lambert, Conway Regional Health System

IRS Guidance for Tax-Exempt Hospitals The Department of the Treasury and Internal Revenue Service on December 30, 2013 posted two notices on their websites announcing additional guidance for taxexempt hospitals in regard to Section 501(r) requirements under the Patient Protection and Affordable Care Act. Notice 2014-2 confirmed that hospitals may continue to rely on 2012 and 2013 proposed regulations (addressing the requirements for financial assistance policy, limitation on charges, limitation on collection practices, and community health needs assessments, as well as 24

Spring 2014 I Arkansas Hospitals

the consequences for failing to satisfy any of the requirements), pending the publication of final regulations or other applicable guidance.

The agencies noted that hospitals will not be required to comply with the proposed regulations until they are finalized. The agencies gave no indication of when final regulations will be issued.

Notice 2014-3 is a follow-up to the 2013 proposed regulations regarding the consequences for noncompliance with Section 501(r) requirements. Under the proposed regulations, infractions that are

more than minor or inadvertent, but not willful or egregious, may be eligible for “excused noncompliance” if corrected and disclosed according to certain procedures. The notice describes the proposed correction and disclosure procedures that must be followed, as well as offers some examples of this type of noncompliance. The American Hospital Association distributed a Legal Advisory to its member hospitals on January 23, providing further information on the two notices. The Advisory can be found on the AHA’s web site at www.aha.org.

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N E W S S T A T

12 Hospitals Recognized for Outstanding Performance The Arkansas Hospital Association Workers’ Compensation SelfInsured Trust (AHAWCSIT) is proud to recognize 12 of its member hospitals for outstanding performance and commitment to workplace safety during the year 2012.

These members achieved a combined average incidence rate for medical only and lost time claims of 49% or less of the Bureau of Labor

Statistics (BLS) incidence rates for hospitals (the nationwide rate for hospitals is 6.8).

Controlling costs of workers’ compensation can result in dividend payments to members of the AHAWCSIT. Congratulations go to: Johnson Regional Medical Center, Clarksville; Baptist Health Medical Center – Hot Spring County, Malvern;

Arkansas Methodist Medical Center, Paragould; Ouachita County Medical Center, Camden; Little River Memorial Hospital, Ashdown; Delta Memorial Hospital, Dumas; Drew Memorial Hospital, Monticello; McGehee Hospital; Magnolia Regional Medical Center; Ashley County Medical Center, Crossett; Chambers Memorial Hospital, Danville; and Dallas County Hospital, Fordyce.

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Crisis Response Training Offered by AHA In past years or so, Arkansas hospital employees and physicians have experienced many emotional periods during crisis situations…. serious injury of a well-known physician, death of a business leader, injuries to friends and family from tornadoes, flooding, ice, and more.

During any of these situations, it is extremely important to take care of your staff, particularly those in the emergency department, and offer them the appropriate training to deal with a crisis.

Crisis intervention is invaluable in a hospital setting where the staff is routinely under high amounts of job-related stress. This is especially true after intense or difficult cases, as well as periodically, to deal with never-ending chronic stressors that are part of the day-to-day jobs for hospital workers.

The Arkansas Hospital Association in collaboration with the Arkansas Crisis Response Team will present a three-day training course, “Basic Crisis Response Training,” May 14-16, at the AHA headquarters.

The three-day training will emphasize the fundamentals of crisis and trauma by providing techniques for peer-to-peer crisis intervention. The goal of the workshop is to provide emotional first aid and crisis response training to first responders, hospital staff, emergency management, community volunteers and all others interested in the training. So far, more than 145 hospital representatives have been trained since we began offering the courses in 2011, making the hospital group one of the largest trained in crisis response.

Workshop facilitators will explore crisis intervention theory and techniques for traumatized communities. The course provides an overview of group and individual interventions; death, dying and spirituality; culture and ethnicity; care for the caregiver; and protocols for response in the field.

Registration for the three-day event is only $125, with lunch and materials provided each day. A program with registration information is available at http://www.arkhospitals.org/calendarpdf/BasicEmotionalFirstAid2014.pdf.

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Spring 2014 I Arkansas Hospitals

25

SPOTLIGHT: careSkills Performance and Competency Management

Effectively develop your workforce and improve the quality of care you provide by implementing the careSkills Competency and Performance Management System.

Identifying and addressing the areas for improvement within a healthcare organization is one of the most important factors for success. careSkills can help your organization maximize the use of your competency assessment results and truly develop your employees’ abilities.

The careSkills Competency Management System comes populated with skills required for successful performance by clinical and nonclinical employees, and they are easy to customize.

With a focus on exemplary customer service, careLearning provides its clients with the tools you need to get the best out of your organization with ease, convenience and top-of-the-line products. is at the end of this process you will have meaningful, real-time data reports that will help with:

• Employee Selection Find employees whose skills best match your needs as a new employee or involvement in a project or committee.

• Employee Retention

• Career Development Allow employees to create a career development plan based on the skills required for potential advancement opportunities.

• Succession Planning Find potential replacements for key roles at risk because of retirement, outsourcing, downsizing or disasters.

Identify employees at-risk because of skill proficiency levels that are too high or too low. Allow your organization to create individual employee development plans based on the skills required to achieve success.

• Strategic Learning Align learning resources with identified skill gaps on an individual, departmental or organizational level. Invest in learning resources that meet the highest priority needs, rather than relying on assumptions or guesswork.

• Workforce Planning Once you have defined what is expected, you can use the system to create automated assessments. This will make it easy to collect and track employee competence and eliminate misplaced documents. The best part 26

Spring 2014 I Arkansas Hospitals

Gain an understanding of the skills needed for success in your organization. Inventory the skills, knowledge and abilities present now and plan for those needed in the future. Ensure organizational goals are met by clarifying expectations for all employees.

Studies show that the work observed two months prior is what most performance appraisals represent. The careSkills Performance Management System assists your organization in each step of the process from setting goals to feedback and review.

• Goal Setting The appropriate appraisal template is shared electronically by your managers with the employee

during performance planning so they understand expectations.

• Continuous Feedback Performance journals allow the managers to provide feedback throughout the year to employees.

Employees can also document performance events they deem noteworthy.

• Performance Appraisals Create an unlimited number of online appraisal/ evaluation templates using your organization’s existing paper-based appraisals or through the customization of templates populated in the system. Managers complete the appraisal at the performance review based on journal entries.

Employees can also selfevaluate. Add value to the performance management process using multiple weighted performance scales to determine points earned at each level.

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• Analyze Results Reports are available to track the status of each step in the performance management process. The employee’s performance score can be used in supporting compensation decisions.

With a focus on exemplary customer service, careLearning provides its clients with the tools you need to get the best out of your organization with ease, convenience and top-of-the-line products.

Want to learn more about careSkills Competency and Performance Management system?

Visit carelearning.com/careSkills.html or contact Peggy Engelkemier, 866.617.3904.

Our Kids Do Come First!

Help us keep our kids healthy by reminding ARKids First families of the benefits of their enrollment. Let them know that regular checkups can keep Arkansas kids healthy, in school and out of the emergency room.

Remind parents that ARKids First not only covers kids who are ill or injured.

We cover wellness measures like:

• Well-child checkups

• Dental checkups

• Eye exams

Healthy Kids. Healthy Families.

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arkd 307 hosp ad.indd 1

Spring 2014 I Arkansas Hospitals 9/26/13

27PM 2:56

N E W S S T A T

AHA’s ICD-10 Education for Coders Continues through August

Announced in the winter 2014 issue of Arkansas Hospitals, the Arkansas Hospital Association’s (AHA) continuing education to assist member hospitals with ICD-10 coding preparations got off to a rousing beginning January 29. The AHA’s classroom was completely

full with about 60 coders beginning their educational transformation to the new coding platform.

Moving from ICD-9 to ICD-10 is imperative in order for payors to pay claims with proper procedure codes and for the healthcare industry to accurately measure quality of care.

ICD-10 accredited speaker Karen Scott, FAHIMA will teach all eight of the workshops, one per month through August. The remaining schedule in the series is: • March 14 – Session III: Mental, Behavioral and Developmental Disorders, Nervous System, Eye and Ear • April 30 – Session IV: Circulatory and Respiratory • May 21 – Session V: Musculoskeletal, Skin and Subcutaneous • June 25 – Session VI: OB/Newborn/Congenital • July 23 – Session VII: Digestive, Genitourinary • August 27 – Session VIII: Signs and Symptoms, Injury and Poisonings, External Causes, Factors Influencing Health Status

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Spring 2014 I Arkansas Hospitals

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SERVICES: • Revenue Cycle Management • ICD10 Preparation and Training • Clinical Documentation Improvement • Hospital Chargemaster Reviews • Inpatient/Outpatient Audit Services • Appeals Process/ Investigation Expert Witness • Recovery Auditor Appeals • Appropriate use and billing of Observation Services • Physician (RBRVS) Reimbursement

N E W S S T A T

ACHE Opportunities for Face to Face Education – in Arkansas!

The Arkansas Hospital Association (AHA) and the Arkansas Health Executives Forum (AHEF), the local ACHE chapter, will present several opportunities for healthcare leaders to achieve a total of 12 ACHE Face to Face hours in Arkansas in 2014.

On May 22, Scott Mason, DPA, FACHE, Healthcare Practice Group of Cushman & Wakefield, will present a 6-hour workshop, “Growth in the Reform Era – Build a sound structure of managing growth initiatives,” at the AHA headquarters in Little Rock.

Growth, which has always been an ambitious and complex endeavor in healthcare, will take on increasing importance as the focus shifts to competing for market share, addressing barriers to growth and enhancing the patient experience.

Health reform will continue to lower payments to providers, creating an even greater demand for growth opportunities.

This timely seminar will help you build a structure for managing future growth initiatives and create a process for instilling a growth imperative throughout your organization.

Healthcare leaders also will have an opportunity to earn 1.5 hours during the AHA’s Hospital Executive Leadership Conference June 11-13 at the Chateau on the Lake in Branson, Missouri; an additional 1.5 hours at the AHEF’s August luncheon (date to be determined); and three hours during the AHA Annual Meeting where Craig Deao from the StuderGroup will present “Compelling Communication: Creating Engagement, Understanding and Results.”

All programs with detailed agendas will be available at www. arkhospitals.org/events.

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Pursue Excellence: Apply to Advance to ACHE Fellow Others will know your commitment to excellence by simply reading the five letters behind your name: FACHE. By becoming board certified in healthcare management through the American College of Healthcare Executives (ACHE), you carry a credential that symbolizes your professionalism, ethical decision making, competence, leadership skills and commitment to lifelong learning.

Learn about the requirements to advance to Fellow by visiting ache. org/FACHE, and get your questions answered by attending an upcoming Fellow advancement webinar.

Exam Waiver: ACHE is pleased to offer once again the Board of Governors Exam fee waiver promotion to ACHE Members who apply for the FACHE® credential between March 1 and June 30.

Eligible Members must submit their

completed Fellow application and $250 application fee during the promotion period. Pending application approval, ACHE will waive the $200 Board of Governors Exam fee.

All follow-up materials (i.e., references) must be submitted by Aug. 31, 2014, to receive the waiver.

And, as an added incentive, the Arkansas Health Executives Forum will reimburse members up to $200 after completing the ACHE Board of Governor’s exam and progressing to the FACHE credential. For information, contact Beth Ingram at bingram@arkhospitals.org.

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Spring 2014 I Arkansas Hospitals

29

N E W S S T A T by the Arkansas Foundation for Medical Care

“Do It Right” Campaign Saves Lives Arkansas has the sixth highest rate of death due to colorectal cancer (CRC) in the country, and CRC is the second biggest cancer killer in the Natural State. To improve the quality of colonoscopies, the Arkansas Foundation for Medical Care (AFMC) has implemented the “Do It Right” campaign (www.afmc.org/doitright).

“Do it Right” works with patients and doctors to ensure everybody who needs a colonoscopy is getting one, and to make sure those colonoscopies are high-quality tests. Our mission is to make sure colonoscopies are done at the right time, with the right physician and in the right way. Our goals are to promote the adoption of evidence-based best practices for screening procedures and increase the reporting of quality indicators.

The Right Time.

More than 90 percent of people who develop CRC are >50. The majority of patients and those at normal risk of CRC should get a colonoscopy at age 50 and repeat it every 10 years. Screenings should begin before age 50 and occur more frequently if CRC risk factors are present.

The Right Physician.

At least 20 percent of patients have polyps. Physicians performing screening colonoscopies should know his or her rate of polyp detection. When it is higher than 20 percent (15% for women; 25% for men), the physician is doing an adequate job finding polyps. Clinical guidelines now recommend a withdrawal time of at least six minutes.

Going slowly and carefully checking all areas of the colon is what the right physician does.

The Right Way.

Both patients and physicians contribute to a quality colonoscopy.

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Spring 2014 I Arkansas Hospitals

• Achieve a cecal intubation rate of at least 95 percent.

Ways to Improve Colonoscopies

• Stress to patients that they must carefully follow directions in preparing for a colonoscopy. Adequate bowel prep is the first evidence-based quality indicator of this project.

• Physicians need to take enough time to find all polyps in the colon.

A colonoscope withdrawal time = or > six minutes is the second evidence-based quality indicator.

• Physicians should document adenoma detection rates, including number, location and size. This is the third quality indicator.

Endoscopists should: • Monitor performance using recommended quality indicators.

• Adopt evidence-based screening guidelines, specifically record and report adequate bowel prep, colonoscopy withdrawal times; and adenoma detection rates, including number, location and size.

• Document prep quality as “good,” “fair” or “poor” in procedure notes. This enhances appropriate scheduling of screening intervals.

The recommendation is one year if prep quality was less than “good.”

• Document cecal intubation rate (by photo); should be >95 percent.

Referring providers should: • Increase patient awareness of the importance of quality endoscopies, especially with Medicare or high-risk patients.

• Increase patient knowledge of the significance of early identification of polyps and adenomas. Explain the value of a high-sensitivity Fecal Occult Blood Test (FOBT) for appropriate patient popula-

High-Risk Individuals Patients at higher risk for colorectal cancer include those who: • Smoke tobacco • Eat a high-fat, low-fiber diet • Drink alcohol • Are obese (BMI >30 = 1.5 times higher risk of CRC) • Are > 60 • Are sedentary • Are African-American, Native American, Alaskan native, Ashkenazi Jew or Eastern European • Have a history of CRC; cancer of the ovary, endometrium or breast; inflammatory bowel disease; family history of polyps; or CRC • Have hereditary cancer syndromes (familial adenomatous polyposis or hereditary non-polyposis colon cancer).

N E W S S T A T tions, and that it must be done annually. Use either a high-sensitivity guaiac-based FOBT (Hemacult Sensa has better sensitivity) or an immunochemical FIT test.

The latter has higher sensitivity and specificity and is not influenced by food or medication. Positive screening results should be followed up with a colonoscopy.

• Refer patients to endoscopists who provide a highquality procedure and meet ASGE quality guidelines.

patient is responsible for completing the entire prep the day before.

The cost of over-the-counter prep medications is less than $10. Medicare requires a $50 co-pay for prescription prep medications. Private insurance does not cover prep medications.

The quality of the patient’s prep determines success in cecal intubation and the adenoma detection rate.

It also strongly influences the complication rate. PCPs must emphasize the importance of carefully following prep directions.

A physician’s recommendation is the most consistently influential factor in CRC screening. And while screening has increased from 39 percent in 2000 to 59 percent in 2010, there is still enormous progress to be made.

•

Increase Patient Compliance

The number one reason patients gave for not getting a colonoscopy is that their doctor never talked to them about it.

Patients cited fear, embarrassment, discomfort, time and cost as specific reasons for not getting a CRC screening.

Patients were not aware of the benefits of screening or of their individual risk for CRC (smoking, obesity, being sedentary, family history of cancer, age 60+ and high-fat-lowfiber diet). For example, there are no signs or symptoms of polyps or early colon cancer.

The only way to know if you have polyps is to have a quality colonoscopy. Colon cancer can be prevented with a colonoscopy and polyp removal.

The five-year survival rate is > 90 percent if cancer is in situ when identified; <10 percent if distant metastases. Polyp removal confers a 53 percent lower risk of CRC death than the general population.

PCPs should explain that colonoscopy prep is now easier, gentler and causes less discomfort. It no longer requires suppositories, enemas or harsh laxatives. The recommended prep is PEG with electrolyte replacement (MOVIprep or Miralax with Gatorade). The

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N E W S S T A T

OIG Issues 2014 Work Plan The 2014 Office of Inspector General (OIG) Work Plan outlines current focus areas for the OIG, U.S. Department of Health and Human Services, and states the primary objectives of each project. There are a number of new reviews scheduled that will impact hospitals, including: • New inpatient admission criteria to determine the impact of the new criteria on hospital billing, Medicare payments and beneficiary payments.

• Medicare costs associated with defective medical devices and their impact on the cost to the Medicare Trust Fund.

• Analysis of salaries included in hospital cost reports to determine the potential impact on the Medicare Trust Fund if the amount

of employee compensation that could be submitted to Medicare for reimbursement on future cost reports had limits.

• Comparison of provider-based and free-standing clinics to determine the difference in payments made to the clinics for similar procedures and assess the potential impact on the Medicare program of hospitals’ claiming providerbased status for such facilities.

• Review of provider data from CMS’ Intern and Resident Information System (IRIS) to determine whether hospitals received duplicate or excessive graduate medical education (GME) payments.

• Review of how hospitals assess medical staff candidates prior to granting initial privileges, includ-

ing verification of credentials and review of the National Practitioner Databank.

• Review of hospitals’ security controls over networked medical devices to determine if they are sufficient to effectively protect associated electronically protected health information (ePHI) and ensure beneficiary safety.

For more information, click here for the work plan: http://oig.hhs. gov/.

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Spring 2014 I Arkansas Hospitals

N E W S S T A T

Your Hospital’s Path to the Second Curve: Integration and Transformation Environmental pressures are driving hospitals and care systems toward greater clinical integration, more financial risk and increased accountability. To provide high-quality, efficient and integrated care, hospitals and care systems must explore and pursue transformational paths that align with the organization’s mission and vision and cater to patients and communities. Hospital leaders need to develop strategies that move their organizations from the first curve, or volume-based environment, to the second curve, in which they will be building value-based systems and business models.

To navigate the evolving healthcare environment, the 2013 American Hospital Association (AHA) Committee on Research developed the report Your Hospital’s Path to the Second Curve: Integration and Transformation. This report outlines must-do strategies, organizational capabilities to master and 10 strategic questions that every organization should answer to begin a transformational journey. The report’s “guiding questions” will help hospitals and care systems reflect and gain new perspectives

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on the benefits and value of integration. A comprehensive assessment, also found in the report, may lead healthcare organizations toward a customized path or series of paths to successfully transform for the future. Five paths for hospitals and care systems to consider are: • Redefine to a different care delivery system (i.e., either more ambulatory or oriented toward long-term care) • Partner with a care delivery system or health plan for greater horizontal or vertical reach, efficiency and

resources for at-risk contacting (i.e., through a strategic alliance, merger or acquisition) • Integrate by developing a health insurance function and/or services across the continuum of care (e.g. behavioral health, home health, post-acute care, long-term care, ambulatory care) • Experiment with new payment and care delivery models (e.g., bundled payment, accountable care organization, medical home) • Specialize to become a highperforming and essential provider (e.g., children’s hospital, rehabilitation center) There is no single “right” transformational journey and not all hospitals need to become an integrated entity. However, the time is now for hospitals and care system to accelerate organizational transformation, which requires making strategic, yet swift, progress toward achieving the Triple Aim of healthcare—improving care quality and patient experience, improving population health and reducing per capita costs.

To obtain a copy of the report, click here http://www.aha.org/ research/cor/paths/index.shtml.

•

SAVE THE DATE

“Hospital Executive Leadership Conference” June 11-13 Chateau on the Lake Resort Branson, Missouri Maureen Swan – Strategic planner and healthcare analyst Barry Bittman, MD – Changing the way we care for patients Jim Kopf – No, you’re not paranoid, they ARE after you!

Dan Mulholland – Finding ways to survive audits Program and registration information will soon be available at http://www.arkhospitals.org/events/arkansas-hospital-executive-leadership-conference Spring 2014 I Arkansas Hospitals

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N E W S S T A T

Rural Hospitals Need to Recruit, Embrace, and Engage their Physicians A recent article from Trustee magazine discusses how for rural hospitals, it’s not enough to just recruit physicians. They must also embrace and engage them. To be effective, the article says physician retention must be a multifaceted community effort, from troubleshooting housing headaches to introducing the doctor’s spouse to job opportunities or people with like-minded interests.

In addition, hospital leaders should stay flexible and attuned to shifts in the physician’s needs and stressors, whether that’s a bumpy transition to a new electronic record system or another physician’s departure that’s ramped up the on-call workload. The article offers five strategies to recruit-

proof your physicians. They are: 1. Cement personal connections 2. Strengthen collegial backup 3. Know the market 4. Demonstrate flexibility 5. Think longer term In a related article from H&HN Daily, some rural and inner-city hospitals are offering physicians a different incentive to entice them to practice there, such as extra time off in order to travel around the world and help needy populations. For example, Christ Community Health Services (CCHS) in Memphis offers physicians an extra two weeks off, in addition to their standard four weeks of vacation, to do mission work in one of four international locations where CCHS has long-term relationships.

The article in Trustee is available at http://www.trusteemag.com/ trusteemag/dhtml/article-display. dhtml?dcrpath=TRUSTEEMAG/ Article/data/01JAN2014/1401TRU_ coverstory&domain=TRUSTEEM AG&utm_ source=twitter&utm_ medium=social&utm_ campaign=HF. The article from H&HN may be found at http://www.hhnmag. com/display/HH N-news-article. dhtml?dcrPath=/templatedata/HF_ Common/NewsArticle/data/HHN/ Magazine/2014/Jan/fea-time-offpto& utm _ source =Daily& utm _ medium= email&utm _ campaign=general&utm _ s o u rc e = D a i l y & u t m _ medium= email&utm _ campaign=general.

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Group Issues Self-Assessment Tool for Hospitalist Practices The Society of Hospital Medicine (SHM) recently released a framework for assessing the performance of Hospital Medicine Groups (HMG) – medical practices composed of hospitalist physicians and other clinicians who specialize in the care of hospital patients. Developed with input from the American Hospital Association’s Committee on Clinical Leadership, the framework identifies 47 key characteristics of an effective HMG in 10 areas: • Leadership • Care coordination • Clinician engagement • Role in addressing key clinical issues in the hospital or health system 34

Spring 2014 I Arkansas Hospitals

• Resources • Approach to scope of clinical activities • Planning/management infrastructure • Patient/family-centered, teambased practice model • Alignment with the hospital/ health system • Clinician recruitment/retention “The framework is designed to be aspirational, helping to ‘raise the bar’ for the specialty of hospital medicine,” said co-author Patrick Cawley, M.D., CEO at the Medical University of South Carolina Medical Center in Charleston. “In the long-term, SHM envisions that hospitals and HMGs everywhere will

“The framework is designed to be aspirational, helping to ‘raise the bar’ for the specialty of hospital medicine.” use it to conduct self-assessments and develop pathways for improvement, resulting in better healthcare and patient care.”

The self assessment tool is available at http://www.hospitalmedicine.org/Content/NavigationMenu/ PracticeResources/KeyPrinciplesandCharacteristics/content.htm.

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N E W S S T A T

by Beth Ingram, Senior Vice President, Arkansas Hospital Association

Mamie’s Poppy Plates...Preserving Memories Mamie was to be the first child for Sarah and Taylor Adams of Little Rock. Sarah Bussey grew up across the street from my family and was one of my son’s close friends.

She was bouncy, crazy fun and laughed all the time!

Sarah and Taylor married after meeting at the University of Arkansas. She started a photography business and became very successful and sought after for special events, weddings and children’s photos.

Discovering they were going to have a baby was a thrill for both of them.

They decorated the baby’s room and prepared a special place for the beautiful baby girl named Mamie.

Unfortunately, Mamie wasn’t going to occupy her new little room. Instead, she was a stillborn or a sleeping angel, one of the many approximately one in every 115 pregnancies that end in stillbirth each year.

But Sarah’s loss and the losses suffered every day by others, inspired her to begin Mamie’s Poppy Plates (MPP), a 501(c)(3) non-profit founded to provide a keepsake for parents who are not able to take their babies home from the hospital.

“We parents cherish the handprints and footprints of our children, whether they’re in Heaven or on Earth. So I wanted to find a beautiful way to preserve such a precious reminder of our babies,” said Sarah.

She and her sister Britney Bussey Spees work together in the growing non-profit business. A plate is provided to bereaved families who are delivering at MPP partner hospitals or to anyone who places an order through their website. The baby’s birth statistics, hand and footprints are stamped and painted on the front of the plate while the donor’s name and organization is painted on the back. Each plate is hand-painted by volunteers, unique and fired for the best quality work. All plates are provided through donations to MPP. The organization’s goal is to make plates available to all delivering hospitals in Arkansas and be nationwide in the next 10 years.

Right now they are available in the following hospitals: • Arkansas Children’s Hospital, Little Rock • Baptist Health Medical Center – Little Rock • Baptist Health Medical Center – North Little Rock • Baxter Regional Medical Center, Mountain Home • CHRISTUS St. Michael Health System, Texarkana • Jefferson Regional Medical Center, Pine Bluff • Le Bonheur Children’s Hospital, Memphis • Mercy Hospital of Northwest Arkansas, Rogers • North Arkansas Regional

Medical Center, Harrison • Northwest Medical Center, Bentonville • Siloam Springs Regional Hospital, Siloam Springs • St. Bernards Medical Center Neonatal Intensive Care, Jonesboro • St. Vincent Medical Center, Little Rock • UAMS, Little Rock • Washington Regional Medical Center, Fayetteville • Willow Creek Women’s Hospital, Johnson • White County Medical Center, Searcy The organization holds an annual Family Friendly 5K certified Walk/ Run-Race to Remember in June, Mamie’s birth month, to honor all the precious babies who have passed.

Families volunteer in the planning stages and approximately 2,500 have attended the past two years to participate in the day of food, fun, and a balloon release. Many create teams in memory of their children during this day of remembrance. This year’s race, the third event, will be held June 14 at Dickey Stephens Park in Little Rock.

More information about Mamie’s Poppy Plates, including Mamie’s story and a short video describing the process of making a plate possible, may be found at http://mamiespoppyplates.com/.

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Spring 2014 I Arkansas Hospitals

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Q U A L I T Y / P A T I E N T

S A F E T Y

CMS Grants Third Year (First Option Year) for HENs The Hospital Engagement Network (HEN) program, a part of the national Partnership for Patients project, has been granted a third year of operation by the Centers for Medicare & Medicaid Services (CMS).

The Arkansas Hospital Association’s (AHA) HEN is a part of the HEN of the American Hospital Association’s Health Research and Educational Trust (HRET). Our HEN encompasses 31 states and more than 1500 hospitals.

Arkansas Children’s Hospital, Little Rock Ashley County Medical Center, Crossett Baxter Regional Medical Center, Mountain Home Bradley County Medical Center, Warren Chicot Memorial Hospital, Lake Village Community Medical Center of Izard County, Calico Rock Conway Regional Health System CrossRidge Community Hospital, Wynne Delta Memorial Hospital, Dumas DeWitt Hospital Drew Memorial Hospital, Monticello Five Rivers Medical Center, Pocahontas Forrest City Medical Center Fulton County Hospital, Salem Great River Medical Center, Blytheville

Forty-six AHA member hospitals were a part of the first two years, focusing on improving care in eleven areas and lowering preventable readmissions.

We welcome three new participants for this first option year: Harris Hospital, Mercy Hospital Berryville, and Conway Regional Health System. We are glad to announce that the following hospitals are new or returning AHA HEN hospitals (as of February 10, 2014):

Harris Hospital, Newport Howard Memorial Hospital, Nashville Jefferson Regional Medical Center, Pine Bluff Johnson Regional Medical Center, Clarksville Lawrence Memorial Hospital, Walnut Ridge Magnolia Regional Medical Center McGehee Hospital Mena Regional Health System Mercy Hospital Berryville Mercy Hospital Fort Smith Mercy Hospital Hot Springs National Park Medical Center, Hot Springs North Metro Medical Center, Jacksonville

Ouachita Medical Center, Camden Ozark Health Medical Center, Clinton Ozarks Community Hospital, Gravette Piggott Community Hospital Pinnacle Point Behavioral Health, Little Rock Saint Mary’s Regional Medical Center, Russellville Saline Memorial Hospital, Benton South Mississippi County Regional Medical Center, Osceola Sparks Regional Medical Center, Fort Smith Stone County Medical Center, Mountain View Summit Medical Center, Van Buren UAMS Medical Center, Little Rock White River Medical Center, Batesville

The goal of the Partnership for Patients is to reduce hospital-acquired conditions by 40% and preventable readmissions by 20% by the end of this third year of HEN work.

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AHA/HRET HEN Annual Report Shows Significant Improvements in Quality The American Hospital Association (AHA) / Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN) has released its Annual Report, which highlights the program’s major successes of the past two years.

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Spring 2014 I Arkansas Hospitals

The report shows that over the 31 states involved in the HEN, significant improvements in quality were made in key clinical areas.

Together these improvements resulted in better care for an estimated 69,072 patients with asso-

ciated cost savings of more than $201,811,600.

The program has helped the hospital field develop the infrastructure, expertise and organizational culture that will support further improvements for years to come.

The report shows that over the 31 states involved in the HEN, significant improvements in quality were made in key clinical areas.

Together these improvements resulted in better care for an estimated 69,072 patients with associated cost savings of more than $201,811,600.

The AHA/HRET HEN has accelerated improvement nationally, and patients are benefiting every day from the spread and implementation of best practices.

Among other quality and patient safety improvements, participating hospitals have: • reduced early elective deliveries (which can increase complications) by 57%; • pressure ulcers by 26%, • CLABSI in intensive care units by 23%, • VAP in the ICU by 13% and across all units by 34%; and • readmissions within 30 days for heart failure patients by 13%.

Access the annual report: http://www.hret-hen.org/ index.php?option=com_con tent&view=article&id=103 &Itemid=256.

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Q U A L I T Y / P A T I E N T

S A F E T Y

by Nancy Robertson Cook, Director, Communications and Quality Services, Arkansas Hospital Association

Arkansas Pharmacist-Led Collaborative Breaking New Ground

Dr. Niki Carver and Nancy Godsey with one of the Collaborative’s groups.

Mother Nature may have painted Arkansas highways with ice January 8 and 9, but she couldn’t keep a determined group of hearty health system pharmacists, nurses and physicians away from an exciting new collaborative that should yield amazing results in our state.

The Pharmacist-Led Collaboration to Reduce Adverse Drug Events (ADEs) was jointly sponsored by the Arkansas Association of HealthSystem Pharmacists (AAHP), the Arkansas Hospital Association (AHA) and its Quality arm, ARbestHealth (Care Advancement for Arkansans). It is the first such collaborative in the state, where health system pharmacists take the lead role in a team effort inside our hospitals, guiding pharmacy, quality, medical and front-line nursing staff in a united approach to reducing ADEs. 38

Spring 2014 I Arkansas Hospitals

Nationwide, ADEs have been identified as one of the major areas where quality improvement efforts are most needed. Hospitals involved in the country’s 26 Hospital Engagement Networks (HENs), including the American Hospital Association’s Health Research and Educational Trust (HRET) HEN in which 46 AHA hospitals are engaged, are tackling the ADE challenge head-on.

Key to the formation of the new Arkansas Pharmacist-Led Collaborative is Dr. Niki Carver, PharmD and assistant director for medication safety at the University of Arkansas for Medical Sciences (UAMS Medical Center). She has been deeply involved in the AHA/ HRET HEN for the past two- and a-half years, serving as a Fellow in the program’s Improvement Leader

Fellowship program for two years.

Carver has been nationally recognized as a leader in pharmacy and ADE prevention innovation due, in part, to her role as an Improvement Leader Fellow.

“Pharmacists are the most knowledgeable members of the healthcare team when it comes to medication use, so it makes sense that we should be the ones leading the efforts in ADE reduction,” Carver says. “The Collaborative will bring hospital pharmacists across the state of Arkansas together so they can network and share tips, tools, successes, and challenges with peers, and learn about ‘best practices.’ It is my hope that by encouraging communication, collaboration and transparency, the Arkansas Hospital Pharmacy Collaborative will ultimately raise the quality, patient safety and value of healthcare in Arkansas.”

Keynoting the new collaborative with Carver January 9 were Dr. Lanita White, PharmD, director of the UAMS 12th Street Health and Wellness Center and president of AAHP, and Matthew Grissinger, RPh, director of error reporting programs with the Institute for Safe Medication Practices (ISMP).

Fifteen hospitals were represented at the January 9 Collaborative Launch, with more than three dozen of their pharmacists, pharmacy professors, nurses and pharmacy residents in attendance.

Phone calls poured in January 8 and 9 as the other half of the collaborative’s registrants had to cancel due to icy roads.

“Their reluctance to cancel was evident,” says Pamela Brown, vice president of quality and patient

Q U A L I T Y / P A T I E N T

Matt Grissinger and Pamela Brown help facilitate one of the roundtable sessions at the Collaborative.

safety at the AHA. “Because the weather kept so many away, Niki and Matt are preparing a voiceover for their slide presentations so that those who could not attend will not, in essence, have missed the didactic portion of the launch.”

The morning’s sessions included “The Power of Collaboration” presented by White and Carver, “ADEs Caused by High Risk Medications” and “Measuring and Collecting Our Data” presented by Grissinger and Carver.

It’s important, when setting up your strategic team that will guide, say, your opioid ADE reduction program, to be sure you have a truly inter-disciplinary group, says Grissinger. That group must include: • Chief medical officer • Nurse executive • Director of pharmacy • Clinical information technology specialist • Medication safety officer/ manager • Risk management and quality improvement • At least 2 staff nurses (different specialty areas) • At least 2 staff pharmacists (1 clinical/1 distribution) • At least 1 active staff physician who orders opioids This inter-disciplinary approach is where you’ll set your innovations in action, Grissinger says.

“Inviting all involved to the table at the onset has proven to break down boundaries and generate communication between all who have a hand in any process,” Brown adds.

“It also speeds the improvement effort and creates a positive culture in any organization.”

The spotlight was then placed on individual Arkansas hospital pharmacy approaches to the reduction of ADEs. A panel of pharmacists including Dr. Erin Beth Hays, PharmD, White River Medical Center, Batesville and Dr. Debbie Caldwell, PharmD, Jefferson Regional Medical Center, Pine Bluff detailed their work and shared best practices and lessons learned. (Dr. Angela Powell, PharmD, Baxter Regional Medical Center, Mountain Home, was kept away due to icy roads.)

The sharing of best practices and specific challenges was then concentrated as the collaborative members broke into roundtable discussion groups. Discussion centered on reducing harm caused by three pharmaceutical families: Insulin and Oral Antiglycemics, Warfarin and Anticoagulants, and Narcotics and Opiates.

“The energy in the room was evident as sharing and use of new tools to chart hospital steps toward collaborative improvement in ADEs generated enthusiastic discussions,” Brown says. “Each person attending left with a blueprint for next

S A F E T Y

steps in the reduction of ADEs in their facility.”

The group will have at least two more face-to-face meetings, and content calls, coaching calls and webinars are under discussion.

The Arkansas Hospital Pharmacy Collaborative supports transformation, learning and spread of best practices for the reduction of ADEs, White says.

Benefits will include innovating at the front lines with improvement methodologies like Plan, Do, Study, Act (PDSA), LEAN and Six Sigma, aligning with state and national efforts and standardizing, when beneficial; building local and hospital-specific capacity for improvement and innovation and encouraging safety leadership at all levels.

“We all get discouraged some days because it feels like we’re not making any improvements,” Carver says. “However, when you hear other people in the Collaborative talk about the same things you are struggling with, you realize you are not alone. You come away with ideas and renewed motivation to carry on with your improvement work.

“Meeting other hospital pharmacists and team members and forming close working relationships with them is exciting,” she continues. “Already, hospital pharmacists are connecting more freely with one another, asking questions and sharing insights. A hospital pharmacy team came to visit us here at UAMS so we could learn from one another.

People are starting to pick up the phone and call one another on an informal basis. Soon I hope that’s an everyday occurrence for our teams.

I look forward to the collaboration; that’s what this is all about.”

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Spring 2014 I Arkansas Hospitals

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Spring 2014 I Arkansas Hospitals

“Building a New Home in Health Care” is the theme of the Arkansas Foundation for Medical Care’s 21st Annual Quality Conference to be held April 3-4 at the Embassy Suites in Little Rock. The conference features a day and a half of learning opportunities, with the first day offering two Learning and Action Network (LAN) breakout sessions addressing a variety of quality improvement topics across all healthcare settings.

On day two, plenary speakers include Andy Allison, PhD, Arkansas Medicaid director, and Michael S. Wolf, PhD, MPH, professor of medicine and learning sciences and division chief of the general internal medicine research division at the Northwestern University Feinberg School of Medicine. There will also be two sets of breakout sessions, followed by the Quality Awards banquet. The guest speaker for the banquet will be Matt Knight, MS, LPC, of MidSouth Health Systems.

For information about the conference, see http://www. qualityconference.org.

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Q U A L I T Y / P A T I E N T

S A F E T Y

Governor’s Quality Award Health Care Seminar Set for June 18 The Arkansas Institute for Performance Excellence/Governor’s Quality Award recently announced its annual healthcare seminar is scheduled for June 18 at the Embassy Suites in Little Rock. This year’s theme is “Improving Quality through Patient-Centeredness.”

Keynote speaker for the conference will be Joan Brennan, DNP, CPPS, vice president for quality and performance excellence for AtlantiCare, a Homecare Elite Top 100 and Magnet health system based in Atlantic City, New Jersey. Brennan will speak about AtlantiCare’s journey to achieve the 2009 Baldrige National Quality Award, key lessons learned and how the organiza-

tion continues to evolve using the Baldrige framework. In addition, she will share AtlantiCare’s current transformation work, which includes a focus on patient-centered care and population health capabilities, and will share the results achieved so far.

Other seminar sessions will focus on achieving patient-centered care through the creation of clinical care communities, where patient care is coordinated through open communication and teamwork across all healthcare settings.

Partners for the seminar include the Arkansas Foundation for Medical Care, the Arkansas Hospital Association and American Data

Keynote speaker for the conference will be Joan Brennan, DNP, CPPS, vice president for quality and performance excellence for AtlantiCare, a Homecare Elite Top 100 and Magnet health system based in Atlantic City, New Jersey.

Network. Registration is available at www.arkansas-quality.org.

For more information about the seminar, contact Sue Weatter at 501-372-2222 or sweatter@arkansasstatechamber.com.

•

Hughes, Welch & Milligan, LTD. Certiied Public Accountants

At Hughes, Welch & Milligan, CPAs, we have made a commitment to providing professional services to the Healthcare Industry. Our experienced professionals work closely with clients and their staff to ensure they are receiving the level of service you should expect out of your CPA firm.

Visit Us Online at www.hwmcpas.com Batesville, Arkansas Bill Couch, CPA, FHFMA 870-793-5231 bcouch@hwmcpas.com

Hughes, Welch & Milligan, CPAs is a full service accounting firm offering a wide range of services to the Healthcare Industry: • Financial Statements and Employee Beneet Plan Audits • Medicare and Medicaid Cost Report Preparation • Reimbursement and Compliance Issues Consulting • Critical Access Hospital Consulting • Strategic Planning for Acquisitions, Sales, Mergers & Expansions • Revenue Cycle Analysis • Feasibility Studies • IRS Form 990 Preparation

Spring 2014 I Arkansas Hospitals

41

PRIVATE OPTION ENROLLMENT M E D I C A R E / M E D I C A I D

BY COUNTY As of February 6, 2014

Private Option Enrollments Continue to Increase in Every County: More Than Half Under 40 At press time, the latest countylevel review of Arkansas’ “Private Option” data shows enrollment continues to increase in every Arkansas county, with hundreds, and in many cases thousands, of people in each county now getting healthcare coverage under the new program, according to information released by the Arkansas Department of Human Services (DHS) on February 10.

“We are pleased to see that enrollment has remained steady across the state,” said DHS Director John Selig. “We can tell word is really getting out about the program and people are really seeing its value.”

In all, 96,950 people had gained healthcare coverage through the Private Option as of February 6.

Coverage under the Private Option (formally known as the Health Care Independence Program) began January 1. Of those enrolled so far, 87,061 were covered by a private health insurance plan and 9,889 had been determined to be better served by the traditional Medicaid program because of exceptional healthcare needs.

The 10 counties with the highest enrollment are: Pulaski County with 12,094; Washington County with 4,338; Garland County with 4,202; Benton County with 4,078; Craighead County with 3,318; Faulkner County with 3,303; Jefferson County with 3,263; Sebastian County with 3,122; Crittenden County with 2,560; and Saline County with 2,310.

The Department also released the ages of enrollees. As of February 6, 53% of Private Option enrollees were under the age of 40. The ages break down as follows: • 18-29 = 25,437 42

Spring 2014 I Arkansas Hospitals

PRIVATE OPTION ENROLLMENT

BY COUNTY As of February 6, 2014

Source: Arkansas Medicaid

Total- 96,950

Source: Arkansas Medicaid

Total- 96,950

• • • •

30-39 = 26,427 40-49 = 20,435 50-59 = 18,839 60+ = 5,808 The Private Option allows the state of Arkansas to use federal Medicaid funding to pay the private health insurance premiums for eligible individuals who make no more than 138 percent of the federal poverty level. Those annual income lim-

its, by household size, are: Household of 1 – $15,856; Household of 2 – $21,404; Household of 3 – $26,951; Household of 4 – $32,499; Household of 5 – $38,047.

Arkansans who, based on their income, believe they are eligible for the program can apply at www.access.arkansas.gov. People also may apply at their local DHS county office.

•

M E D I C A R E / M E D I C A I D

Medicaid to Cover Inpatient Care for State Inmates As of January 1, 2014 the Arkansas Department of Corrections (ADC) and its sister agency, the Department of Community Corrections (DCC), made some changes related to healthcare services provided for inmates in state custody. This change was two pronged, with the major portion related to a new contractor.

Prior to the end of the year, ADC and DCC contracted with Corizon, Inc. to provide comprehensive healthcare services for inmates, including both inpatient and outpatient care. Corizon then contracted with individual healthcare providers. That changed on January 1 when Correct Care Solutions (CCS) became the new state contractor, which entailed new provider contracts, but there is more to it.

In an effort to save state dollars, the new contract with CCS applies only to outpatient services. Inpatient care for the state inmates are covered under the state’s traditional Medicaid program, a relatively small portion of the care provided to the population covered by the

department. According to ADC, 404 inmates were admitted as hospital inpatients in 2012; Medicaid covered 48 of those admissions.

This change does not apply to prisoners in the custody of counties or cities. In brief, at the time an inmate is in a hospital for more than 24 hours, therefore becoming an inpatient, Medicaid kicks in as the payer and covers the inpatient care from admission through discharge at the existing rates (those covering the per diems and payments for ancillary services) and under existing policies that apply for all other Medicaid patients.

The move expanded on similar Medicaid policies in effect for pregnant women and a few others.

It is possible because the Affordable Care Act makes an individual’s income the absolute eligibility benchmark for Medicaid coverage.

Since inmates have no income, they qualify. Under former criteria, a person must not only be poor, but also must be disabled or at least 65 in order to qualify for Medicaid,

which limited the options for the state. In contrast, Medicare policies generally prohibit paying for medical items and services furnished to a beneficiary who is incarcerated or in custody at the time any items and services are furnished.

Procedurally, a person in custody who meets the admission criteria for inpatient care typically will not have a Medicaid billing number at the time, so his/her eligibility status will be transmitted to CCS as “Medicaid pending.” CCS will file an application with Medicaid, where full eligibility will be established and a number assigned.

At that point, Medicaid will notify ADC or DCC with written verification of eligibility and a billing number. The department(s) will then notify the hospital so that a bill may be submitted.

If you have eligibility or billing issues for inmates, please contact Lance Marshall, vice president of network development, CCS at 615815-2756 or by email at lamarshall@correctcaresolutions.com.

•

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43

E M E R G E N C Y

P R E P A R E D N E S S

Updated Tip Sheets: Managing Behavioral Health Issues After a Disaster The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Revised tip sheets designed to help specific audiences cope more effectively with the behavioral health challenges that often follow a disaster are available free from the SAMHSA. On the website, click on the titles below to link to the tip sheets. Audiences include children to college-age students, disaster survivors, and responders.

Tips for Survivors of a Disaster or Traumatic Event: What To Expect in Your Personal, Family, Work, and Financial Life For some survivors, disasters can remind them of earlier trauma and make it harder to recover.

But with good social support and coping skills, most survivors are resilient and have the ability to recover. This tip sheet explains how traumatic events affect sur-

vivors in all facets of life and provides tips for managing the effects after the event.

Tips for Survivors of a Disaster or Traumatic Event: Managing Stress It is common for survivors to show signs of stress after exposure to a disaster or other traumatic event. Monitoring physical and emotional health is important.

This tip sheet lists symptoms of stress, offers tips for relieving it, and provides helpful resources for those who wish to seek additional help for themselves or someone they care about.

Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers When children experience a trauma, watch it on TV, or overhear others discussing it, they can feel scared, confused, or anxious. Young people react to trauma differently than adults. This tip sheet informs parents, caregivers, and teachers about common reactions children and youth may have after an event.

The sheet also provides helpful responses when talking directly to

affected children and tips for when to seek additional support.

Tips for College Students: After a Disaster or Other Trauma This tip sheet lists common reactions to disasters and other traumatic events as a way to reassure students that they are not alone in their reactions. Tips for coping include reaching out to supportive friends and family as well as other ways college students can manage their reactions.

Tips for College Students: After a Disaster or Other Trauma: R U A Survivor of a Disaster or Other Trauma? How R U Doing?

This tip sheet uses text-message shorthand to reach college students whose primary means of communication is electronic. Tips for coping after a disaster or other traumatic events are presented using common icons and text-messaging abbreviations.

The SAMHSA website (www. samhsa.gov) offers many useful tools including new information on: • Coping with trauma: school shootings • Media guidelines for bullying prevention • Opiod Overdose Prevention Toolkit

•

Regional Drill Practices with Alternate Care Site The Southeast Arkansas Preparedness Region, one of seven regional Arkansas hospital groups, held its annual Table Top exercise drill on a cold, dreary January 31 in Monticello. The object of the drill was to set up the region’s alternate care site using 44

Spring 2014 I Arkansas Hospitals

tents purchased with the federal ASPR Hospital Preparedness Grant distributed through the Arkansas Department of Health. The region purchased tents for each of its nine hospitals and two for their regional trailers that can be moved to any location during a disaster.

This drill offered the opportunity for each hospital’s employees to learn how to properly assemble and set up the tents, which are military Deployable Rapid Assembly Shelter, or DRASH™, tents. They can be connected together to form a “tent city” if necessary in the event of an actual disaster.

When purchasing equipment each year, the region researches and selects items that can be beneficial to the entire state, not just what the Southeast region needs. In cooperation with the Arkansas Department of Emergency Management, these tents were deployed to Scott County in northwest Arkansas last year after a devastating flood hit the area May 30. “I received many thanks and appreciation for the use and delivery of the tents. … It made me feel good to know that out of all the hospitals in Arkansas, the Southeast Region was able to pro-

SPRING 2014

E M E R G E N C Y

P R E P A R E D N E S S

vide the help needed,” commented Michael Morgan of McGehee, coregional leader of the Southeast Region. Phil Gilmore, CEO, Ashley County Medical Center, Cros-

sett, and Shirley White, human resources director, Ashley County Medical Center, are co-regional leader and secretary, respectively, of the group.

•

www.arkhospitals.org

CEO Profile: Barry Davis Arkansas General Assembly Fiscal Session

A M A G A Z I N E F O R A R K A N S A S H E A LT H C A RSpring E 2014 PRO F E S SHospitals I O N A L1 S I Arkansas

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mgilbert@pcipublishing.com Spring 2014 I Arkansas Hospitals

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G O V E R N A N C E

A Toolkit for Health Care Boards

Promote Quality of Care  Create a comprehensive policy and objectives to define your quality improvement and patient safety program.

Ensure your stakeholders share a common vision of quality. To give your program real impact, incorporate its objectives into employee performance evaluations and incentive compensation.  Establish a board quality committee and make quality of care a standing board agenda item.

A Toolkit for Health Care Boards

A Toolkit Health Boards  Ensure you have sufficient clinical expertise on thefor board.

To Care address potential conflicts, some hospital boards recruit physicians who are not medical staff members, or who are retired.

Promote Quality of Care  Understand how management assesses the credentials of the medical staff and stay current on best practices.  Create a comprehensive policy and objectives to define your quality improvement and patient safety program. comes and patient satisfaction. board on the structure of the Promote Quality of Care Ensure yourconflict-of-interest stakeholders sharepolicies a common vision of quality.

Tofinancial give your program real impact, its  Implement to You identify and manage interests that may affectincorporate clinical judgment. should track how your orgacompliance program, and the • Create a comprehensive policy objectives into employee performance evaluations and incentive compensation. nization compares to its peers on organization’s fraud and abuse and objectives to define your  quality Use dashboards and benchmarks to measure the success your organization outcomes and patient these qualityofindicators.

Afteras it improves risk areas.

Publicize training so improvement and patient  Establish a board quality committee and make quality of care a standing board agenda item. indicators. After all, satisfaction.

You should track how your organization compares to its peers on these quality all, “What gets measured is employees know the board consafety program. Ensure your "What gets measured isa what gets done." what gets done.” siderssome compliance priority. share common  stakeholders Ensure you have sufficient clinical expertise on the board. To address potential conflicts, hospital aboards vision of quality.

To give your • Ensure that your organization recruit physicians who are not medical staff members, or who are retired.

Evaluate the Compliance Program program real impact, incorporate Evaluate the Compliance Program can validate the accuracy of its objectiveshow into employee per- • theAsk qualityon data.

Federal program questions that assess your  its Understand management medical staff and stayinvite current best practices.  Ask questions that assess yourassesses compliance credentials program. Ifofathe business unit is lagging, the managers to discuss formance evaluations and incenreimbursement is tied to quality compliance program. If a business their strategy for improvement. Our website offers resources that can help at compensation. care.

Accurate is critical. is lagging, invite the manag tive Implement conflict-of-interest policies to unit identify and manage financial interests thatofmay affect clinicaldata judgment. http://www.oig.hhs.gov/compliance/compliance-guidance/compliance-resource-material.asp.

Concealing unfavorable informaers to discuss their strategy for • Establish a board quality comtion or outcomes failing toand investigate improvement.

Our website offers and make of care  mittee Use dashboards andquality benchmarks to measure thebysuccess of your organization as itlegal improves patient sigProtect the compliance officer’s independence separating this role from your counsel and senior inconsistencies not only resources can help http:// asatisfaction. standing board agenda item.

You track how your compares to itsatpeers on thesenificant quality indicators.

After all, management.

All should decisions affecting the organization compliancethat officer’s employment or limiting the scope of the compliance your should quality improvewww.oig.hhs.gov/compliance/ • Ensure you have sufficient clini-done."

"What gets measured is prior what board gets program should require approval.

If your compliance officer leaves, theundercuts audit committee ment program; it can lead to compliance-guidance/compliancecal expertise the board. To conduct an exiton interview. criminal and civil liability. resource-material.asp. address potential conflicts, some Evaluate the Compliance Program physi• Protect information the compliance Talk totheemployees to learn how  hospital Learn howboards quality, recruit patient safety and compliance flows toofficer’s the board.• Educate board on the  cians Ask questions your compliance program.

If a by business unit abuse is lagging, invite the to discuss whoofare notassess medical staff separating thisrisk areas. theyPublicize seemanagers the training organization’s valstructure thethat compliance program, and independence the organization’s fraud and so their strategy for improvement.

Our website resources thatcounsel can helpand at members, or who areboard retired. roleoffers from your legal ues and culture of compliance. employees know the considers compliance a priority. http://www.oig.hhs.gov/compliance/compliance-guidance/compliance-resource-material.asp. senior management. All deciPersonal appearances by board • Understand how management affecting compliance membersreimbursement at staff meetings demontheyour credentials ofcan thevalidatesions  assesses Ensure that organization the accuracy of itsthe quality data. Federal program is tied  medical Protect the officer’s by separating this role from your legal counsel and seniorcommitment officer’s employment or information limiting atotop-down staff and stay current on to quality ofcompliance care.

Accurate dataindependence is critical.

Concealing unfavorable or strate failing investigate significant to management. affecting thequality compliance employment limiting the scope ofcivil the liability. compliance inconsistencies notdecisions only undercuts your improvement program; it procanorlead toquality criminal andcompliance. the scope ofofficer’s the compliance and best practices. All program should require prior board approval.

If your compliance officer leaves, the audit committee should gram should require prior board • Perform regular self-assessments • Implement conflict-of-interest conduct an exit interview.  policies Talk to employees to and learn manage how they see the organization’s and culture Personal approval.

If yourvalues compliance offi- of compliance. to identify of your board and appearances its committees. by board members at staff meetings demonstrate a top-down commitment to quality and compliance. cer leaves, the audit committee financial interests that may affect Evaluate the composition of your  clinical Learn how quality, patient safety and compliance information flowsinterview. to the board. Educate the board on the committees. should conduct an exit judgment. compliance, quality structure of the compliance program, and the organization’s fraud and abuse risk areas.

Publicize training so  Perform regular self-assessments of your board and its committees.

Evaluate the composition of your compliance, Review the board’s responses to • Use dashboards and benchmarks • Learn how quality, patient safety employees know the board considers compliance a priority. committees.

Review board’s responses to systemic failures and lapses insystemic patient care. failures and lapses in toquality measure the success of the your and compliance information patient care. organization as it improves outflows to the board. Educate the  Ensure that your organization can validate the accuracy of its quality data. Federal program reimbursement is tied to quality of care. Accurate data is critical. Concealing unfavorable information or failing to investigate significant inconsistencies not only undercuts your quality improvement program; it can lead to criminal and civil liability.

•

 Talk to employees to learn how they see the organization’s values and culture of compliance. Personal appearances by board members at staff meetings demonstrate a top-down commitment to quality and compliance.

Our Our Friends  Advertisers, Perform regular self-assessments of your board and its committees. Evaluate the composition of your compliance, Our Advertisers, Our Friends quality committees.

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